What does a score of '4' indicate when measuring reflexes?

A score of '4' when measuring reflexes indicates the presence of clonus. In reflex testing, scores are typically assessed on a scale from 0 to 4, where 0 represents no reflex activity and 2 denotes a normal response. When a reflex is rated as '4', it usually reflects an exaggerated or hyperactive response, which is characteristic of clonus. Clonus is defined as a set of rapid, rhythmic contractions and relaxations, typically seen when there is an upper motor neuron lesion. Observing clonus is significant in a clinical setting, as it can point towards neurological issues such as a central nervous system dysfunction or upper motor neuron damage. Hence, the score of '4' is an important clinical finding that indicates a heightened level of reflex activity.