Functional hemiparesis: clinical signs
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Functional hemiparesis: clinical signs. The subject is kept supine. Fully referenced neurology checklist.
Hoover’s sign
- The subject is kept supine
- Hip flexion on the normal side is tested against resistance
- The expected hip extension on the abnormal side is absent
The abduction finger sign
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The Spinal Injuries Centre test
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Give-way weakness
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The co-contraction sign
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Absence of pronator drift
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The Barré test
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Absence of platysma sign
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The Babinski trunk-thigh test
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The arm drop (hand strike) sign
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Hysterical tongue spasm
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The abductor sign
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The elbow flex-ex sign
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The inverse pyramidal leg weakness sign
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References
- Daum C, Hubschmid M, Aybek S. The value of ‘positive’ clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review. JNNP 2014; 85:180-190.
- Stone J, Warlow C, Sharpe M. The symptom of functional weakness: a controlled study of 107 patients. Brain 2010; 133:1537-1551.
- Daum C, Aybek S. Validity of the “Drift without pronation” sign in conversion disorder. BMC Neurol 2013; 13:31.
- Sonoo M. Abductor sign: a reliable new sign to detect unilateral non-organic paresis of the lower limb. JNNP 2004; 75:121-125.
- Lombardi TL, Barton E, Wang J, et al. The elbow flex-ex: a new sign to detect unilateral upper extremity non-organic paresis. JNNP 2014; 85:165-167.
