1_FACE,NECK,ELBOW & HANDS
2_MUSCLE BULK,TREMOR & FASCICULATION
3_Ask : Hold your arms out infront of you
4_Test:TONE,POWER,REFLEXES
5_Test: Coordination and Sensory Screen
Face and Neck look normal.
Arms and forearms are wasted,more marked proximally.
No tremor or fasciculation is noted.
And the patient can not outstretch both arms.
Tone is reduced both proximally and distally.
Proximal power 2/5,3/5 distally.
Cases for PACES
Comments
Scan the whole patient and look at:
1_FACE,NECK,ELBOW & HANDS
2_MUSCLE BULK,TREMOR & FASCICULATION
3_Ask : Hold your arms out infront of you
4_Test:TONE,POWER,REFLEXES
5_Test: Coordination and Sensory Screen
Face and Neck look normal.
Arms and forearms are wasted,more marked proximally.
No tremor or fasciculation is noted.
And the patient can not outstretch both arms.
Tone is reduced both proximally and distally.
Proximal power 2/5,3/5 distally.
All of the upper limb reflexes are sluggish.
Sensation is normal.
most likely motor neuron disease
bilateral polio , but usually it is unilateral
This patient has positive family history of gradual weakness over a few year in his brother.
Trackbacks
[...] Examine this patient’s Arms_2 October 2009 4 comments [...]