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Doctor insights on:
Ankle Clonus Reflex
1
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
Clonus (Definition)
Clonus = involuntary, muscular contractions & relaxations which may be seen ...Read more
2
Slow reflex in foot?

Slow foot reflex: Suggests possible nerve compression in lumbar or sacral spine, which could result from bulging/ruptured disc, bone spur compressing spinal cord or nerve root, or spinal stenosis. Suggest seeing orthopedic or neurosurgeon for evaluation, tests (including mri), options for treatment. If u have foot drop or similar problems, do not delay. Sooner the treatment, less damage. ...Read more
3
Can reflex sympathetic dystrophy rsd happen after a stress fracture in their foot?

Yes: Any trauma can possibly lead to rsd although there is not a high probality. ...Read more
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4
Why hyperactive deep tendon reflex occure in hypocalcemia?

Spastic muscles : Muscles get "tetanic" when there isn't enough calcium. They contract more easily because the decreased calcium affects contractility of muscle fibers. ...Read more
5
Ankle stiffness diminishes with ankle circles, right?

Not always: Depending on the cause of the ankle stiffness, motion might help to remove some of the stiffness. ...Read more
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7
How does a hyperactive stretch reflex (due to spinal cord injury) result in clonus?
Brakes are released: The quick answer: the brain/spinal cord send electrical fibers to control the muscles. When the fibers are severed, the muscles "do their own thing", unregulated. http://www.livestrong.com/article/197920-causes-of-clonus/. ...Read more
8
Paralyzis and hyperalgesia in one limb initiated 2 weeks after scoliosis surgery. sphincter incont Clonus. Spasticity. upper motor neuron lesion? why?

Postop complication: One has to worry about a delayed postoperative complication-significant!!!! Need to see operating surgeon . Potential causes would be hematoma(blood) compressing spinal cord or even a spinal cord lesion remote from operative site ...Read more
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9
What is reflex sympathetic dystrophy?

Now CRPS: Complex regional pain syndrome, formerly rsd, is a pain syndrome, usually occurring in an arm or leg after an injury, but lasting much longer than would be normal for that type of injury. It typically has a component of redness or swelling and is described as burning or aching. There is also no obvious damage to a specific nerve that doctors can find. The cause is not clearly understood. ...Read more
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10
What are hyperactive deep tendon reflexes?

See below: A DTR is a brisk contraction of a muscle in response to a sudden stretch induced by a sharp tap by a finger or rubber hammer on the tendon of insertion of the muscle. Absence of the reflex may be caused by damage to the muscle, peripheral nerve, nerve roots, or spinal cord at that level. A hyperactive reflex may indicate disease of the pyramidal tract above the level of the reflex arc being tested. ...Read more
11
What's reflex sympathetic dystrophyk?

Pain following injur: Reflux sympathetic dystrophy is a condition usually follows injury affects mostly hands and feet. This condition usually progresses through different phases. Definitive cause is unknown. It can happen with or without nerve injury. Treatments available. ...Read more
12
What is it? I have ankle swelling, ankle stiffness, limb pain, ankle weakness, popping or snapping sound from joint, ligament laxity, ankle pain, difficulty moving joint, painful swollen joints (better by: splinting joint, compression wrap, ice, rest) (qu

Juvenile arthritis?: It may be an inflammatory process. Please see your primary care provider for an evaluation. ...Read more
13
Peroneal tendon subluxation- w/ heel to toe walk, pivot, down stairs, up ramps. Tried stirrup brace but increased sublux. Other conservative options?

Surgery: If your peroneal tendons are subluxing, surgery would be required. ...Read more
14
Swelling back leg isolated below gastrocnemius to ankle. MRI, arteriovenous US normal.Tightness both sides of leg near ankle w/ dorsiflex. Tendonitis?

MRI of what?: This is tendonitis the MRI should have picked it up. If it was a Baker's cyst the US should have picked it up. What else did these examinations show? You need to discuss with your physician the results of the tests and what was and what was not imaged. ...Read more
15
Avulsion fracture of cuboid left foot. Sprain of calcaneofibular ligament
in tibial walker boot, triathlete. Time to return to training??

It takes about 6-8: weeks for bone to heal. If your a triathlete then I would not recommend you returning until this time elapses to ensure complete healing. Obviously you need to work closely to the doc you are seeing who will evaluate you clinically and radiographically. ...Read more
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16
12d s/p 2nd deg ATFL ankle sprain. Still 2+ pitting edema entire foot dorsum, not just ankle. Elevating helps a bit. Why circulation issue? What 2do?

May be due to HTN: It is common to have swelling for 3-6 months after a severe ankle sprain. But pitting edema is usually a result of venous disease. The veins do get damaged when you sprain your ankle, leading to swelling, but since you have high blood pressure as well, the veins have been insufficient before the injury and are now damaged more. I recommend you see a vascular specialist. ...Read more
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17
Knee injury while dancing. Heard pop tearing sensation. Unstable knee x3 weeks medial swelling swelling down into foot. Dx?

Possible ACL tear: It could be an ACL tear, or medial meniscus, or both. See a sports medicine trained orthopedic doctor, for an accurate diagnosis and treatment. ...Read more
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19
Went to dr for clumsiness.I had hyperreflexsia legs/arms jaw jerk present positive hoffman's sign babinski present & clonus. Neuro. ordered MRI. ??
Dr ordered MRI: What is your question? Is your question why the doctor ordered an MRI? Please state the reason the doctor gave for ordering an MRI, and also, an MRI of what? Brain? Heart? Left foot? If you did not ask the doctor the reason, please state why not. ...Read more
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20
Ankle MRI report - ant tib tendon bowing, tendonitis in ant tib, tenosynovitis in posterior tib, mild tendonitis in Achilles'. Best treatment?

Cold compresses help: I have found that tendinitis frequently responds to application of cold compresses, particularly gel devices kept in a freezer which when applied to tendinitis will cut the inflammation down and provide comfort without the potential side effects of listed medications (which help as well but can cause considerable side effects). Such gel devices can be found in drug stores (OTC). ...Read more
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21
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
22
Used to have normal neuro exams but now doctors find 3-4 beats clonus in right ankle? Causes?
Every once in a: while this is seen and nothing overly concerning so long as there are no other symptoms. ...Read more
23
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
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24
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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25
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?

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
27
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
28
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
29
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
30
Could periodontal disease cause clonus in ankle?

No. The two issues: Are totally unrelated.
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31
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
32
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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33
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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Is it normal if 28mos boy hv sustained ankle clonus in both sides without other symptoms ,have a good milestone&developments?2 neuropaed said he is ok

Not an issue?!: as a sole sign with no other symptoms and no progression unlikely to be due to serious problem ...Read more
35
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
36
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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37
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
38
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
39
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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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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