Neurophysiology of lower-limb function in hemiplegic children.
Equinus in hemiplegic children is multifactorial. In some cases it is due to a short muscle, in others to simple foot-drop, tonic spasticity, rigidity, compensation for a short limb, fixed flexion contracture at the hip, dominantly inherited forefoot deformity, forefoot equinus secondary to chronic toe-walking, or abnormalities of the visco-elastic properties of the muscle, with true intramuscular contracture. This neurophysiological study confirms that hemiplegia in children is not a homogeneous condition. Some have tonic spasticity; some, although stiff, show electrical silence on stretching; some appear to have a short muscle, with no hypertonicity; and others have hypertonicity in relation to position (i.e. rigidity). A short muscle is not always associated with tonic spasticity with reciprocal inhibition. Weakness can occur without spasticity. Speed of movement of toes, ankle and hip is also significantly reduced.
Brown
J K
JK
Department of Paediatric Neurology, RHSC, Edinburgh.
Rodda
J
J
Walsh
E G
EG
Wright
G W
GW
D000293:Adolescent; D001341:Autonomic Nervous System / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D005684:Gait / Q000502:physiology; D006429:Hemiplegia / Q000503:physiopathology*; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D007866:Leg / Q000294:innervation*; D008124:Locomotion / Q000502:physiology*; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology; D009129:Muscle Tonus / Q000502:physiology; D009132:Muscles / Q000294:innervation*; D009460:Neurologic Examination; D009469:Neuromuscular Junction; D016059:Range of Motion, Articular / Q000502:physiology; D011930:Reaction Time / Q000502:physiology