11 replies to this topic

[stacyandmike]

Hello all,

My fiance is paralysed, level C6 at the moment. He is still in hospital at the moment.

He had botox on his legs last week (to help calm his spasms) but now his reflexes in his legs are working.

He got me to tap below his knee, and his leg kicked out, you know, how a doctor checks your reflexes.

Does anyone think this is a good sign?? xx

[Joed]

It's hard to say. And I don't want to give any false hope. Our neurology can do some pretty weird and confusing things sometimes. There is a spot to the left of my shin that, when tapped, will cause my foot to flex upward. My therapists decided to use that response to help me to elicit muscle recruitment during my sessions. It was stressed to me over and over that involuntary movement was not signifcant...only voluntary movements indicated a return of function. But frankly, I'm not convinced. Always have hope.

It's still very early for him, post-injury. Any improvements will be evident after two years or so. I hope that this reflex is a good sign and that he'll be able to build upon each new return.

[Simon]

The reflexes are initially shutoff by the body after injury, it could just be his reflexes have returned and its coincided with the botox etc. You need at least 8 weeks before all the swelling in the area affected ie c6 level reduces down. Then some or more or no nerve sensation can return to what is the situation now, unfortunately its impossible to predict, just wait to see.
I hope things improve.

[Apparelyzed]

Hi,

Stick a pin in my leg, and you'd better get ready for a kickin', and I'm a C5/6 complete!

This is probably just his natural relex arc mechanism. There is a bit more on this here:

http://www.apparelyz...spasticity.html

There is a method of detecting spinal cord damage called the Babinski reflex or Babinski sign.

This is from Wikipedia:

The Babinski Reflex

In medicine (neurology), the Babinski reflex or Babinski sign is a reflex that can identify disease of the spinal cord and brain. It is more properly called the plantar reflex, as Babinski's sign in reality only refers to the pathological form.

The lateral side of the sole of the foot is rubbed with a sharp or hard implement (usually a series of pinpricks or the tip of a tendon hammer), running from the heel along a curve to the metatarsal pads. It is an unpleasant sensation for most. There are roughly three responses possible:

•Flexor: the toes curve inwards and the foot pronates; this is the response seen in healthy adults. This is not a reflex; it is under voluntary control.
•Indifferent: there is no response (sometimes a feature of peripheral neuropathy).
•Extensor: the hallux (large toe) extends upwards, and the other toes to a lesser extent; this response is Babinski's sign.

In decerebrate patients, a more complex reflex is observed, which includes the lifting of the whole leg. This is a primitive reflex, indicating that the brain has been damaged severely.

The extensor response can indicate damage of the spinal cord in the thoracal or lumbar region, or brain disease. Occasionally, a pathological plantar reflex is the first (and only) indication of a serious disease process, and a clearly abnormal plantar reflex often prompts detailed neurological investigations, including CT scanning of the brain or MRI of the spine, as well as lumbar puncture for the study of cerebrospinal fluid.



I hope this helps

Simon

[loolie]

stacyandmike, on Mar 27 2006, 01:30 PM, said:

Hello all,

My fiance is paralysed, level C6 at the moment. He is still in hospital at the moment.

He had botox on his legs last week (to help calm his spasms) but now his reflexes in his legs are working.

He got me to tap below his knee, and his leg kicked out, you know, how a doctor checks your reflexes.

Does anyone think this is a good sign?? xx

Always have hope no matter what...... Docs go by others injuries and there medical books. They put it in ones mind this is the way your going to be except it and move on. You cant look at it like that. I know its hard to but your mind is what is going to get you farther than expected. You has his finiance need to really help him in this time not on emotionally but phyiscally. What I mean is I dont care if he cant move his leg you pick his leg up for him move it in a motions have him think in his mind he is doing it. This is what my mother did for me after my accident. I hated it i screamed at fought at the age of 16 but here at 26 I thank God she did it. I was a t 12 injury not severed but i had no feeling waist down today i can feel to my knees i can move my legs i have the function of my quads one is weaker than the other but hey....... I can walk with braces before i became so lazy i was using only one brace... I was told when I left that hospital that was the way i was going to be i didnt know my mom was going to do all that for me but i did say to that doc your not God your going to write another chapter in your medical book....... So keep his muscles in good shape make him want to stretch them bc i stopped stretching my foot got drop foot but help him get started and see what comes......

[keps]

When I asked whether it was significant that I had reflexes, I was told not really.

When I first became paralysed (following a spinal bleed), and was rushed to hosptial, people seemed not to be too worried. But when a doctor scraped a key up my foot, and muttered "no plantar response" (which I presume meant my feet didn't react at all) - I was in the MRI machine in next to no time.

Then, after some weeks in the spinal unit, the doctors said that my reflexes had returned. But I understood that this was not significant in the way of recovery, as it was completely involuntary, and I could not feel anything happening.

[LizzyB5280]

I was in nursing school before my illness, and am trying to get back into clinicals, so let me give everyone the low-down on why SCI patients can be paralyzed yet still have reflexes.

