Abnormal knee jerk

Cause pathogenesis of shares afferent nerve center of the spinal cord 2 ~ 4, efferents to the femoral nerve. Knee jerk weakening or disappearance of the most common in the spinal cord or peripheral nerve lesions is lower motor neuron signs of paralysis, more common in myopathy, cerebellum and extrapyramidal disease. Hyperreflexia for upper motor neuron signs of paralysis were observed in hyperthyroidism, tetanus, hypocalcemia convulsion, the spirit of excessive tension may arise. Clinical manifestations in patients with supine position, check to use the left hand or forearm try to jack up the Department of patients hip and knee flexion was obtuse angle. Heel not to leave the bed, so as not to affect the reflectivity of the campaign is not easy to arrive at a correct result. Check to use the right hand with spontaneous delivery hammer tapping quadriceps tendon and the lower legs stretch out. Seats at the legs fully seized with the flip drooping perpendicular to the thigh, knee tapping the lower part of four tendon, the reaction of the legs extended. Leg increase was mostly reflected in the pyramidal tract damage, knee high reflectivity can often associated with hyperthyroidism kneecap jerks. Differential diagnosis (1) peripheral neuritis (peripheral neuritis) symmetry of the distal limb Division sensation and movement disorders, from distal to proximal development, accompanied by burning pain, tenderness lesion area. Symmetry distal limb motor neuron paralysis, muscular tension reduction, muscle atrophy and autonomic dysfunction, there sweating or sweat, limbs or reduce tendon reflexes disappear and ankle reflex reduce knee jerk lower than earlier. (2) of Guillain-Barre syndrome (Guillain-Barre's syndrome) is more upper respiratory tract infection, symmetry Ascending flaccid paralysis, proximal to the distal weight, serious cases involved because of where the intercostal muscles and diaphragm respiratory paralysis. Accompanied cranial nerve involvement, a sexual feeling abnormal or hyperalgesia, the distal extremities obvious muscle tenderness. tendon reflexes weakened or disappeared, pathological reflex negative. CSF 2 weeks after Jordan White-cell separation. (3) muscular dystrophy (progressive myodystrophy) belongs with sexual recessive inheritance, the almost exclusively male, women rarely see. In more than three-six-year-old started to clear and gradually increased beyond trunk and proximal limbs, lower limbs heavy in the upper limbs. Walking and climbing stairs difficult, running pelvic instability since curl up again, there's Al Gore (Fujian Normal Univ) levy, About 90% of patients showing at the gastrocnemius muscle hypertrophy, or the increase of muscle size is not increased After 6-year-old accompanied by the gradual muscle atrophy and contracture. First to reduce tendon reflexes, muscular atrophy finally reached a critical level when the knee tendon reflexes disappear, and in the early pseudo-mast, muscle hypertrophy Department tendon reflexes can be active. (4) periodic paralysis (periodic paralysis) in the disease more young children to the disease, meal and more intense activities, the cold and often emotional induced the disease. More than incidence night, and morning found Peter symmetry limb paralysis. Since the typical attack of low back and lower extremities proximal, distal spread to the lower limbs. Can expand upward involving upper limbs and neck muscle. Attack early often sweating, thirst, oliguria, constipation and muscle swell flu. Visibility lax inspection paralysis, the knee jerk reflex decreased or disappeared. With solid muscle disease, normal feeling, consciousness-and serum potassium general only mildly lower urinary potassium levels were significantly reduced. (5) epidemic myalgia syndrome (epidemic limiting symptom) multiple children and young, the incidence sharp and are fever, throat tightness, headache, quickly emerged under his chest and upper abdomen muscle pain and tenderness. Breathing, a cough and exertional intensified, sometimes involving major neck, back and shoulders, or to the knee reflex weakened, skin hypersensitivity. Some patients may be associated with inattention, dizziness, photophobia, neck, and so on mild symptoms of meningoencephalitis. It can also occur enteritis, myocarditis, rheumatoid testis. (6) optic myelitis (ophthalmoneuromyelitis. infrequently-optic myelitis) on the disease before flu history, acute or subacute onset. first side of blurred vision, the progressive development of both sides. Poor eyesight, orbit or orbital pain, some out there first. 