My 14 yo son has started to have twitching of thumb

[okwjoe]

My 14 yo son who at this time at Shriner's hospital in Philadelphia for a 5 day evaluation, has started to twitch his right thumb. Three weeks go he moved his left big toe, although the toe movement comes and goes. They did a new ASIA test and still they still think he is an A. He had a subluxation of c5 C6 vertbratae. He aslo has a trace movement of his right triceps. Tommorow ends his evaluation at Shriner's.

[madcolin]

Hello, I am a recently injured incomplete C5 C6. I have been hurt for about six months. When I first was injured I was classified as Asia a but had trace movement in my triceps and wrists. I firmly believed that I was incomplete and that the Asia tests were wrong. Several weeks later my left wrist began to move, then my fingers began to twitch (which also comes and goes), then I began to wiggle my toes in the same come and go fashion. They did the test on me again and I was reclassified as Asia b. The Asia test has been done on me several times and people have still told me that I'm Asia a. When I went to see my neurosurgeon, he did a reflex test on my legs, hitting my knee with his little hammer to see if my legs reacted. They did. He told me that this was much more important in the incomplete classification than the Asia tests. From the moment I was hurt I believed I was incomplete no matter what anyone told me. Six months later I still have a long road ahead of me but now I have had much recovery in my abdominals, wrists, and some triceps. They will do all kinds of tests on your son but don't worry about the results because no matter what anyone says, anything is possible if you have faith and believe. Don't get discouraged and tell your son to never give up.

my wife , son, and I all feel the way we do. his is months post. He has trace triceps, started to wiggle his big left toe 3 weeks ago, now has twitching of thumb, can feel warm water near his anus, can feel pressure there too when we put a pin near his anus, felt throbbing pain when he had a ingrown toenail. feels at times the cathteter in his penis. Twice he has been tested his ASIA by his rehab and at shriner's still they say he is an A. go figure

[madcolin]

Sounds incomplete to me. You should get them to do a reflex test on his knees, using that little hammer hitting right below the knee. When my neurosurgeon did this test on me, my muscles reacted. He told me that this was a much more important test in the classification of incomplete.

[dglosek]

okwjoe, please check your private topics

[SCI-Nurse]

Madcolin, presence of spinal reflexes returns below the level of injury in most people with SCI, and does not indicate an incomplete injury. Spasticity is also not an indicator of either complete or incomplete injury. The ASIA standard is the one agreed to by physicians all over the world for determining consistently the degree of completeness or incompleteness of an injury. A person can appear to be ASIA A and later be reassessed as ASIA B, C, D, or even E.

(KLD)

[madcolin]

Kld,

I'm assuming that the curling of the toes when pressure is applied to the soul of the foot is a spinal reflex. If this leads to the assumption that there could be possible openings of the spinal tract then wouldn't then knee reflex represent the same thing? Does an opening of the spinal tract represent incompleteness?

thanks,
colin

[SCI-Nurse]

A spinal reflex (patellar, plantar, etc.) is expected to return below the level of injury. It does not indicate an incomplete injury. A spinal reflex works by stimulation of a sensory nerve, which travels to the spinal cord (which is usually intact below the level of injury) where it connects to a motor nerve which leaves the spinal cord and travels to a muscle, causing some type of muscle movement. The brain and upper spinal cord are not involved in spinal reflexes at all.

Spasms are a type of spinal reflex, as is a reflex erection or reflex urination, or reflex defecation which is stimulated by digital stimulation.

Incompleteness would be more likely if you could voluntarily inhibit or prevent the reflex from occuring (which AB people can do), which would indicate some type of intact pathway from the brain being involved.

In this diagram, the spinal reflex is showing the direction of this message. The nerve come from the brain down the cord would be the one damaged after a spinal cord injury. There is a loss of reflex activity ONLY in the area where the spinal cord is damage. Reflexes below this usually return even without any neurologic improvement (except in some infarctions and conus or cauda equina injuries).

http://www.dushkin.com/connectext/psy/ch02/reflex.gif

I am not sure what you mean by "an opening of the spinal tract".

(KLD)

[QuadMedic]

Babinski reflex: An important neurologic test based, believe it or not, upon what the big toe does when the sole of the foot is stimulated. If the big toe goes up, that may mean trouble except if you are a newborn baby. They are not neurologically mature and therefore show a Babinski response. Upon stimulation of the sole, they extend the great toe .

This test does prove neurological damage ..... but not complete or incomplete ... we mainly used it on CVA's and TBI's

Originally posted by madcolin:

Kld,

I'm assuming that the curling of the toes when pressure is applied to the soul of the foot is a spinal reflex. If this leads to the assumption that there could be possible openings of the spinal tract then wouldn't then knee reflex represent the same thing? Does an opening of the spinal tract represent incompleteness?

thanks,
colin

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