Clonus

Clinic

• Clonus is a set of involuntary and rhythmic muscular contractions and relaxations which occurs after Stretch Reflex.
• It is associated with upper motor neuron lesions involving descending motor pathways
• It is accompanied by spasticity
• Unlike fasciculations, it causes large motions that are usually initiated by a reflex.
• It is a entity of UMN series.

Cause

• Cerebral palsy
• Stroke
• Multiple sclerosis
• Spinal cord damage
• Hepatic encephalopathy
• Epilepsy as part of a generalized tonic–clonic seizure
• Pre-eclampsia and eclampsia

Related entities

• Fasciculations: It is sign of LMNS.
• Myoclnous: It differs from clonus, because of its irregularity.
• Spasticity: Clonus and Spasticity are co-occurring signs

Entity / Miasm

	EEE/ WEE	GSS	JE	FFI
Hyper Refexia	+++	+++	+++	+++
Tremor	+++	+++	+++	+

Clonus vs Spasticity

• Previously the co-existance of these two entities has been discovered. But their different identity has been emphasized.
• Now TLT could explain the problem. They are two different entities that share a common symptom, which is Hyper reflexia.
• Spasticity have paralysis and painful spasm but Clonus has tremor.
• So most of patient have both entities but not all since spascity enter the field of hypertonocity and paralysis, and clonus go to trembling

Entity/ Miasm

		CJD	EEE	JE	FFI	GSS
	Hyper Reflexia	+++	+++	+++	+++	+++
Clonus	Tremor		+++	+++	+++	+++
Spasticity	Spasm	+++			+++	+++
	Paralysis		+++	+++		+++

Conclusion

• GSS cover both Spasticity and Clonus.
• JE and EEE only cover Clonus