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The corticospinal pathway synapses in the anterior horn (motor grey matter) of the spinal cord just prior to leaving the cord.
This is important, for motor neurons above the level of this synapse (connecting the cerebral cortex and anterior horn) are termed upper motor neurons (UMN), whereas those beyond this level (the peripheral nerve neurons) are termed lower motor neurons (LMN).
The lesion involves both the anterior horns (motor) of the grey matter (causing a lower motor neuron lesion) as well as the corticospinal tracts (resulting in an upper motor neuron lesion).
Polio attackes the anterior horn cells (Fig. 18D) leading to lower motor neuron involvement, with weakness, atrophy, fasciculations, fibrillations, and hyporeflexia.
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