2 ~ 3 months after the limbs, numbness, paralysis or tetraplegic. Concentric vision was narrowing, blind or blind quadrant. Lower initial strength, tendon reflexes weakened or disappeared, plantar stretch reflex at the bilateral, then increased muscle tension, knee tendon hyperreflexia, Pathological positive reflection. Loss of sensation usually up to thoracic. Plane lesions following sensory loss and autonomic dysfunction, accompanied by autonomic dysfunction, abnormal sweating. urine barriers. (7) of congenital muscular dystrophy (congenital - muscularmaldev-el opment) is infant myopathy, autosomal recessive genetic, or genetic dominance see. See both sexes. Infants at birth appeared to reduce muscle tension and myasthenia gravis, a limb and trunk muscles obvious, and not part of the disease first vertical, with no chair or standing knee tendon reflexes and limbs tendon reflexes diminish or disappear. No false hyperplasia. Most of the course was not for development, and some muscular atrophy can occur. Patients with serious respiratory effects. Can be associated with joint contracture, or congenital joint majority bending. (8) familial autonomic dysfunction syndrome (familial autonomic dysfunc tion) in this disease in infants disease, the symptoms varied. If fewer lacrimal gland secretion or lack of excitement, obviously caused a rise in blood pressure, the sky tends to lead to blood pressure immediately dropped. Hands cold, skin redness, breathing fast and the temperature increased, swallowing and speech impairment, with diarrhea or constipation, seizures and vomiting. excessive saliva or not, hypotonia, incoordination, biceps, triceps, knee tendon reflexes disappear, is not sensitive to pain, easily agitated emotional, mental retardation, physical accompanied left-right asymmetry, malformations. (9) rough skin disease (pellargra, pellagrosis. chichism) slow onset, and conceal, long course. Chang Yi tired early, weakness, anorexia, tongue pain. Later diarrhea, lack of geriatrics and gastric juice. Exposed body parts of the appearance of erythema, dermatitis. The initial neurasthenic symptoms are often overlooked Later, impaired memory, desires or occurrence of manic depression, usually late for the performance of dementia. The most common cable posterior joint damage, the performance of lower limb rigidity, ataxia, knee tendon hyperreflexia, Babinski sign was. Deep sensory dysfunction. Symmetry of peripheral neuropathy, mainly to physical pain. There will be the visually impaired and diplopia, there will be tinnitus, dizziness and facial nerve paralysis. (10) hematoporphyrin disease (hematoporpnyria. porpnyria) is lower extremity pain, distal limb paralysis of the muscles, the wrist was pedal disease. No more sensory dysfunction, knee tendon reflexes disappear. Sometimes were quadriplegic, the two re-arm its characteristics, its upper limb paralysis often paralyzed from the extensor of the people. Ptosis, diplopia, dysphagia, hoarseness, and dyspnea. May have epilepsy, consciousness and coma. Accompanied by headache, weakness, insomnia and peron. Emotional instability, mental disorders, mania, depression, hallucinations. Because of gastrointestinal smooth muscle spasm caused severe abdominal pain. (11) nodular arteritis (TA hairs) was symmetry, to the distal limb Obviously, the performance limb paralysis, sensory dysfunction, knee jerk reflex disappeared. Some of the performance of single neuritis, there is an asymmetry of motor sensory dysfunction. Paralyzed than the loss of sensation more common, often caused encephalitis symptoms, such as headache, vomiting, disturbance of consciousness, retinal vein tortuosity, palilledema. Retinal artery thrombosis or nodules. There will be hemiplegia, aphasia, heminopia, epilepsy and