Let's speak first about a "normal" person. For a voluntary movement, the signal has to go from the brain to the extremity. Well, if you put your hand on something that's hot, or step on something sharp, it would take too long to send the sensory message to the brain, and then send the motor signal back down to the extremity. So that's when a reflex occurs. The sensory message only has to go from the extremity to the spinal cord, and then the spinal cord sends the motor signal back down before the brain has gotten the sensory message. This allows the extremity to jerk back quickly before it is burned, cut, etc.

Well, for us, there is nothing keeping the sensory message from getting to the spinal cord, it just can't get from the cord to the brain. So when the sensory message gets to the cord, the cord sends the reflex motor message back down, even though the sensory message can't get to the brain.

That's a good thing for us, because it means our bodies can still try to protect themselves even when we don't know there's a problem. For example, I didn't know it but I had an ingrown toenail. I thought everything was fine, but one day I squeezed my big toe and my leg jerked back violently. This was because even though my brain didn't know it, squeezing my toe had caused it pain. I've also had these "protection" mechanisms kick in while showering if the water was either too hot or cold.

When we're first injured though, we have swelling in our cords, which can inhibit reflex actions. That's usually why reflexes seem to disappear and reapper in SCI patients right after injury. So while it's a good sign that swelling is going away, it's not necessarily indicative of any motor return that may occur.

I hope I explained all this thoroughly enough to be helpful without being too technical.

[rooster1005]

GREAT response LizzyB.
I think that was the best answer I have ever seen to reflexes before. Very simply put and easy to read. Wish the doctors would learn to answer that simply.

[laura]

couldn't agree more with rooster1005!

many thanks LizzyB

think i might show this to some medics, if that's ok with you LizzyB?

reading your post to my mum has really helped. thankyou from all of us!

[keps]

LizzyB - I agree with what others have said.

Thank you!

[mttb14]

Lizzy B,

I hope you carry on training as your explanation made a lot of sense to me, which I can pass on to my husband.

He injured his neck 8 years ago and because he damaged the discs which have led to a flattening of part of the spinal cord at C5 and C6, things keep happening to him which we don't understand and no doctors explain. He was never really hospitalised only for a decompression and nothing was explained to us, in fact it was about 5 years before we even new his cord was flattened. We weren't even told that he was on the verge of being quadriplegic before they operated, we discovered that 3 years later in a medical report. We knew he was really struggling to walk and straighten his arms and that they brought forward the decompression operation, but we never really had any explanations about anything.

I wish someone had explained to us, we could never understand why he had so much pain in the tendons behind his knees and in his elbows, which he kept explaining hurt like really bad toothache. No-one explained to us that an incomplete SCI at C5 and C6 cause problems with legs and arms. No-one has explained anything to us properly, until our solicitor sent us by luck to see a spinal rehabilitation expert, he has been marvellous, but he writes his report and it is not until we read it, and then look up things in it, that we have discovered what is going on with John's body.

He suffers from Chronic pain, and when we read the letter to those without chronic pain, it described John's day and injury perfectly. This site and a few others have explained to us many of the things which keep happening to him, which no doctor has even thought to explain to us. We didn't even know what spasms were or that they were caused by SCI until recently, until we were told it was caused by SCI we didn't know where to look for advice or help.

In fairness to the Spinal doctor he has been brilliant, John was showing signs of retention and he insisted John saw a urologist and luckily or unluckily John has now been told that he will have to self catheterise with my help, the UTI part frightens us, but not as much as the autonomic dysreflexia which we keep being told about. Even though John has been admitted to hospital twice with sky igh blood pressure and retention no one thought to link the two things and refer us to a urologist until Dr Baker insisted and told us why 4 years after the first hospitalisation. : angel:

He is a doctor for the compensation claim John is going through, but he emails us and phones us with replies to any questions we may have, thank god the solicitors are paying his bill at the moment. When he was concerned about John not peeing, and having increased blood pressure, the doctor was phoning us at 11 pm. That made us think that the problem with peeing was obviously something to worry about, and was obviously causing problems. We are finally getting some answers, but most of it is due to this site and all of you wonderful people who talk so frankly and truthfully about the situations they find themselves in.

You all post topic which are relevant and when we read them it makes us realise what is linked to the SCI and has given us a real insite, which I think the doctors and hospital should have given us, they write their notes, but have told us very little. At least we can read this site and it gives us an idea of questions we need to ask and shows us what other things to look out for and gives us explanations to things that are happening to John's body that no one else has ever explained to us.

Any way thanks to you all, keep us the answers and questions they are so helpful, it is impossible for a doctor to express or understand a lot of the things SCI causes because they haven't experienced it personally, and they don't have to live with it day and night. John's injury is progressively causing more and more problems and they have said he will have to us a wheel chair shortly, and they think in a few years he will get progressively more and more disabled, but we are trying as hard as we can to keep fighting back against the SCI and trying to keep him as mobile as we can for as long as we can. He like all of you has good days and bad days, but his biggest problem is pain, he has pain in areas of his body that cannot possibly hurting for any reason other than his signals are really confused and he has sensory pain as well as motor pain and whatever the other pain names are.

You are all keeping us sane.

Maria

[benok]

Quote

When we're first injured though, we have swelling in our cords, which can inhibit reflex actions.

Hi lizzy, how long does the inflammation subside. Would it take years. and when it does subside, does it regrow or i mean heal itself. tnx