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.