Dejerine’s
Sign
Clinical Pearl
Patients with radicular symptoms and pronounced Dejerine’s
sign, especially if it is in the lumbar spine, should be told to bend the knees
and lean into a wall during a cough or sneeze. This maneuver reduces
intradiscal pressure and minimizes the effect of the cough or sneeze on the
nerve root. A more worrisome situation is the sudden, unexpected absence of
Dejerine’s sign when all other clinical findings indicate an active nerve root
compression. The loss of the sign indicates fragmentation of the disc with
momentary decompression of the nerve.
Distraction
Test
The complaints of patients with chronic or degenerative
conditions of the cervical disc are quite different from those of patients with
acute conditions. Patients with chronic conditions experience intermittent
episodes of pain, discomfort, and muscle spasm. Exacerbations come from
exertion. Pain and stiffness may result from weather changes or unexplained
causes. Radiculopathy is not always present. Hyporeflexia, motor weakness, and
sensory disturbance (especially paresthesia) are common.
No comments:
Post a Comment