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.