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Doctor insights on: Ankle Clonus Causes

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Unilateral hoffman's sign and on the same side have non sustained ankle clonus. What's the cause of this?

Unilateral hoffman's sign and on the same side have non sustained ankle clonus. What's the cause of this?

Poss c-spine prob: Hoffman's sign is used by clinicians when there is a suspicion of cervical spine pathology possibly pressing on the spinal cord. The sign is more accurate when present bilaterally but can be seen when unilateral. It has also been reported in hyperthyroidism and anxiety states. I hope this helps. Good luck and well wishes. ...Read more

Dr. James Dukelow
62 Doctors shared insights

Clonus (Definition)

Clonus = involuntary, muscular contractions & relaxations which may be seen ...Read more


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I heard that immature myelin in toddlers can cause mild ankle clonus, is it true? When does the myelin will get mature?

I heard that immature myelin in toddlers can cause mild ankle clonus, is it true? When does the myelin will get mature?

Maturation: The nervous system matures from top down and inside to outside. Ankle clonus is normal in infants until they begin to walk, which the maturation allows. Persistence after 15-18 mo would be a problem. They first gain a wide grasp with fingers like pincers, but fine motor control of the individual fingers will not come in until well into school age. ...Read more

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My eight year old seems to have clonus reaction in ankle when sitting with her heels raised. Full neuro exam normal. What can the cause be?

Likely normal: Some clonus is not abnormal. If the clonus is sustained (keeps going and going) then that indicates some neurological issue and may need to be further investigated with a brain or neck mri. However, if there are no other issues then nothing may need to he done. ...Read more

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Possible causes for bilateral ankle clonus if spine and brain MRI are normal? Clonus is more prominent on the left side. Can clonus ever be bening?

Possible causes for bilateral ankle clonus if spine and brain MRI are normal? Clonus is more prominent on the left side. Can clonus ever be bening?

Ankle clonus: Yes. Ankle clonus and hyper reflexes can be inherited and are a benign variation of normal reflexes. As long as there is no compression on the spinal cord and no damage to the brain, then there is no reason to worry ...Read more

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I have bilateral ankle clonus. Spine MRI was normal. Seeing a neurologist soon. Could MS-disease cause this by affeting the brain instead of spine?

Clonus: Clonus is a sign that suggests the pathway that regulates muscle contraction was disrupted at some time. It is possible that changes in the brain, not the spine, caused this. But consider this- some people are born this way, and it does not mean that you will eventually be found to have MS. If you had clonus in one ankle, maybe I would think otherwise. ...Read more

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When is ankle clonus normal?

It is not: Ankle clonus is a reflex seen in states such as stroke, multiple sclerosis, spinal cord damage, hepatic encephalopathy and serotonin syndrome. If it is present, a neurologic referral is in order. ...Read more

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What are some sign that I may have ankle clonus?

What are some sign that I may have ankle clonus?

Spasms & relaxation: Ankle clonus is a series of abnormal reflex movements of the foot, induced by bending the foot upward at the ankle, causing alternate contraction and relaxation of the calf muscle. This can be present in stroke patients, spinal cord injury, and multiple sclerosis. If this is indeed present, talk to your doctor about getting a neurology referral. ...Read more

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Who can I ask to explain the ankle clonus test results to me?

Who can I ask to explain the ankle clonus test results to me?

Movement disorder: Ankle clonus is a movement disorder characterised by involuntary waves of muscle contractions in the ankle that occur in responce to streching the muscle in and around the ankle.
It is usually sign of neurological disorder as body normally prevents such contractions from occuring. ...Read more

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Developed nonsustained ankle clonus unilateral. 2 years ago had a neuro exam and this was not present. Is developing it a bad sign?

Clonus meaning?: Sometimes it means something. Non sustained clonus sometimes does not hold up from exam to exam- some people are not good at detecting this.

Clonus of any kind should indicate something happening in the spinal cord or the brain. If you have it on one side, it should be the brain. Sometimes the cause is not found however.

If it was found in a new exam, a work up will be planned. ...Read more

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Left non-sustained ankle clonus is nothing to be concerned about correct?

Left non-sustained ankle clonus is nothing to be concerned about correct?

Maybe, maybe not: If I find this in any patient over 2 years of age I am concerned. A more thorough evaluation would be needed for such a patient to rule out other issues. ...Read more

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So my son walking (13 months) is still a toddler? I may have from time to time ankle clonus (bits 1-2)? Yes or not?

So my son walking (13 months) is still a toddler? I may have from time to time ankle clonus (bits 1-2)? Yes or not?

A 13 month old..: ...Is a toddler. He is therefore expected to walk like a toddler. Because you have clonus does not mean he will have clonus.
I'm not certain what you are asking when you type "yes or not.". ...Read more

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Dr james. So my son (13 month) walking is still a toddler? I may have from time to time ankle clonus (bits 1-2)? It is normal? He is perfect!

Normal finding: I see no reason for you to obsess over this issue. The only way to know if your child has a normal nervous system is to have a complete exam done by a physician knowledgeable about kids in this age group. ...Read more

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22 months Boy have ankle clonus since he 3 weeks old. He have a normal milestone&posture. Could a normal child have a clonus for the rest in his life?

22 months Boy have ankle clonus since he 3 weeks old. He have a normal milestone&posture. Could a normal child have a clonus for the rest in his life?

Nl devel reassuring: It is very reassuring that your child's development has been very normal in spite of ankle clonus. It is not uncommon to see several beats of anke clonus in healthy children and for children to tiptoe with walking for the first few years, but continuous clonus is unusual and subtle signs of muscle tightness may show up in the future. Hopefully not. ...Read more

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Is it normal for babies to have ankle clonus during sleep?

