On physical examination, findings were clear mind, slower verbal reaction, slightly dull, the tongue to the right, limb muscle strength of grade 5, hypermyotonia
, hyperreflexia, tendon hyperreflexia, bilateral symmetry for sense of depth, and bilateral Babinski syndrome (+).
It has been found mainly in children and may accompany mild trauma, upper respiratory infection, a damaged joint capsule and ligament, or hypermyotonia
Factors such as types of muscle state (e.g., atony or hypermyotonia
), phases of stroke (chronic, acute, or subacute), and levels of stroke (from mild to severe stroke) should all be taken into consideration for individualized treatment .
With disease progression, she developed obvious expressionless face, bradykinesia, marked rigidity, and hypermyotonia
in her extremities.
Our examination revealed hypermyotonia
accompanied with hyperpigmentation of the limbs.
Among the 57 PD patients who reported pain, 37 cases were PD-related pain (64.91%) (Figure 1): skeletal muscle pain in six cases, dystonia pain in 31 cases (hypermyotonia
and/or reverse position), arthralgia in one case (no joint image changes), testicular pain in one case, headache in one case, and unexplained systemic unbearable pain in one case, which are considered central pain; the remaining 20 cases were non-PD-related pain (35.09%): psychogenic pain in 12 cases (60%), radicular pain in six cases, peripheral neuropathic pain in one case, and arthritis-caused joint pain in one case (Figure 2).