Milkmaid Grip

Milkmaid Grip

Milk maids grip is appreciated as an alternating squeezing and releasing of the finger like a milking motion, when asked to maintain a constant, firm grip of examiner's fingers, probably caused by combination of chorea and motor impersistence.

Inability to apply steady pressure during handshake leading to a characteristic squeeze and release of grip has been termed the milkmaid's grip. 

Similarly, patients have difficulty maintaining forced eyelid closure or sustained tongue protrusion. 

Huntington's disease is a progressive neurodegenerative trinucleotide repeat (CAG) disorder characterized by chorea, psychiatric disturbances, oculomotor dysfunction and cognitive decline. 

Motor exam often shows difficulty with fine motor skills and motor impersistence - the inability to maintain sustained voluntary contraction of a muscle group at a constant level. Motor impersistence occurs independently of chorea and has been shown to be linearly progressive over the course of disease suggesting a potential role as a surrogate marker of disease progression.

Also a finding typical of Sydenham’schorea, one of the Jones’ major criteria for diagnosing rheumatic fever