Clinical examination:
(1) motor weakness (motor deficit)
(2) muscle wasting
(3) sensory loss
(4) tendon reflexes
Motor weakness is scored from 0 (no strength) to 5 (normal). The precise scale for scoring is not described; for the implementation I will use the MRC scale for muscle power.
|
Muscle Strength
|
Scale
|
|
no contractions
|
0
|
|
flicker or trace of contractures
|
1
|
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active movement with gravity eliminated
|
2
|
|
active movement against gravity (but not resistance)
|
3
|
|
active movement against gravity and resistance
|
4
|
|
normal power
|
5
|
If the muscle weakness is asymmetric, then the more affected side is graded.
For a cooperative patient 6 muscle groups are evaluated:
(1) deltoid
(2) biceps
(3) wrist
(4) iliopsoas
(5) quadriceps
(6) foot
For an uncooperative (not able to cooperate) patient 2 muscle groups are evaluated:
(1) flexion at the elbow
(2) flexion in the hip
motor sumscore =
= SUM(points for all motor groups evaluated)
Tendon reflexes are described based on the global assessment:
(1) increased
(2) normal
(3) decreased
(4) absent
The authors also performed electrophysiologic testing, which will be included in the next section.
Interpretation:
• minimum motor sumscore: 0
• maximum motor sumscore for a cooperative patient: 30
• maximum motor sumscore for an uncooperative/unconscious patient: 10
