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Abduction finger sign: A new sign to detect unilateral functional paralysis of the upper limb

Authors

  • Michele Tinazzi,

    1. Dipartimento di Scienze Neurologiche e della Visione, Università di Verona, Italy
    2. Unità Operativa di Neurologia Ospedale Civile Borgo Trento, Verona, Italy
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  • Sara Simonetto,

    1. Dipartimento di Scienze Neurologiche e della Visione, Università di Verona, Italy
    2. Unità Operativa di Neurologia Ospedale Civile Borgo Trento, Verona, Italy
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  • Laura Franco,

    1. Dipartimento di Scienze Neurologiche e della Visione, Università di Verona, Italy
    2. Unità Operativa di Neurologia Ospedale Civile Borgo Trento, Verona, Italy
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  • Kailash P. Bhatia,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom
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  • Giuseppe Moretto,

    1. Unità Operativa di Neurologia Ospedale Civile Borgo Trento, Verona, Italy
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  • Antonio Fiaschi,

    1. Dipartimento di Scienze Neurologiche e della Visione, Università di Verona, Italy
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  • Cristina Deluca

    Corresponding author
    1. Dipartimento di Scienze Neurologiche e della Visione, Università di Verona, Italy
    2. Unità Operativa di Neurologia Ospedale Civile Borgo Trento, Verona, Italy
    • Dipartimento di Scienze Neurologiche e della Visione, Università di Verona, Piazzale Scuro 9, 37134 Verona, Italy
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  • Potential conflict of interest: None reported.

Abstract

Objective of this study is testing a new sign to differentiate functional from organic paralysis of the arm. Thirty-six healthy subjects, ten patients with acute functional paralysis of one arm and eleven patients with acute organic paralysis of one arm were enrolled. The test consisted of abduction finger movements of one hand against resistance with a maximal sustained contraction to detect synkinetic abduction finger movements of the contralateral hand. For both hands, contralateral hand synkinesias were observed in healthy subjects. The task performed with the unaffected hand evoked synkinesias of the presumed affected hand in functional patients, but did not evoke synkinesias of the affected hand in organic patients. The abduction finger test had 100% sensitivity and specificity in distinguishing functional from organic paralysis of the upper limb in this cohort of patients. The abduction finger sign may be a reliable bedside test to discriminate functional from organic arm paralysis. © 2008 Movement Disorder Society

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