0
Article |

The Distance Shortening Phenomenon or the Lazy Arm Sign as a Subtle Pyramidal Sign

Lea Pollak, MD; Colin Klein, MD; Jose-Martin Rabey, MD
Arch Neurol. 1997;54(8):935-935. doi:10.1001/archneur.1997.00550200005001
Text Size: A A A
Published online

We noticed that in patients with pyramidal lesion, the distance between the finger and nose on repeated finger-nose testing shortens progressively in the paretic hand. The shortening of distance is also present in those patients in whom, on routine neurological examination, no obvious weakness, pronation drift, or changes in tone and reflexes can be found.

The patients set u the starting point of the finger at a progressively shorter distance from the nose, despite the efforts of the examiner to correct the shortening. This shortening or lazy arm phenomenon can be explained by primary affection of the extensor muscles in upper limbs by a corticospinal lesion, resulting in the tendency to flexion and pronation of the elbow.1-4 The increased tone of the elbow flexors and pronators acts as an agonist during finger-nose touching, and as an antagonist on rendering of the finger to its primary position, thus causing a

REFERENCES

Wartenberg R. Diagnostic Tests in Neurology . Chicago, Ill: Year Book Medical Publishers Inc; 1953;:101-120.
Clinical Examinations in Neurology by Members of the Department of Neurology and the Department of Physiology and Biophysics, Mayo Clinic, University of Minnesota, Rochester . 5th ed. Philadelphia, Pa: WB Saunders Co; 1981;:103-108.
De Jong S. The Neurologic Examination . 5th ed. Philadelphia, Pa: JB Lippincott; 1992;:316-319.
Adams RD, Victor M, Ropper AH. Principles of Neurology . 6th ed. New York, NY: McGraw-Hill Book Co; 1997;:45-63.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Wartenberg R. Diagnostic Tests in Neurology . Chicago, Ill: Year Book Medical Publishers Inc; 1953;:101-120.
Clinical Examinations in Neurology by Members of the Department of Neurology and the Department of Physiology and Biophysics, Mayo Clinic, University of Minnesota, Rochester . 5th ed. Philadelphia, Pa: WB Saunders Co; 1981;:103-108.
De Jong S. The Neurologic Examination . 5th ed. Philadelphia, Pa: JB Lippincott; 1992;:316-319.
Adams RD, Victor M, Ropper AH. Principles of Neurology . 6th ed. New York, NY: McGraw-Hill Book Co; 1997;:45-63.

Correspondence

CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.