Muscles & Reflexes At time of diagnosis Before pregnancy During pregnancy Post-partum L R L R L R L R Upper limb                 Elbow extension 5 5 5 5 4 4 5 5 Elbow flexion 5 5 5 4 5 4 5 4 Wrist flexion 5 4 5 4 4 4 5 4 Wrist extension 5 4 5 4 4 4 5 4 Adduction thumb 5 4 5 4 4 4 5 4 Abduction thumb 4 4 4 4 4 4 4 4 Lower limb                 Foot plantar flexion 5 5 5 5 5 5 5 5 Foot dorsal flexion 5 5 5 5 4 4 5 5 Reflexes                 Biceps normal absent normal absent normal absent normal absent Triceps normal absent normal absent absent absent normal absent Achilles normal absent absent absent absent absent absent absent Muscle strength measured in MRC grade. MRC: Medical Research Council ranging from 0 (=no movement, no contraction) to 5 (=normal)

Table 1: Neurological examination at time of diagnosis, before pregnancy, during pregnancy and post-partum.