top of page
Case of the Month - June  2018

Patient with spastic paraparesis, with  signs of myelopathy and bilateral patellar clonus. Contrast MRI shows a compressive extra axial lesion that enhances homogeneously with the contrast medium at the T10 level. 

Screen Shot 2018-06-30 at 4.30.08 PM.png
Screen Shot 2018-06-30 at 4.30.28 PM.png
2018-06-30 16.32.23-1-1.jpg
2018-06-30 16.32.23-1-2.jpg

Patient underwent resection of the lesion via the posterior route with laminectomy. Final diagnosis meningioma. Complete recovery from neurological deficit.

How to evaluate the motor examination of a patient?

​

The following 4 items should always be evaluated:  

​

Strength (Oxford / Van Allen)

​

  • 0  Paralysis

  • 1 Contract (+/-)

  • 2 Moves if gravity is removed (+/-)

  • 3  Move against gravity (+/-)

  • 4 Move against a certain resistance (+/-)

  • 5 Normal force

​

Reflexes

​

  • 0 crosses              Areflexia

  • +  (a cross)           Hyporeflexia

  • ++ (two crosses)        Normal

  • +++ (three crosses)       Hyperreflexia

  • ++++ (four crosses)   Clonus

​

Trophism

​

  • Atrophy

  • Hypotrophy

  • Eutrophy

  • Hypertrophy

​

Muscular tone

​

  • Spastic

  • Hypertonic

  • Hypotonic

  • Atonic

​

​

​

References

 

1. Kunam VK, et al.  Incomplete Cord Syndromes: Clinical and Imaging Review.  Radiographics.  2018 Jul-Aug; 38 (4): 1201-1222. doi: 10.1148 / rg.2018170178.

bottom of page