Professor Shu Leong Ho, Dr Gary Lau, Dr Richard Chang, Dr Sonny Hon and Dr Joseph Kwan
These two videos are from a middle-aged man presenting with progressive bilateral lower limb and right upper limb weakness for few months. In the first video, there are prominent fasciculations over the entire right upper limb. Whilst in the second video, fasciculations can also be noted over both lower limbs, but more prominent on the…
In this video, the examiner is testing the tone of the lower limbs. After ensuring that the patient is fully relaxed, he first of all rolls each leg using both hands – one placed above the knee and another below the knee. Then, the examiner lifts up each leg at the level of the popliteal fossa. Besides…
To elicit this sign, the examiner strikes the patient’s sole using a blunt orange stick, starting from the heel, along the lateral border of the sole then medially to the base of the first toe. As one can see from the two videos, the patient demonstrates dorsiflexion of the big toe when testing for the…
In this video, the presence of ankle clonus is being tested. Clonus is defined as a series of rhythmic, involuntary muscular contractions induced by sudden passive stretching of a muscle or tendon. To test for ankle clonus, the leg and foot should be relaxed and the knee and ankle placed in a slight flexed position….
One can appreciate from this photo that there is significant lower limb wasting (or muscle atrophy) of the right leg compared to the left. The right leg is also shorter compared to the left. Muscle wasting (or atrophy) is due to denervation of the muscle supplied by the motor nerve and occurs in lower motor…