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Bilateral ankle clonus
by sheri123, Mar 12, 2008 03:30PM
In November of this year I had a very thorough physical at Cooper Clinic. I am a 37-year-old female. Oddly enough bilateral ankle clonus (3+) and overall whole body hyperflexia were discovered at the time of my physical. MDCT scan was performed along with CT of the head and neck, then subsequent MRI of the head and neck with and without contrast. Findings included a prominent disc bulge at C4-5 that indents the CSF space anterior to the cord but does not cause direct cord or root compression and no evidence of mass effect on the cord. Canal dimensions are normal. There is also a bulge at C5-6, at T2-3 and T3-4. These indent the CSF space anterior to the cord but are not producing appreciable edema or displacement of the cord proper.
The only other symptoms I have had that could even remotely be related to this is occasional mild body twitching that probably would go unnoticed by me if I were not becoming hypersensitive to anything that might indicate a problem and occasional tingling sensations along my neck and upper shoulders. I have normal gait and strength and negative Babinski.
Everything I read about clonus indicates a potential for MS or ALS. I have an aunt on my father's side with MS that has been fairly latent until recently..she was in her 30s at diagnosis but mainly without symptoms until now, in her early 60s. My MRI, however, did not show anything that would bear this out as a diagnosis for me. I am, obviously, terrified of anything that could indicate ALS but my understanding is that there is no definitive test for this disease.
I have chosen to this point not to pursue neurological consultation, as I am functioning pretty much normally and this has not affected any quality of life issues or restricted my activities. Occasionally the clonus makes itself felt when I am on an elliptical trainer or exercise bike but that is mild and minimal. If I have ALS, I figure it will manifest itself relatively soon and if I have MS, it too will eventually become obvious. I have no desire to go through rigorous testing that is mostly aimed at ruling out this that or the other rather than proving anything, particularly since I have no appreciable debility and even if something like ALS or MS were found, nothing would be done at this point to treat it or improve outcomes. However, I do wonder and worry. My primary care doctor seemed to feel the bulging discs were unlikely to be causing this. I have been on Wellbutrin XR for some time and we tried switching to generic to see if it would eliminate the clonus and then switched back to name brand when it did not. Getting off the Wellbutrin is not really an option at this time as I lost my 13 year old son just over a year ago and am still grieving.
My question is:
A. Can a person have clonus and hyperreflexia on physical exam as a completely benign finding or is it always indicative of a problem?
B. Could the bulging discs be a potential cause, and if so, should I be seeking treatment for them?
C. Could this be caused by obesity and potentially cured with weight loss?
D. Is it possible to have a tumor or other spinal lesion and not have it show up on closed MRI with and without contrast?
Thank you in advance.
The only other symptoms I have had that could even remotely be related to this is occasional mild body twitching that probably would go unnoticed by me if I were not becoming hypersensitive to anything that might indicate a problem and occasional tingling sensations along my neck and upper shoulders. I have normal gait and strength and negative Babinski.
Everything I read about clonus indicates a potential for MS or ALS. I have an aunt on my father's side with MS that has been fairly latent until recently..she was in her 30s at diagnosis but mainly without symptoms until now, in her early 60s. My MRI, however, did not show anything that would bear this out as a diagnosis for me. I am, obviously, terrified of anything that could indicate ALS but my understanding is that there is no definitive test for this disease.
I have chosen to this point not to pursue neurological consultation, as I am functioning pretty much normally and this has not affected any quality of life issues or restricted my activities. Occasionally the clonus makes itself felt when I am on an elliptical trainer or exercise bike but that is mild and minimal. If I have ALS, I figure it will manifest itself relatively soon and if I have MS, it too will eventually become obvious. I have no desire to go through rigorous testing that is mostly aimed at ruling out this that or the other rather than proving anything, particularly since I have no appreciable debility and even if something like ALS or MS were found, nothing would be done at this point to treat it or improve outcomes. However, I do wonder and worry. My primary care doctor seemed to feel the bulging discs were unlikely to be causing this. I have been on Wellbutrin XR for some time and we tried switching to generic to see if it would eliminate the clonus and then switched back to name brand when it did not. Getting off the Wellbutrin is not really an option at this time as I lost my 13 year old son just over a year ago and am still grieving.
My question is:
A. Can a person have clonus and hyperreflexia on physical exam as a completely benign finding or is it always indicative of a problem?
B. Could the bulging discs be a potential cause, and if so, should I be seeking treatment for them?
C. Could this be caused by obesity and potentially cured with weight loss?
D. Is it possible to have a tumor or other spinal lesion and not have it show up on closed MRI with and without contrast?
Thank you in advance.
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