Hyperreflexia
- Hyperreflexia is a classic sign of UMN disease but can be seen in other conditions such as thyrotoxicosis.
- Hyperreflexia in one limb or in lower but not upper extremities can help localize lesions.
Patient 1:
This is an older man who presented with progressive paresthesias of the hands and difficulty walking. He was diagnosed with severe cervical myelopathy from degenerative joint disease.
This patient also has a positive Hoffmann’s sign and a spastic gait.
Patient 2:
A healthy student with no complaints with diffuse hyperreflexia. Medial Hamstring reflex assesses the L5 myotome, while the patellar is L4 and the Achilles is S1
Patellar Reflex
Medial Hamstring Reflex
Patient 3:
This is a middle-aged man with cervical myelopathy from severe cervical stenosis.
Patient 4:
This is a young man with neurosarcoidosis with right-sided brain lesions corresponding to left-sided hyperreflexia and clonus.
Patient 5:
This is a middle-aged female with cervical myelopathy resulting in hyperreflexia (including spread to adjacent muscles) and Hoffman’s sign.