|
Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Ankle clonus in critically ill burn patientsForum: Neurology Forum
| |
I work in a burn center and have had several patients who are critically ill with no known upper motor neuron lesion or documented anoxia who exhibit ankle clonus with dorsiflexion. This is always a concern to the PTs who suspect some type of UMN lesion,although most patients upon recovery and weaning from the vent exhibit no long term problems. Could anyone explain to me what might cause this clonus? The most frequent pain meds given prior to dressing changes are morphine and versed. I would appreciate any input .Thank you.
Dear D.J.: That is an interesting observation. Hypostheses to explain this are: 1. Anxiety, pain, hyperadrenergic state. Clonus can occur even in normal individuals who are very tense and anxious. 2. Metabolic encephalopathy. Clonus can occur transiently in encephalopathy from verious causes. 3. Possible mild central pontine myelinolysis related to osmolar fluctuations from burns.
| |
