Dangling Hand Symptom

The "dangling hand" symptom is one of the most characteristic signs of Sydenham's chorea. This symptom is associated with a hypotonic state of the muscles and manifests itself in an excessive amplitude of passive movements of the wrist and hand when the doctor examines the patient’s forearm.

To diagnose chorea, it is important to pay attention to this manifestation,

Dangling hand symptom This is a pathognomonic symptom of Hutchinson's chorea.

This symptom is characterized by the appearance of excessive movement of the lower limb with its accidental, voluntary and untimely contraction. This movement cannot be controlled. The lower limb continues to maintain increasing movement due to inertia. According to the development mechanism, it is related to the activity of intramuscular polysynaptic neurons (Ia + b). Their impulses through rubrospinal interneurons (trunk interneurons) are switched to synergists (a motor neuron plus all other motor neurons of a given segment of the peripheral nerve).

The cause of the symptom: disruption of the conduction of excitation along nerve fibers. This is manifested by 4 types of hyperactivity of polysynaptic transmission in corticonuclear, pyramidal and extrapyramidal synapses. In the fourth type, the neurophysiological phenomenon is a periodic increase in action potentials up to 60 mV instead of the usual 40 mV. As a result, spontaneous muscle contractions occur, as well as increased contractions with accompanying nerve impulses. The latter, together with non-contracting muscles, is called automatic activity. Asynchronized and unrhythmic abduction and abduction of the hips leads to pathological straightening of the legs and develops the symptom of a loose pelvis (pelvic symptom) and the feeling of a heavy load in the legs. Thus, choreography for children includes oscillations of the arms, with the torso tilting forward, during which