The Clonus Horror

Hello, Apoplectics!  Today’s post comes to you from Gallifrey.  Not the home planet of Doctor Who, but the convention celebrating him in Los Angeles.  I didn’t expect to be here four months ago!  There will be a full report on Monday, I’m sure.  Well, full-ish.  Days before our departure, there had already been a specific request from a reader to exclude any discussion of The Mile High Club, so I’ll only mention this link, which suggests that the Brits are the most likely nationality to be members of the club.  I was hoping to read that William Hartnell, who played the first incarnation of the Time Lord and is well-known among Whovians for the “Billy-fluff”, or muffed line, might have had a stroke.  Unfortunately, it seems the cause of his problems was arteriosclerosis, or a stiffening of the arteries.  So, in the absence of a Whovian Whook (geddit?!)….

Wish you were here!

I’m sure you’re all aware of the idea of the doctor (not that one) doing his or her rounds in the hospital wards, checking out the patients.  Even if you haven’t been the subject of such rounds yourself,  the phenomenon has passed into popular culture, whereby Doctor Basil Exposition drops in upon our hero (or his tragically afflicted wife or offspring) and gives him a quick summary of the injuries and prognosis.

“He’s stolen your “Basil Exposition” thing, Dr. K!”
“I know. Shall we feed him to the sharks, Mrs. Whiskers?”

The rounds during my stay at Rusk were mostly predictable.  The usual questions to check on brain function (Where are you?  Why are you here?  What day is it? What’s your name?  Where are your papers?  WO SIND IHRE PAPIERE?!!!)  Checks on reflexes and sensation.  Checks of comparative strength on the left and right sides.  However, there was one test that I was always a little curious about.  The doctor (again, not that one) would take my hand, and flick back a finger above the top knuckle.  Each time I asked (because I never could remember) I was told that this was a test for clonus, although I wasn’t sure what that was.

I mention clonus, because the other night Beth was concerned that, shortly after falling asleep, I was having a fit.  It was, in fact, a bout of clonus.  Clonus (from the Greek for “violent, confused motion”; did the Greeks really have a particular word for that?  That’s great!) refers to a series of “involuntary, rhythmic, muscular contractions and relaxations“.  In this case, it’s kind of a form of “the shakes”, but with larger motions.  It’s a sign of certain neurological conditions, particularly associated with upper motor neuron lesions (I assume this is where I come in) involving descending motor pathways.  For some weeks now, particularly upon waking, I’ve sometimes felt a tension in my left leg, and if I flex in the right way, can generate a good old shake.  It’s quite satisfying; it’s the new uncontrolled crying!  A coughing fit will generate a similar response in my left arm.  Although Beth was familiar with the leg shake, the nighttime “fit” was quite disturbing; she was concerned it was some sort of neurological event.  Which, as it turns out, it was.

As for how disturbing that would be for an onlooker, take a look at this video:  (youtube link)

That would be a bit freaky to witness, right enough.  A bit Exorcist-y again, in fact.   I’m beginning to think that there might be a story in the idea of someone who shows all the symptoms of a stroke, but turns out to be possessed.  It’s less entertaining than the other idea I have about a person who deliberately tries to bring one on.  But that’s quite literally another story.  Anyway, if that’s not bad enough, here’s a message board account from someone who “had a stroke (blow out from high blood pressure) eleven years ago“.

It’s not Never Let Me Go

As someone mentions below the line, “[n]o faking that orgasm any more….  My husband can tell every time.”

Perhaps the most unsettling aspect of this fit is that, over four months after The Event (never mind eleven years), I’m still experiencing new symptoms.  Similarly, in recent weeks, I’ve been feeling “nervy” or “tingling” sensations in my left arm and, occasionally, leg.  That was more easily dismissed, though, as a good sign relating to the return of sensation while I barreled on with outpatient physical rehab.  On a related front, another commenter on the message board post mentions that their “clonus appears reduced when riding stationary bike and at orgasm.  Possibly brain still reorganizing, but more likely rehab is shifting balance of power to my voluntary control.  PT [physical therapist] suggested working through clonus rather than avoiding it.”

I’m optimistic that, with increasing strength, my brain may rewire, and ongoing incidents of clonus can be avoided.   The “fit” occurred after a particularly strenuous day of physical rehab.  Not sure if this will be helpful when I’m asleep, though.  Apparently, the other popular remedial step is to make use of botox injections.  However, notwithstanding the good anecdotal reports I’m hearing about botox from other stroke survivors, I’ve read enough horror stories (thanks, Vanity Fair!) to be happy enough to avoid injections of botulism toxin (!) while the clonus isn’t too frequent.  Apparently botox injections can be measured in the number of mice they can kill!

Don’t panic!

I’d be interested to know how any other stroke survivors have been affected by late-occurring symptoms and how botox treatments have worked out.  As always, comments are welcome, so feel free to jump in below the line.

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4 thoughts on “The Clonus Horror

  1. I happened upon your site after googling the word “clonus”. I was interested in the term because I suffered an ischemic stroke 3 1/2 years ago and it scared the hell out of wife on those occasional nights when my entire body goes into some kind of clonus fit. She’d gotten used to my leg spasms which are typically a nightly occurrence but every once in a while the whole body seizes up and I get the Hippie Hippie Shakes. It’s like someone plugged me into a 480 V 4 amp circuit.

    The good news is you can train yourself to relax your muscles and stop the spasms almost immediately. The bad news, for me anyway, that I went through this thing hundred times until I finally figured out how to stop it. And as you well know it’s a lousy way to wake up.

    So stay positive and work with what you got and things will continue to improve.

    1. Hi, Steve. And thanks for your thoughtful comment. I have to admit that while I kind of enjoyed my leg shakes, Beth, like your wife, would get pretty freaked out by them. It was enough of a concern, and my doctors were (rightly) sufficiently conservative, to have me sent off for an ambulatory EEG (more here and here)

      In the end the results of the test were sufficiently unremarkable that the hospital didn’t even report back before the whirlwind of preparations surrounding our move to Scotland started, but the shakes stopped. The best theory seems to be that I was suffering from a combination of muscle atrophy and hyper-reflexiveness. Building up the strength in my leg turned out to be the best solution for me. I kind of miss the odd satisfaction of a good shake in the morning, but this is probably better for everyone.

      Lovely to have you, and if you’d like to keep up with, you can sign up for notifications at this link, or follow me on twitter. There’s a button around here somewhere in the bottom right…

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