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clonus
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clonus - December 10, 2007 4:41:58 PM
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ragempt
Posts: 111
Joined: August 14, 2006
From: linden, michigan
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forgive me, this is not my speciality. i have a 5 year old that is visiting me bc he walks on his toes. babinski is negative but he has clonus to his right ankle and a little on the left. his mom is having a hard time getting him into see a neurolgist. I am an orthopedic therapist. he is seeing the neuro doctor in march "they are busy"
the kid jump plays and i see no issues except he walks a little on his toes. PROM is wnl.
what could this clonus lead too or could it be nothing? obviously a pyramial track problem but what else could it lead to?
oh sorry about the spelling. my spell check is not working.
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RE: clonus - December 10, 2007 8:25:17 PM
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bonez
Posts: 230
Joined: August 29, 2007
Status: offline
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This is rare but spinal cord issues stuck in canal from a failure of segmentation. Sort of an osseus/cartilagenous bar within the spinal canal causing a tethering. Dermoid inclusion cysts meningiomyelocele are possibilities.
Is there signs to suggest short cord?
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RE: clonus - December 11, 2007 4:53:23 PM
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ragempt
Posts: 111
Joined: August 14, 2006
From: linden, michigan
Status: offline
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the mom says he does fall alot, babinski is negative, no pain, no bilateral symptoms. hard to rule out saddle anestesia on a 5 year old. he is getting evaluated in march. moms main complaint is "he walks on his toes". i personaly didnt feel it was that bad. is there anything i should be doing? kid plays soccer in the gym with me and i didnt see anything wrong. he can hop, skip, duck walk stand on one leg and dribble a soccer ball. could the clonus be nothing?
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RE: clonus - December 11, 2007 4:56:36 PM
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ragempt
Posts: 111
Joined: August 14, 2006
From: linden, michigan
Status: offline
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sorry bonez,
short cord? stright leg raise test was negative. do you want me to try a slump test? overall the little guy does not have any complaints.
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RE: clonus - December 12, 2007 12:36:31 AM
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bonez
Posts: 230
Joined: August 29, 2007
Status: offline
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I would expect clonus to be absent by this age. If you have true clonus then we should look for a reason.
I have seen 3 toe walkers in my 20 years, One under 5 two 5 and over. The ped physiatrist(sp) casted the yuong one 3 times to passively stretch gastro/soleal complex. Mixed results he will still try to run on toes and has bad functional flat feet. One of the other 2 with functional flat feet uses a neutrally posted otc foot bed. I gave him lots of proprio drills heel cord stretches retrowalking with emphysis on heel strike, duck walking and some body weighted squats with concentration slow controlled rising and he did well. I thought about Janda sandals with the small foot emphysis but never tried. I see his mom from time to time and she sees a bit of relapse after growth spurts but on the whole he does better.
hope that helps
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