(1) Lack of ankle clonus in patients with acute tramadol poisoning
Ankle clonus was defined as the plantar reflection of rhythmic movements in response to a sudden stretch held in muscles and sustained clonus was defined as the presence of five or more beat means of ankle clonus .
Clinicians that only use Babinski sign and ankle clonus
in the lower extremities to evaluate for the possibility of upper motor neuron disease should consider expanding the scope of their neurologic evaluation.
Possibly affected' members are asymptomatic at- risk subjects who have a normal gait but who show possible corticospinal tract deficits on examination (mild hyper-reflexia a few beats of unsustained ankle clonus
but with flexor plantar responses).
On neurological examination, Glasgow coma scale was 6/15, pupils were equally reactive, deep tendon reflexes were brisk, plantar responses were extensor and bilateral ankle clonus
Abnormal deep tendon reflexes, crossed adductors, and ankle clonus
are other signs of upper motor neuron lesions.
Reflexes were brisk with bilateral spontaneous ankle clonus
of both ankles.
and Babinski sign were positive in the left side.
of one to three beats is normal in an infant during the first few months of life, but sustained clonus is not.