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"As the hemiplepic patient begins to Yawn his paralysed arm may flex involuntarily at the elbow, the arm is drawn up in front of him and it returns to its resting position as the yawn ceases. During this movement the hand and fingers are said to be held in extension (6, 9,10). Many of our stroke patients had these movements. As they differed in pattern from previous descriptions and as many patients had false ideas about their nature and implications, I decided to investigate the phenomenon."
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"Patients and methods : Forly hemiplegic stroke patients who were attending the out-patient physiotherapy department at Nottingham General Hospital were studied."
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" Thirty-two patients had experienced automatic movements of the hemiplegic arm. In 15 of them, the movements had begun within a month of the stroke but in 4 a yaer or more had elapsed between the stroke and the onset of movements. In most of the patients. the movement started within 6 months of the stroke."
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"ln 2 patients, the movement of the arm was so violent that the hand hit their face."
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"Activities producing associated reactions : In 31 patients, the arm moved involuntarily in association with yawning. The arm movement would begin at the onset of the yawn and subsided as the yawn ended. Fifteen patients had arm movements every time they yawned. Several piatients found that the degree of arm movement was proportional to the size of the yawn. Others noted that yawn-induced arm movements were more likely to occur when they were lying in bed. In some cases, the arm fell to the side quite abruptly at the end of the yawn. One patient had to hold his paralysed arm when he yawned to prevent wrenching of the shoulder by sudden downward arm movement."
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"DISCUSSION Involuntary movements of the affected arm are common in hemiplegia. occurring in 80% of the patients studied...
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To see the whole study go here...
http://webperso.easyconnect.fr/bail...emiplegic2.html
"Although yawning has been considered to be of minor medical importance, it is clearly not without interest and merits much more detailed study."
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So what do you tell the patient who wants to know why his arm moves when he yawns?
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"Patients and methods : Forly hemiplegic stroke patients who were attending the out-patient physiotherapy department at Nottingham General Hospital were studied."
...
" Thirty-two patients had experienced automatic movements of the hemiplegic arm. In 15 of them, the movements had begun within a month of the stroke but in 4 a yaer or more had elapsed between the stroke and the onset of movements. In most of the patients. the movement started within 6 months of the stroke."
...
"ln 2 patients, the movement of the arm was so violent that the hand hit their face."
...
"Activities producing associated reactions : In 31 patients, the arm moved involuntarily in association with yawning. The arm movement would begin at the onset of the yawn and subsided as the yawn ended. Fifteen patients had arm movements every time they yawned. Several piatients found that the degree of arm movement was proportional to the size of the yawn. Others noted that yawn-induced arm movements were more likely to occur when they were lying in bed. In some cases, the arm fell to the side quite abruptly at the end of the yawn. One patient had to hold his paralysed arm when he yawned to prevent wrenching of the shoulder by sudden downward arm movement."
...
"DISCUSSION Involuntary movements of the affected arm are common in hemiplegia. occurring in 80% of the patients studied...
***********
To see the whole study go here...
http://webperso.easyconnect.fr/bail...emiplegic2.html
"Although yawning has been considered to be of minor medical importance, it is clearly not without interest and merits much more detailed study."
***************
So what do you tell the patient who wants to know why his arm moves when he yawns?
