Document Detail

Foot-dipping in coma: a physical sign indicative of evolving herniation.
MedLine Citation:
PMID:  20664269     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Intermittent spontaneous recurrent foot movement characterized by sudden ankle dorsiflexion followed by slower relaxation, termed foot-dipping (FD), may occur in coma. The clinical significance of this easily overlooked sign is unknown.
METHODS: Twenty-three cases were identified by a single observer over a 10-year period of predominant inpatient neurologic care. Details of neurologic examination, clinical outcome, and CT and/or MRI findings were collected and analyzed.
RESULTS: All 23 patients presented with either an acute supratentorial vascular lesion accompanied by a midline brain shift (Group I, 12 cases) or a primary brainstem or cerebellar insult (Group II, 11 cases). FD in Group I patients was observed transiently only during evolving transtentorial herniation manifested by coma and partial brainstem areflexia.
CONCLUSION: The onset of FD in patients with acute supratentorial vascular lesion is indicative of a transtentorial herniation with secondary brainstem encroachment.
Gregory Youngnam Chang
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Publication Detail:
Type:  Journal Article     Date:  2010-07-27
Journal Detail:
Title:  European neurology     Volume:  64     ISSN:  1421-9913     ISO Abbreviation:  Eur. Neurol.     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-03     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150760     Medline TA:  Eur Neurol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  145-7     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 S. Karger AG, Basel.
Department of Neurology, University of California at Irvine Medical Center, Orange, Calif., USA.
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MeSH Terms
Aged, 80 and over
Coma / complications*,  pathology
Databases, Factual / statistics & numerical data
Foot / physiopathology*
Hernia / etiology*
Magnetic Resonance Imaging / methods
Middle Aged
Movement Disorders / complications*
Neurologic Examination / methods
Tomography, X-Ray Computed / methods
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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