Yes: Babies have ankle clonus as a normal finding both asleep or awake until they are about a year of age. It is a reflection of the immaturity of their nervous system and not a sign of damage as it would be for an older kid or adult. ...Read more

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My 24 months son have ankle clonus in both sides since newborn. Mostly clonus occured less than 5 beats, he has a good milestone. Is it normal?

My 24 months son have ankle clonus in both sides since newborn. Mostly clonus occured less than 5 beats, he has a good milestone. Is it normal?

Within Normal Limits: Ankle clonus is only considered pathologic with other abnormal neurologic findings on exam, a history of abnormal neurologic behavior, and sustained clonus. Your son has none of those findings, he is okay ...Read more

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GP found a few beats clonus in right ankle which wasn't present before. Referred to neuro. Is seeing a neuro necessary? Don't feel like it is anything

GP found a few beats clonus in right ankle which wasn't present before. Referred to neuro. Is seeing a neuro necessary? Don't feel like it is anything

More to story?: This can be seen in neurological disease and in some drug use. Is there more to the story the doctors should know so inappropriate tests are not wasted? ...Read more

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3 months 10 days old premature delivered boy have frequent ankle clonus but other neurological exam normal n he behaves a normal attitude. Is it norma?

Normal: I'm not a neurologist and someone here will correct me if I'm wrong, but if I remember correctly to my medical school days: clonus is normal in neonates. ...Read more

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My 2 month old son (10 weeks) has ankle clonus. It happened a few times after I picked him up and his foot pressed against me. I then realized that I?

My 2 month old son (10 weeks) has ankle clonus. It happened a few times after I picked him up and his foot pressed against me. I then realized that I?

Normal: We expect this as a sign of the immature nervous system in infants. It begins to disappear as the nerves mature enough to support walking. Once walking it is gone. ...Read more

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Do babies usually have ankle clonus while sleeping?

Do babies usually have ankle clonus while sleeping?

Yes: Ankle clonus is considered normal in infants up to a year or more asleep or awake. It is a primitive reflex that will subside when the child's nerves mature enough to support standing and walking. ...Read more

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My daughter is 2.5 months old. I was abler to elicit ankle clonus both awake and asleep (intermittently) with beats less than 4. Is this normal?

My daughter is 2.5 months old. I was abler to elicit ankle clonus both awake and asleep (intermittently) with beats less than 4. Is this normal?

IMMATURE NERVOUS SYS: Ankle clonus at this age is expected and felt to represent the normal immature nervous system. As the head to toe progression of nerve maturity continues, it is less often found in normal kids by a year and disappears as the kid pulls to stand, cruises and walks. ...Read more

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My 15 months son, active & healthy, have ankle clonus (3-4 beats)in both leg since 3 weeks old, asleep&awake. He start walking at 13 months. Is it normal?

Probably normal: Many infants will have ankle clonus. It can take a few years to go away. Disturbing signs would include worsening clonus, difficulty with balance or coordination, and not achieving other normal developmental milestones on time. If these occur, see a doctor urgently. ...Read more

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Is clonus when awake more dangerous than when asleep in children? 14months son w/ good millestone have 2-3beats ankle clonus in both ankle, asleep&awake

Is clonus when awake more dangerous than when asleep in children? 14months son w/ good millestone have 2-3beats ankle clonus in both ankle, asleep&awake

Normal: Normal

and again normal in the setting of normal development milestones etc.
Ask your Pediatric Health Professional to relieve your anxiety about this (which by the wau is often accompanied by a pronounced "startle' effect...
hope this helps
Dr Z ...Read more

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My 15 months son, active &healthy, have ankle clonus (3-4 beats)in both ankle since 3 weeks old, asleep&awake. He start walking at 13 months. Is it normal?

Not likely: Clonus is not typically felt to be normal and is usually associated with underlying spasticity, which can have a number of potential causes. Certainly a full neurological work up is indicated if he truly has clonus. ...Read more

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3 months 10days old premature (34 weeks) delivered with frequent ankle clonus bilateral more than 10 beats sometimes...other neurological exam normal n?

Could represent more: An infant with these findings should be carefully examined and followed by a pediatrician and a pediatric neurologist. This clonus could represent a spinal cord problem. ...Read more

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I took my 3 year old son to the Doctor and found that he had 3-4 beats of clonus in his Left ankle? What could this mean? Should I be worried?

I took my 3 year old son to the Doctor and found that he had 3-4 beats of clonus in his Left ankle? What could this mean? Should I be worried?

Hyperreflexia: Or overactive tendon reflexes suggests injury to brain or spinal cord. This could be from inflammation like infection, electolyte imbalance, tumor or other lesion. Kids tend to have active ankle reflexes, and several beats of clonus in the ankle is a common finding but asymmetry or persistent clonus needs investigation. It is very common in mild cerebral palsy. Symptoms and developement are clue ...Read more

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28 months boy have 4-5 beats ankle clonus in both side since newborn, without other symptoms. He have a good milestone, he can walking-running normally.

28 months boy have 4-5 beats ankle clonus in both side since newborn, without other symptoms. He have a good milestone, he can walking-running normally.

The significance of: Ankle clonus in infancy is not reliably known and relates to the number of beats (>10 seemingly important) and persistence at advancing age. The fact that your son has reached developmental milestones normally is very important. I would, however, have your son followed by a good neurologist as there are possible issues down the road. Good wishes:) ...Read more