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Worth a neurology referral?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by RobinP, Feb 20, 2013.

Tags:
  1. RobinP

    RobinP Well-Known Member


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    Dear All,

    Seeking the greater wisdom of those with more neurological knowledge than myself

    PC
    Very mild "fluttering" of muscles in feet.
    Muscles affected are mainly the long extensors, flexor hallucis longus and peroneus longus
    Onset after running home in work shoes or at least he has been unaware of it before then.
    Seems to occur mainly at rest now

    RMH

    NSMH
    Gp was non committal and mentioned "something about a claw toe"

    SH
    Moderate activity level - does a little running
    Issue is not apparent when exercising

    OE
    Percussion of neurological structures round the foot and ankle illicits none of the symptoms
    SLR and slump tests also negative for pain or for recreation of fluttering
    Observation of the muscle contraction showed a very rapid activation of the muscle, not long enough to cause joint movement, just enough to be visible on the skin
    Babinski sign normal
    Fogg test normal
    Rapid ankle dorsiflexion creates 2 beats mild clonus on the Rt but nothing on the Lt
    Ankle reflex normal Lt and absent Rt


    Pt has had no investigations as yet

    PLAN

    Ask him to request blood tests from GP to check for mineral and vitamin deficiencies(although he has a varied and full diet)

    Here is my question, is this worth a referral to the neurologist?The GP is not the most proactive so it could be a bit of a fight. Without the ankle clonus, I would not have been in the slightest bit bothered but it is a little obvious to ignore.

    Any opinions?

    Thanks

    Robin
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    yes............
     
  3. RobinP

    RobinP Well-Known Member

    Hmmm yes, I thought that might be the answer. Sort of answered my own question when writing it.

    Well... I guess I had better open that can of worms

    Cheers Craig
     
  4. markjohconley

    markjohconley Well-Known Member

    "Rapid ankle dorsiflexion creates 2 beats mild clonus on the Rt but nothing on the Lt", missed that lesson also, what does this indicate?, thanks, mark
     
  5. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    UMNL


     
    Last edited by a moderator: Sep 22, 2016
  6. markjohconley

    markjohconley Well-Known Member

    Thanks Craig, amazing i got through, definitely never shown that test; makes sense, i'll go practice ......
     
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