Thijs R D, Notermans N C, Wokke J H, van der Graaf Y, van Gijn J
Department of Neurology, University Hospital Utrecht, The Netherlands.
J Neurol Neurosurg Psychiatry. 1998 Nov;65(5):794-6. doi: 10.1136/jnnp.65.5.794.
According to the established clinical tradition about the distribution of weakness, the ratios of flexor/extensor strength of patients with upper motor neuron lesions are expected to be relatively high for the elbow and wrist and low for the knee. To assess the diagnostic value of these patterns of weakness, muscle strength of 70 patients with limb weakness of central or peripheral origin was measured with a hand held dynamometer. The ratios of flexor/extensor strength at the knee, elbow, and wrist did not differ significantly between patients with central or peripheral origin of muscle weakness. The examination of tendon jerks proved to be of more value as a localising feature. The traditional notion about the distribution of weakness in upper motor neuron lesions may be explained by an intrinsically greater strength in antigravity muscles, together with the effects of hypertonia.
根据关于肌无力分布的既定临床传统，上运动神经元损伤患者的肘和腕屈肌/伸肌力量比预计相对较高，而膝部则较低。为评估这些肌无力模式的诊断价值，使用手持测力计测量了70例中枢性或周围性肢体肌无力患者的肌肉力量。肌无力起源于中枢或周围的患者，其膝、肘和腕部的屈肌/伸肌力量比无显著差异。事实证明，检查腱反射作为定位特征更有价值。上运动神经元损伤中肌无力分布的传统观念，可能是由于抗重力肌本身力量较大，以及张力亢进的影响。
