Overlooked Holmes’ clinical signs: reevaluation by recent physiological findings

摘要

Holmes proposed not only the term ataxia, but also opposite clinical signs related to muscle recruitment, which have escaped clinical attention; ( 1 ) asthenia , representing delay in initiating muscle contraction and slowness in attaining exertion of full power, and ( 2 ) adventitiousness , representing adventitious movements. Recent physiological studies have shown that cerebellar outputs are modified by release or facilitation of Purkinje cell-mediated inhibition on dentate neurons. We believe that asthenia and adventitiousness, which correlate with deficits in the control of disinhibition and inhibition, respectively, deserve more attention in clinical examination.