Holmes rebound phenomenon

Holmes Rebound Phenomenon

The Holmes rebound phenomenon is a neurological sign that is observed during a clinical examination. It is named after the British neurologist Gordon Holmes, who first described it. This phenomenon is used to assess the integrity of the cerebellum and its connections.

Description

The Holmes rebound phenomenon is elicited during a neurological examination by asking the patient to flex their arm against resistance. The examiner then suddenly removes the resistance, and the patient's arm should stop at the intended position without overshooting. In a normal response, the cerebellum coordinates the movement to prevent the arm from moving too far. However, in the presence of cerebellar dysfunction, the arm may overshoot the intended position, demonstrating the rebound phenomenon.

Clinical Significance

The presence of the Holmes rebound phenomenon can indicate cerebellar ataxia or other forms of cerebellar dysfunction. It is often used in conjunction with other tests to assess cerebellar function, such as the Romberg test and the finger-to-nose test.

Associated Conditions

The Holmes rebound phenomenon may be observed in various conditions that affect the cerebellum, including:

• Cerebellar stroke
• Multiple sclerosis
• Cerebellar degeneration
• Friedreich's ataxia

Examination Technique

To test for the Holmes rebound phenomenon, the examiner should:

1. Ask the patient to flex their elbow and hold their forearm in a horizontal position. 2. Apply resistance to the patient's forearm, instructing them to maintain the position. 3. Suddenly release the resistance and observe the movement of the patient's arm.

A normal response is for the arm to stop at the intended position without overshooting. An abnormal response, indicating the rebound phenomenon, is when the arm overshoots the intended position.

History

The phenomenon was first described by Gordon Holmes in the early 20th century. Holmes was a pioneering neurologist who made significant contributions to the understanding of the cerebellum and its functions.

See Also

• Cerebellum
• Neurological examination
• Cerebellar ataxia