My 2 month old sometimes has ankle clonus

[sbpa05]

My 2 month old son sometimes exhibits ankle clonus.  It has even occured when he strongly stretches his legs out even if his feet are not touching anything.  Other times it cannot be elicited at all, for instance, at his well check with his pediatrician.  When the clonus does occur it ranges from 4-20 beats. He doesn't seem to have increaed tone.  The only other thing that I have noticed (just 2-3 times) is that he will occasionally seem to get a "chill" and his head and shoulders briefly quiver.  He does hold his head up well when being held but not yet during tummy time.  He also, sometimes, pushes with his legs very strongly as if he were going to "jump" out of my lap.  

My questions are:  how long can ankle clonus be considered normal in an infant, or is it ever normal?  
                            is there anything else that I should be watching for or be concerned about?
                            has anyone out there ever had a similar situation?
  

[rheakris7911]

Anymore updates?

[kellzymorgan]

I need to comment on this DESPERATELY!

My daughter had bi-lateral ankle clonus (sustained - well over 20 beats, especially when asleep or very relaxed) until 7 months or so.  Then she developed white patches on her foot/leg (20 or so, with some in an "ash leaf" shape) and had a cafe au lait spot.  Between the white patches (a MAJOR marker for Tuberous Sclerosis - an AWFUL genetic disorder that causes severe seizures and potentially severe mental retardation, among many other things), the cafe au lait spot and the ankle clonus, I was CONVINCED CONVINCED CONVINCED she had Tuberous Sclerosis - DESPITE how well she was doing developmentally.  I was even CONVINCED she was having seizures - infantile spasms to be exact and I recorded some strange head drops.

So far my daughter has seen 4 pediatric neurologists who've all given her a clean bill of health.  And lest you think I live in podunk somewhere, my last two pediatric neurologists are the directors of the Pediatric Epilepsy Center at NYU.  They're world renowned and are like gods in the arena of pediatric neurology.

Well, after giving them her history and when seeing her white spots, she was promptly admitted to NYU for a 3-day video EEG (her second video EEG in 6 months).  Result:  PERFECT.  I was told "there is no way this child has ever had an infantile spasm with this EEG."  Then she had an MRI.  Result:  PERFECT.

She has no evidence of tumors ANYWHERE on her body, her brain is perfect, she is ABOVE average developmentally (currently 18 months) and wicked smart.  

Between month 4-16 of my daughter's life, I have been a wreck.  An absolute basketcase.  I was convinced she had cerebral palsy and when she saw the first Pediatric Neurologist at 7 months (who specialized in Cerebral Palsy) and he chuckled "there is no way this child has cerebral palsy," I was barely able to breathe before I was on to the next thing:  Tuberous Sclerosis.  And she's completely cleared of that.

Life is short.  TOO SHORT.  I intend to spend the rest of mine enjoying my daughter instead of reading medical literature that scared the hell out of me and turned out to contradict what my experience was.  The papers I read were clear that NO CHILD should have ankle clonus AT ALL beyond 6 months - otherwise it was a neurological abnormality.  

You know what FOUR pediatric neurologists told me?  That that was PATENTLY UNTRUE and that though they couldn't say why the child had some sporadic ankle clonus, it did NOT mean she was neurologically impaired.  They weren't even remotely concerned about it.  

In fact, my best friend's son saw a Ped Neurologist (for an unrelated issue) and my friend thought to probe her regarding my daughter's ankle clonus and this doctor (Harvard Med School) said she'd personally triggered a couple beats of ankle clonus in each of her 3 children up until they were 18 months old.  

My daughter's bi-lateral ankle clonus meant nothing in the end.
Her multiple white patches and cafe au lait spot meant nothing in the end.
She's perfect, smart and developing like a champ.

I've aged decades, however!!!  (God help us all!!!)  :)

[Sophiam]

So sorry for the delayed response to all of your reply's but life has been a bit hectic over the last couple of months as we have been relocating back to the UK from Australia with a 1 year old.... so this reply is for :
ANYONE WHO IS READING THIS THREAD NOW WITH CONCERNS AND EVERYONE WHO HAS PREVIOUSLY RESPONDED:
My little boy is now 16 months old and other than being a bit cheeky is doing very well, he has been walking for a few months now after cruising for what seemed like an eternity so my comments are, please please try and relax and enjoy your little ones. I spent endless months worrying, stressing and crying over ''what could be'' despite everyone squashing my concerns. I became so anxious at times I am sure my little one could sense it !
I wish you all the best and hope that my reply here helps some parents who went through the same concerns as we did.
Best wishes to all x

[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 (high risk, general) 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.

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 wise 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 with your child I truly believe things will turn out much better than your fears will lead you to believe.

Take care of yourself and best wishes :0)

[Sophiam]

My little boy who is 3 months has similar symptoms ... I was wondering what your outcomes were ? At what age did it stop ? Thank you.

[aprmmom]

Your comments on your child sound alot like my son who is now 4 months old. He saw a pediatric neurologist who suggested an MRI and it came back normal. So I'm assuming either it's an immature nervous system or something spinal cord related, but he's meeting his milestones, etc.

[dianam101]

my daughter is almost 10 wks. She has clonus in both of her ankles. Lately it has been about 6-10 beats, but a couple weeks ago it was sustained. I caught this about 2-3 wks ago. I told her pediatrician who said he thinks it is normal, but sent her to a neurologist. The neurologist says that he thinks she will out grow it and that it is just b/c her nervous system is immature. He wants to follow-up with her in 2 months. He says the intensity of the clonus should be less by this point. If not, then he will consider other tests, i.e. MRI. I am terrified about this. I don't want my child to have cerebral palsy or any other problem. Her neurologist really seems to think she will be fine because her tone is normal, she is reaching all of her developmental milestones and she is very alert and attentive. I pray that it is gone by 4-5 months although he says clonus can last up to 1 yr in some kids and still be normal. But he really wants to see that the intensity of the clonus is much less by 4-5 months. Meanwhile the neurologist says just watch and make sure her tone does not increase in the meantime.

Forgot to mention that he thinks if there is anything wrong it would be a tethered spinal cord. But b/c her tone is fine he is not that worried about this either.

If you have not already, I would ask your ped to refer her to neurologist just to find out more for yourself and so they can check your baby's tone, reflexes, development etc... Also I found it very hard to find a neurologist appoint. within a reasonable time frame so doing this know will help if later there really is a problem.

I hope both of our babies will be fine. Best wishes!

[mdhatton]

My 13 year old started with clonus in Sep. 07. Clonus started gradual in left leg then in 2 mths. it was in right leg. When he was little he was a toe walker but all of his life has complained of leg pain. My advice is to seek a pedi neurologist just to let them do some test to make sure this does not get worse. I do know by the experiences with my son is clonus is very painful because of the spastic clonus. One of the things you can do is put you hand on the bottom of your sons foot up toward the toes and see if the clonus sets off. My sons clonus sets off worse when he puts his foot on the floor or if Dr.'s do that to his feet.
When he was little he  walked on his toes actually all the way until 10 years old. Then we had surgery called tendon release.  They have done all the tests and nothing but since your sons clonus started early maybe they can catch. this.  They did a test for mycroplasma test which will be back next week. I hope they have finally found it after all this time. This is a bacterial infection that can be worse with kids with low immunity.
As a mom dealing with the clonus I say please contact a neurologist. Do not let your pedi Dr. just pass this off because clonus is something that needs to be addressed.
With his age it is very important to find out now.
Best of luck