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Neurology (Expert Forum)
Should I seek a second opinion?
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Doctor's Answer
by CCF-Neuro-M.D.-JT, Oct 03, 2001 12:00AM
If you truly have sustained ankle clonus in which your feet continue to jerk after being pulled back at the ankle towards your face forcibly, then you should definitely be seen by a neurologist and have further imaging done on your brain/spinal cord according to the exam findings. As you are relatively young, brisk reflexes are considered normal in many people your age. We have a standardized way of grading reflexes in the neurological community from 0 to 4. Up to 3 is considered ok. CLonus is considered a 4. This is a sign of spasticity and increased tone which points to a problem with the spinal cord or brain depending on the symmetry and remainder of the neurological exam. Weakness, stiffness, and gait abnormality would be some symptoms that would be concerning if accompanied by true clonus and increased reflexes. Also, he should have checked for a "Babinski's sign" in which he stroked the bottom of your foot with a key or similar object to elicit a sign of increased tone. This would have confirmed his findings.
The other point is that a GP may not be able to pick up neurological signs of spasticity especially if they're subtle or may overcall signs that aren't really there (as he may have done with the term "clonus.") Talk to him about seeing a neurologist to get a formal neurological exam if you have other neurological symptoms such as the ones I mentioned previously. Otherwise, he needs to do a very careful exam himself to further evaluate his neurological findings.Good luck.
The other point is that a GP may not be able to pick up neurological signs of spasticity especially if they're subtle or may overcall signs that aren't really there (as he may have done with the term "clonus.") Talk to him about seeing a neurologist to get a formal neurological exam if you have other neurological symptoms such as the ones I mentioned previously. Otherwise, he needs to do a very careful exam himself to further evaluate his neurological findings.Good luck.
