踝阵挛

随病情的进展，均出现四肢痉挛性瘫痪，肌力Ⅲ~Ⅳ级，肌张力呈折刀样增高，四肢腱反射亢进，两侧踝阵挛及Babinski征（+）。

As the disease progressed slowly , the patients presented with spastic paralysis of four extremities , reduced muscle strength ( 3 to 4 degree ), clasp-knife like of muscular tension , hyperactivity of tendon reflexes , ankle clonus and presence of Babinski sign .

踝阵挛阳性是另一有重要意义的体征。

The positive sign of ankle clonus is an another important sign .

下肢肌张力增高，肌力Ⅳ级，腱反射亢进，髌、踝阵挛阳性，Babinski征阳性，屈性病理反射阳性；

Hypermyotonia and ⅳ - level myodynamia in both lower extremities , tendon hyperreflexia , knee cap clonus ( + ), ankle clonuses ( + ), Babinski sign ( + ), and flexion pathologic reflexes ( + );

踝阵挛试验在脊柱侧凸手术中的监测价值

The ankle clonus test in surgery of scoliosis

踝阵挛出现的时间明显早于唤醒试验（P<0.001）。

The ankle clonus test appeared significantly earlier than the wake-up test ( P < 0.001 ) .

由同一位医生在1周内2次评定患侧下肢的痉挛，内容包括跟腱反射、小腿三头肌的肌张力及踝阵挛。

Spasticity was assessed twice at the same time on different days within one week by the same doctor .

踝阵挛及病理反射消失率100%，12例术前膝腱反射亢进的患者，术后膝反射减弱。

All ankle clonus and pathologic reflexes disappeared . The brisk knee reflex in 12 patients became sluggish after operation .

因此在本观察中，踝阵挛试验无真阳性和假阴性结果，4例假阳性结果（8.16%）。

Therefore , the ankle clonus test had no false-negative or true-positive result and 4 false-positive results ( 8.16 % ) .

结果19例患者术后肢体痉挛都得到缓解（100%），表现在肌张力下降，踝阵挛和病理反射消失或减轻。

RESULTS Spasticity in lower extremities got lessened in all patients ( 100 % ), which showed decreasing of muscle tone , disappearance or decrease of ankle tremor and Babinski sign .

结果术后随访3～6个月，16例患者肌张力增高均得到缓解，踝阵挛和病理反射消失或减轻。

Results During the follow up of 3 to 6 months , all the sixteen patients showed decreasing of the muscular spasticity , disappearance or relief of the ankle tremor and Babinski sign .

结论：踝阵挛试验对脊柱侧凸矫形术中脊髓功能的监测具有应用价值，且出现较早、简单易行，应作为常规监测，甚至可取代唤醒试验。

Conclusion : The ankle clonus test is a safe , easily performed and early parameter for intraoperative monitoring the spinal cord function during corrective surgery of scoliosis and should be routinely scrutinized .