limitations extrapyramidal symptoms. The existence of two lower limb weakness, muscle atrophy, weakness and muscle tenderness. (12) alcohol Polyneuritis (alcoholic polyneuritis) an onset as slow, but several days of acute onset persons. Sensorimotor prominent obstacles to lower extremities, the anterolateral calf muscles paralyzed Obviously, rear leg muscles, or quadriceps can also involved. Was flaccid paralysis, knee tendon reflexes disappear and there may be muscle atrophy, but also a swelling of the skin, thin skin, dry Matt, fat cooler or purple pigmentation, nail changes, loss of hair and other autonomic changes. Late muscular atrophy, there will be muscle contracture, a muscle tenderness. (13) syringomyelia (syringaomyeli) more men than women, In more than 20 ~ 30-year-old incidence. Slow onset, often starting at the side of cervical enlargement horn base, the early symptoms are often the corresponding ipsilateral upper extremity pain control district, Thermal loss acumen and deep feeling of relative retention, patients often scalded skin without perception. Extended to empty the ash appeared before Link bilateral segmental separation pain, thermal barriers (T-shirt was short form). Lack feel there are burning spontaneously unspeakable pain, consecutive, known as the "central pain." Forward angle extension, the corresponding section of the muscle atrophy and muscle fibrillation, such as the cervical enlargement empty, small hands obvious muscle atrophy. Arm brachial two, three or even reduce tendon reflexes disappear. Aggression and spinal cord damage at the thalamus contralateral plane following skin pain, temperature McGREGOR loss. Pyramidal tract illness damaged plane following ipsilateral lateral limb spastic paralysis, knee tendon hyperreflexia. Due to malnutrition, developing joint swelling called Charcot (cnarcot) joints. (14) polio (spinal) (poliomyelitis) paralyzed for the next campaign neuronal , flaccid, hypotonia, knee tendon reflexes weakened. Paralyzed muscles asymmetric distribution, varying severity. Common in the lower limb and upper limb rare, big muscles more proximal to distal muscles paralyzed appears early and heavy, neck back muscles can be affected but not the first vertical, to rise and stand up, etc.. If the cervicothoracic spinal cord involvement, and the next muscle and the intercostal muscles (respiratory muscle) paralysis, respiratory movement. Breathing slowed, the alar fibrillation, voice low, intermittent speech, the inability to cough, muscular paralysis were sneezing, TRAM not cough contraction and may have intractable constipation, urinary retention or incontinence. (15) ataxia (cerebellar ataxia) patients after standing or move left Right wavering or skewed, often two separate foot, aggravating shut, and shut difficult to levy up negative. Unilateral cerebellar lesions, the first and bias on the side of the trunk, easy to dump on the side, the shape of intoxicated men while, it said intoxicated men while gait. Interested in running stand on the side of turning. Disease limb muscle hypotonia, the antagonistic effect is not there to counter the phenomenon. Reduced tendon reflexes, knee reflex may move was pendulum-like. Head and neck bias on the side, sometimes to the contralateral eyes slightly skewed, occasionally eyeball Separation strabismus, thick horizontal nystagmus. Organ pronunciation of the lips, tongue and throat muscles to speak of ataxia so slow, vague and intermittent voice, cadence and was explosive. (16) cerebral ataxia (cerebrumataxia) is the main obstacle to a balanced position. unsteady gait, back or side to the dumping. Frontal ataxia except in the contralateral limb ataxia, accompanied knee tendon reflex, and other hyperreflexia, increased muscle tone, Babinski sign, Cadau grams levy positive, and psychiatric symptoms, and strong grasp reflex, and other symptoms of frontal lobe damage. Parietal lobe lesions occur in the contralateral limb ataxia to varying degrees, close their eyes when obvious symptoms, deep feeling more obstacles were not overweight or a transient. Temporal lobe lesions arise when an off balance obstacles. Less cerebral ataxia associated with nystagmus.