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Clonus is defined as recurrent uninhibited contraction of a skeletal muscle [ often a group of muscles ] to persistent stretch. This may result due to disease affecting the pyramidal tract and occasionally extra-pyramidal tract. The video shows the classical ankle clonus which is obtained by supporting the leg by holding the upper part of the calf muscle just below popliteal fossa and passive dorsiflexion of the ankle joint. This passive dorsiflexion should be quick and the stretch must be sustained for sometime. The video shows recurrent oscillation of the ankle joint due to persistent contraction of the muscles contributing to achiles tendon [ gastronemius and soleus ] .The quick passive dorsiflexion is maintained for 20 seconds in the video. This patient was suffering from cerebro-vascular accident . Presence of sustained clonus indicates a severe pyramidal tract involvement. An ill sustained clonus for few seconds may occur in anxious patients and those suffering from psychiatric illness.
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