clonus, Cogwheeling rigidity

[Thelma]

Good morning Doctor!.
     I posted a question a few weeks ago. Thank you for your answer.  Could you please tell me if clonus or cog wheeling rigidity go away on their own, or if once you have them they will always be present? For example in a neurological exam would a neurologist always be able to detect them? Is there anything that can be done to heal them?  
     I would also like to know if these are signs of neurological insult:  My left arm repeatedly goes into a position of being bent at the elbow so that my forearm is parallel to my waist and my left hand points downward as if it is limp.  But it really isn't limp. I can move it back into the normal position.  Also my left hand repeatedly goes into a clawlike position and then quickly stretches backwards.  It does not hurt but I wondered if I was doing subconsciously to relieve tension in some muscles of arm or hand. Thank you in advance for your time and service.

[CCF Neuro[P] MD, RPS]

Dear Thelma:

The clonus that you might experience in a joint, might be transit in nature if you had an insult to a particular part of the brain, for instance a metabolic insult.  As the insult resolved and the brain began to heal it would go away.  Most of the time it is there and will not go away.  Usually, it is from a stroke, degenerative disease, etc.  Cogwheel rigidity is usually from basal ganglion problems such as in Parkinson's.  This would too not go away, in fact most of the time this gets worse.  What you describe might be a dystonic movement.  This is a movement disorder that is the result from metabolic, genetic, stroke, etc etiologies.

I would seek a good neurological exam to see if this is what is occuring with you.

Sincerely,

CCF Neuro MD

[Joe - LEG CLONUS]

What about clonus in the legs?  Is there a medication that will relieve the clonus?  Is there a chance with MS the clonus will subside and the reverberations (sp?) will diminish or will it only get worse?

[CCF Neuro[P] MD, RPS]

Dear Joe:

The clonus from MS is due to increased muscle tone (spasticity) and upper or central nervous system demyelination.  So, medication can help with the increased muscle tone which will initially help with the clonic movements, but there is no real relief from the clonus.

Sincerely,

CCF Neuro MD

[Joe - ? about Procarin]

I saw some info on this medication/therapy.  Any information available from a scientific (unbiased) perspective?

[CCF Neuro[P] MD, RPS]

Dear Joe:

Is there another name for Procarin?

CCF Neuro MD

[Joe....PROCARIN follow-up.]

I really don't know much other than it is a transdermal patch.  If  you go to www.hotbot.com and search on procarin, there are a few links that appear.... including www.msviews.com/rene/renp47.htm

there is another that gives much better information but the link is far too long to list here.

A friend saw a nurse on some talk show discussing it.  It may be nothing more than a "miracle" tonic....

[CCF Neuro[P] MD, RPS]

Dear Joe:

I can't find the medication in any of my drug information books.

CCF Neuro MD

[Andins]

My 3 year old daughter has just been referred to a Neurologist.  The Orthopedic doctor who recently examined her said he noticed clonus.  She also has a bluish tint to the whites of her eyes.  Can the two things be related to each other?  What is clonus linked with in children? Will Physical Therapy help or make the problem worse?  Thank you!

[CCF Neuro[P] MD, RPS]

Dear Andins:

Usually the presence of clonus indicates that there is abnormal upper motor neuron damage (CNS damage to the motor areas of the cortex).  In an otherwise perfectly normal developing child, this may just be a finding, and not a sign of CNS abnormality.  However, if your child has any features that are not normal, such as developmental delay, spasticity, etc. this may be a sign of the group of abnormalities associated with various disease.  This is the same for the blue sclera.  There are several entities that might be associated with both disorders but not with a perfectly normal 3 year old daughter.

Sincerely,

CCF Neuro MD