Fig. 39.3
 Time course of inhibition of the forearm flexor H-reflex by a single motor threshold conditioning stimulus applied at t = 0 msec to the radial nerve. The timing of the test stimulus to the median nerve at the elbow after the radial nerve shock is given on the x-axis. The first two phases of inhibition can be seen on the average (AV) curve from 10 normal subjects (mean ± SE) at 0–1 msec and 10–40 msec. Only the first phase of inhibition is evident in the patient with simple writer's cramp (Mrs S).

Time course of inhibition of the forearm flexor H-reflex by a single motor threshold conditioning stimulus applied at t = 0 msec to the radial nerve. The timing of the test stimulus to the median nerve at the elbow after the radial nerve shock is given on the x-axis. The first two phases of inhibition can be seen on the average (AV) curve from 10 normal subjects (mean ± SE) at 0–1 msec and 10–40 msec. Only the first phase of inhibition is evident in the patient with simple writer's cramp (Mrs S).

Reproduced with permission from Sheehy MP, Rothwell JC, Marsden CD. Writer's cramp. In: Advances in Neurology: Dystonia 2. Eds. Fahn S, Marsden CD, Calne DB. Raven Press, 1988; 50:457–472. © Lippincott Williams & Wilkins.
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