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The presence of pronator drift is a sign of upper motor neurone disease. The patient is asked to hold both arms fully extended at shoulder level in front of him, with the palms upwards. It is a way of eliciting relatively mild spasticity. The upper motor neurone weakness may be revealed by a tendency to pronate the forearm on the affected side when the eyes are closed. This is caused by a difference in the muscular tone between pronation and supination.
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