Showing posts with label Milkmaid Grip. Show all posts
Showing posts with label Milkmaid Grip. Show all posts

Thursday, January 22, 2015

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