Epilepsy and Ankle Clonus Relation??

Hello,

I had a seizure in January and one in February, these were the first times I ever had a seizure.  They were Grand Mal seizures.  I have been on Phenytoin Sodium Extended 300 mg a day since.  I experienced an "aura" before the seizure, which I had the feeling before.  At Mayo Clinic, they diagnosed me with Complex Partial Seizures with Secondary Generalized Seizures.  Recently I have a muscle twitching in my back--it was going on for 4 days now may have subsided.  I have not noticed it until last Thursday.  I went to a neurologist yesterday and he diagnosed me with Ankle Clonus.

Is this related to epilepsy?  Is their something grander than just having seizures which may have caused all of this?  Mayo Clinic and 2 other neuologists did not test me for Clonus.  I was born premature, which they said is the ONLY reason I could have had seizures.  I am curious if their could be an underlying cause for all of this, or if you can just have Clonus with no underlying cause?  It seems to me it would be related to the seizures.  I had an MRI, EEG, and found nothing.  

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

Ankle clonus is a physical examination finding characterized by sustained contraction at the ankle (in an up-and-down motion of the foot) following forceful dorsiflexion (pulling up of the foot). It is important to understand that ankle clonus can be normal if it is not sustained; if the foot only beats down a few times this may not be significant. However, asymmetric ankle clonus, meaning that present only on one foot, or sustained ankle clonus (more than 5-6 beats) is considered relevant. The causes include injury to the nerves in the brain or spinal cord, of which there could be many potential causes. With a normal MRI of the brain, a lesion leading to both the epilepsy and the ankle clonus is not identifiable, but certainly if there was some sort of injury to the central nervous system in the perinatal period, both ankle clonus and seizures could result.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.