Elbow clonus

A 45-year-old woman presented with a 2-day history of the right upper and lower limb weakness. She had history of craniotomy and blood clot evacuation for hypertensive left basal ganglia hemorrhage in 2014. She had recovered with mRS 2/6 upon discharge. Cranial nerve examination revealed right upper motor neuron facial nerve palsy. Her right upper and lower limbs were hypertonic with positive Hoffman sign. Hyperreflexia was found in the right supinator, biceps, and triceps. Striking the right triceps tendon resulted in sustained right shoulder and elbow clonus (as demonstrated in the video 1). There was also hyperreflexia of the right knee and ankle. The right plantar response was upgoing. The CT of the brain revealed encephalomalacic changes over the left hemisphere with left frontal craniotomy (figure, A and B).
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: All Clinical Neurology, Clinical neurology examination Case Source Type: research