Top Tweets for #Clonus

Serotonin Syndrome - Working in consultation-liaison psychiatry, I’ve seen ankle clonus as the overt presentation of serotonin toxicity. But another important learning point is that the absence of ankle clonus does not exclude serotonin toxicity. I’ve had ED clinician say, “There’s no ankle clonus.” Thankfully not but that does not mean there is no evolving serotonin toxicity. It is better understood as a spectrum of serotonergic hyperexcitability, and milder presentations may be much less dramatic. The task is to look for the pattern 1/ serotonergic medication / recent dose/interaction change 2/ hyperreflexia, tremor, inducible or ocular clonus, myoclonus, agitation, diaphoresis, tachycardia and a rising temperature. The Hunter criteria can also be met with tremor + hyperreflexia, without ankle clonus. 👇