Central medullary stroke (Physical exam question)

[B4y 4RE4 N4Tiv3]

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Had a young lady with central medullary stroke.

Deficits: left sided hemiparesis

Physical exam that I found peculiar was, when checking plantar reflex with babinski and chaddock, she had a rhythmic uncontrollable jerking of the right side (whole body). Asked the patient what it was and replied "That did not feel good, dont do it again".

I was curious if anyone has seen this response, and can they explain what was going on.

 

[DrSatan]

dat s*h*i*t hurt yo

 

[Hank Rearden]

If this was more of a subacute to chronic stroke you likely triggered a clonus response in the leg which can go on for some time and be extremely uncomfortable for the patient. If it was not clonus it was possibly a startle reflex (I think there's some other term for it, but can't remember right now). You see this when patients move the joint even before your reflex hammer hits the tendon because they are anxious.