Premium
Utility of the H‐reflex in diagnosing polyneuropathy
Author(s) -
Teigland Oda H.,
Pugdahl Kirsten,
FuglsangFrederiksen Anders,
Tankisi Hatice
Publication year - 2019
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26639
Subject(s) - reflex , h reflex , ankle jerk reflex , medicine , polyneuropathy , gold standard (test) , anesthesia , nerve conduction
Abstract Introduction An absent Hoffman (H)‐reflex, the electrophysiological equivalent of the Achilles reflex, is assumed to be one of the first detectable signs of polyneuropathy (PNP). In this study we compare the H‐ and Achilles reflexes in patients with suspected PNP to evaluate the diagnostic utility of the H‐reflex. Methods Data from clinical examination and nerve conduction studies (NCS) were analyzed in patients with suspected PNP. Results The PNP diagnosis was confirmed by follow‐up in 209 patients. The sensitivities of the H‐ and Achilles reflexes were similar (70.3% vs 71.8%), whereas the H‐reflex had higher specificity (85.2% vs 70.5%) ( P < .001). Adding H‐reflex to the NCS protocol increased the diagnostic sensitivity from 80.9% to 87.6%. Discussion The H‐reflex is a sensitive method that could provide added value to standard NCS in PNP diagnosis. The simplicity and high specificity make it superior to its clinical equivalent, the Achilles reflex.