Clonus

Introduction The clumps are in a state of tension when the deep-reflected hyperactivity is used to force the muscles to be examined with a sustained force, and the muscles involved in the deep reflexes undergo a rhythmic contraction, called clonic. Common people have sputum, squatting patients supine, hips and knees slightly flexed, the doctor holds the patient's calf, holding the front of the patient's foot, force the ankle joint to stretch. Positive expression is a rhythmic contraction of the gastrocnemius and soleus muscle. The meaning is the same as the deep reflection, which is found in pyramidal damage.

Cause

and are only indications of a high degree of sputum reflex increase, they can occur in any occasion with enhanced tendon reflexes, including when there is no organic disease in the nervous system. Unlike the clonic and organic lesions of neurosis and systemic hyperreflexia, the former is usually not constant, and the degree of performance on both sides is generally equal, without organic symptoms. Two asymmetric reflections indicate an organic disease. The reflex arc in the nerve root or spinal cord gray is damaged, or the side reflection is enhanced, indicating cone beam damage.

an examination

Related inspection

Electromyography neurological examination

The patient is supine and the lower extremities are straight. The examiner uses the two fingers of the thumb to clamp the upper edge of the humerus and suddenly pushes down and maintains no relaxation. The quadriceps tendon attached to the upper edge of the humerus is elongated, causing the knee reflex to increase. The muscle contraction, the tendon continues to elongate, and the tibia appears continuous upper and lower rhythmic vibrations.

Differential diagnosis

The symptoms of clonic need to be identified as follows.

(1) Toxic encephalopathy: history of poisoning, slow onset, disorientation, forgetting, euphoria, mental retardation, ophthalmoplegia, ataxia or tremor, and some retina with hemorrhage, nystagmus, hallucinations And delusion, conscious ambiguity and even coma, accompanied by pyramidal tract damage, convulsions and convulsions, increased limb muscle tension, pathological signs were positive.

(B) viral encephalitis: acute onset, generally have fever, a history of illness before the disease, more vomiting, mental and consciousness disorders. Can appear paralyzed state, lethargy and coma, hemiplegia, sputum, aphasia, hemiplegia, sputum attack and pyramidal tract symptoms, sputum and sputum, with myoclonus, torsion, hand and foot dyskinesia Wait. Cranial nerve spasm, bilateral limb spasms and sensory disturbances, ataxia, respiratory and circulatory disorders occur when the brain stem is involved. There are meningeal irritation, increased lumbar puncture pressure, and increased white blood cells in the cerebrospinal fluid.

(C) familial spastic paralysis: more than the onset of children, progressive, manifested as signs of upper motor neuron damage in the lower limbs, and some gradually progress to the upper limbs. The muscles of the limbs are increased, the gait gait, the sputum reflexes, the sputum sputum and the sputum sputum on the disease side, and the pathological reflex is positive. Most patients have arched feet. No sensory disturbance, there may be mild ataxia. Some patients may have speech impairment. Those with cerebral cortex involvement may have lower intelligence.

(D) acute myelitis: the incidence of acute, more than a few hours to a week to develop peak. There is a history of infection 1 to 2 weeks ago. If the cervical cord is damaged, quadriplegia occurs, the tendon reflex disappears, and pathological reflex cannot be induced. After 3 to 4 weeks, with the disappearance of the spinal cord shock period, the limbs transitioned from flaccid paralysis to spastic paralysis, muscle tension increased, sputum reflexes, convulsions and convulsions, and pathological reflexes were positive. If you have respiratory muscles, you may have difficulty breathing and have a weak cough. Often there is back pain or abdominal pain and chest sensation, all the depths of the lesions below the lesion are missing, early retention of bowel movements.

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