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Jeff Brody
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Ankle Clonus Cerebral Palsy

Cerebral palsy is a very diverse and complex condition because it does not have a clear-cut single cause. While Down syndrome, for example, has a specific cause that is an identifiable chromosomal disorder, cerebral palsy can have a variety of possible causes.

Cerebral palsy is an umbrella term for a wide range of cerebral disorders, which result in poor motor skills, or brain-to-muscle communication. Injuries to the brain prior to three years of age, including the prenatal period, result in neurological impairments and motor skill problems, are cause to look for signs of cerebral palsy.

Early signs of cerebral palsy are usually not noticeable at birth, but some can be early warning signs. Lack of muscle coordination when performing voluntary movements is also a sign of cerebral palsy. Stiff and rigid muscles, known as hypertonia, and exaggerated reflexes are signs of spasticity, a symptom of cerebral palsy. Asymmetrical walking gait, with one foot or leg dragging, variations in muscle tone, from too stiff to too floppy, excessive drooling, difficulties swallowing, sucking, or speaking, and hand tremors are all signs of cerebral palsy.

All the signs mentioned above are usually telltale signs of cerebral palsy. However, there is another sign that could, in some cases, mean the presence of cerebral palsy: ankle clonus. Ankle clonus is a sign of spasticity in which involuntary shaking or jerking of the leg occurs when the toe is placed on the floor with the knee slightly bent. The spasms in the calf muscle make the foot and leg bounce up and down. The shaking is caused by repeated, rhythmic, reflex muscle contractions, rapidly alternating between contraction and relaxation of a muscle. Ankle clonus is the most common form of clonus.

In a study of ankle clonus cerebral palsy, doctors found out of 169 infants who exhibited ankle clonus at least once in the first year of life, thirty-four percent were eventually diagnosed to have cerebral palsy. A child can be tested for ankle clonus relatively easy. First take the foot and bend it backwards, toes toward the face. This is also known as dorsiflexion. Release the foot and observe the ankle reaction. If ankle clonus is present the foot will repeat the motion on its own, at a spastic rate. Ankle clonus can be measured by the length of time it occurs, then classified by the duration of seizure activity; none, mild, moderate, or severe. For instance, a mild rating would be less than 3 seconds, moderate between 3 and 10 seconds, and severe more than 10 seconds.

Any result besides “none” should be followed with a visit to a neurologist. Ankle clonus-cerebral palsy is a likely combination with the event of a mild to severe result. Although ankle clonus may not be a sign of cerebral palsy, it is definitely the sign of a neurological disorder of some sort. A physical therapist, pediatrician, physiatrist, neurologist and neurosurgeon, an orthopedic surgeon, and other physicians can help to evaluate an individual and develop proper diagnosis.

 

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