ankle clonus

my three month old baby has bilateral ankle clonus. i noticed it when he was 3 weeks old. but i ignored it till he was 8 weeks because it is a common sign in neonates. when it persisted after that i voiced my concern to his GP, who referred him to a paediatrician. the paediatrician examined his neuro development when he reached 3 months, and was satisfied with his development. she couldnt ellicit any clonus in him though i have been noticing it once in a while.it is usually 7 - 8 beats but sometimes during his sleep passive dorsiflexion of feet with knees flexed gives more than  10 beats.

could any of the neuro experts tell me about the recent researches on this if it is normal until 1 year.

N.B: he was an undiagnosed breech baby, born by an emergency LSCS. neither me nor the paediatrician has noticed any other abnormality in him so far.

[Abhijeet Deshmukh, MD]

Hello.

This is a tricky situation. Your son is 3 months now. Watch for the next 2 months. If he still continues to have clonus, you should suspect some abnormality.

Presently, it appears he falls in the normal group of infants who have ankle clonus. Just observe if he gets the clonus different positions.

A study about clonus in infants revealed that about 58% were normal children, when there were no other clinical symptoms .

Hope for the best.

Regards

[ddeeppaass]

Thanks Abhijeet, now my son is 5 months old. Luckily his ankle clonus dont appear anymore. He has started rolling over, maintains very well in prone.

[Ericcheng]

Hi Doctor

My baby son was born about 2 months ago and I noticed that he's had bilateral ankle clonus since birth.

Sometimes he doesn't have it but most of the time it's 3-5 beats (occasionally he can have 10-15 beats).  

My wife and I are terrified about this and went to a renowned pediatrician (Prof. Sam) in our city and he told us that he won't even worry about it.

My wife's pregnancy was uneventful other than the fact that the baby was considered very big for her size (3.9kg) and was delivered by way of a csection due to a breech position (i.e. the baby's head was 'stuck' under her ribs and became slightly misshapen).

He's attentive, feeds well, has put on a lot of weight (he is 5.6kg now at 2 months of age). In addition, he tracks with his eyes well, reacts to us and started to smile from 6 weeks).

Is it true that most of the time it's simply an immature nervous system? And what could have caused the nervous system to be immature in a particular child? And would you happen to know how common it is in newborns? I have been asking around my immediate network of friends who has had kids, but none of them seem to recall their baby having had ankle clonus... ...

[JSM333]

Our son was born premature at 33 wks, and he did show signs of ankle clonus for quite some time (~4-5 months) and there were times when it was sustained indefinately (>20 beats) especially when he was asleep or very relaxed.  

While most doctors seem dismissive of this, they could not provide me a lot of additional information to why.  As such I became pretty stressed out and turned to a lot of these message boards and poured over different cryptic medical studies such as www.ncbi.nlm.nih.gov/pubmed/9071490 that did NOT make me feel any better.

In any case, I want to post on these to let everyone know that my son is 100% fine now @ 7 months and it's ME who is still recovering from the anxiety of this experience.  It was NS immaturity.

Through all of this, I've learned that in the case of ankle clonus- the overall health of your child plays a big part of whether this is an issue or not and chances are if *it* is of concern, you probably are already working with your doctors to around more significant hurdles such as muscle tone abnormalites and motor development.

Above all, a nurse once told me at the height of my anxiety that children are amazing in their ability to heal and overcome any obstacle- so no matter the case I truly believe think will be much better than your fears will lead you to believe.