clonus
Table of Contents
clonus
Introduction
- clonus is a series of involuntary, rhythmic muscle contractions and relaxations triggered by a sudden stretch of a muscle, most commonly elicited by the clinician rapidly dorsiflexing the ankle joint and holding it dorsiflexed, but can also be elicited at the knee, wrist, fingers or jaw
- normal physiologic clonus fades away after 1-4 beats
- persistent clonus more than 4 beats is pathologic and usually implies an upper motor neuron (UMN) pathology
- in contrast, myoclonus is a brief, involuntary, irregular twitching of a muscle or a group of muscles
Aetiology of pathologic clonus
- usually occurs along with hyperreflexia, spasticity and muscle weakness as part of upper motor neuron weakness
bilateral
- neonates (due to immature nervous system) - disappears soon as the brain matures
- cerebral palsy
- traumatic brain injury
- spinal cord injury
- spinal cord ischaemia
- transverse myelitis
- leukoencephalopathy (ADEM) - acute, rapidly progressive, mainly in children
- pseudobulbar palsy - involves muscles innervated by the cranial nerves IX, X and XII, may have labile emotions and bilateral upper motor limb signs
unilateral
- other focal intracranial pathology causing unilateral weakness eg. tumour, abscess, multiple sclerosis (MS)
- spinal cord injury
- spinal cord ischaemia
clonus.txt · Last modified: 2026/09/02 03:45 by wh