You are examining a child with severe cerebral palsy. When you suddenly move his foot dorsally, a sustained “beating” of the foot against your hand ensues. What does this represent?
A) A focal seizure
B) Clonus
C) Extinction
D) Reinforcement
B) Clonus
Clonus is a sustained rhythmic “beating” which correlates with CNS disease and hyperreflexia. A focal seizure could be virtually ruled out by stopping the stimulus and watching the phenomenon stop. Extinction is a term applied to sensory testing where one side of a simultaneous, bilateral stimulus is not felt because of damage to the cortex. Reinforcement applies to enhancing reflex examination by distracting the patient, for example, by pulling his hands against each other.
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