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Tone testing

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During the testing for tone in the neurological examination of the upper limb, the examiner should seek to answer the following questions:

  • is there increased tone?
  • if there is increased tone, is it clasp knife ie spastic hypertonicity, or is it lead pipe - ie parkinsonian?
  • is there decreased tone? This is very hard to judge without a great deal of clinical experience.
  • is there cog wheeling?

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