Читать книгу Neurology - Charles H. Clarke - Страница 124

Distinguish between akinetic‐rigidity and spasticity.

Extrapyramidal lead pipe rigidity is detectable throughout all passive movements. Take the hand through slow, extension, flexion, rotation movements. This elicits early stiffness in wrist and forearm muscles and cogwheeling. Stiffness becomes more evident when the opposite limb is moved actively a.k.a. synkinesis. By contrast, in spasticity, the early pronator catch or beats of ankle clonus will only become apparent if sought by brisk movements – quickly supinating the forearm or dorsiflexing the ankle: slow movements can miss these signs. A catch of increased tone at an ankle precedes sustained clonus.