Functional Neurological Disorders & Stroke Mimics: Hoover Sign

#HooverSign #Neuroexam #strokeMimic #psychogenic #nonorganic #functionalneurologicaldisorders
#FND
* In the video, during testing patients, when the black box appears at the bottom of the video, the label reads "Positive" in the absence of Hoover sign. It is blurred out now, but that was a mistake. Hoover sign detects functional neurological disorders (FNDs), therefore, for the purpose of this video it is positive when it detects FNDs (when the affected leg exerts a force on examiner's hand)
Hoover sign is used to differentiate between the organic and functional weakness of pyramidal origin. In this video the Hoover's Test was done on a stroke patient and a suspected stroke patient with nonspecific hemiparesis.
Further reading: strokesciences...

[@meghachalageri2646]

Most accurate and non confusing of all the videos on Hoover's sign

[@StrokeSciences]

thank you

[@sergioalfonsodiasvaldez3830]

Agree😂!

[@luciendanvers7596]

This was the best demonstration of Hoover's sign I could find. Thanks for including the stats and references. How often do you use it at bedside? and do you think functional neurological disorders could also have organic origins?

[@alihamzeh4788]

In the fist patient, the doctor should have held the left heel (healthy leg) of the patient to feel if the there is push down force exerted, to counter balance the attempt of raising the affected leg ( by doing that you can know if the effort is genuine or not ).

[@livinghell3]

i think the video is most accurate. but at the beginning of the video it is said Hoover's sign is positive in non organic or functional conditions but in video of organic paralysis it is shown hoover is positive whereas in non organic it is shown Hoover's sign is negative. This is confusing !!. Can you clarify on that ?

[@StrokeSciences]

Oops! you are right. That is a mistake. Hoover sign detects functional neurological disorders (FNDs), therefore, it is positive when it detects FNDs!

[@LdyChatterleysPlover]

@@StrokeSciences This mistake is common when describing the result of a test as 'positive' or 'negative'. Better to say 'Hoover's test suggests organic disease', or Hoover's test suggests functional weakness'. Thanks for the useful video.

[@chimenumwodu2488]

Thanks for this short video.
I however find your explanation of procedure (displayed test with references at the beginning of the video) a little bit confusing.....a patient with hemiparesis from organic origin will not exert pressure on the physician's hand placed under the heels of the unaffected (should rather be "affected") foot.

[@M-pk5qn]

If Hoover sign is indicating more of a non organic cause of paralysis as shown in the last demonstration, then is that not a POSITIVE Hoover sign rather than negative?

[@bekahtaylor9658]

This is very useful, thank you for uploading!

[@StrokeSciences]

Glad it was helpful!

[@rhcorr]

This was very useful!

[@StrokeSciences]

Glad it was helpful!

[@tendaiphiri3062]

What if the patient has a severe back injury, neuropathy or previous back surgeries? Would that have an affect on the results of the test?

[@cometaire1]

Excellent! Thank you so much🌟

[@StrokeSciences]

pleasure

[@halahasson1588]

Thank you
Very helpful 🌷🌷

[@StrokeSciences]

You're welcome 😊

[@yohanegadama3505]

Thanks for this simple, and straight forward video. I however find the interpretation of the 2nd patient confusing. You say she has a negative Hoover's sign, yet there was clear exertion of force downward on the weak leg on hip flexion of the contralateral leg. Is this consistent?

[@StrokeSciences]

You are correct. I have added some comments in the comment box. The assumption is that Hoover detects functional neurological disorders, so it should be positive when findings supports FND diagnosis, therefore the second patient should have been labelled as positive Hoover, but by error the label reads positive.

[@chimenumwodu2488]

I agree with your observations. Shouldn't it rather be positive?

[@kashmalawaqas2350]

heel of the affected foot*