REFLEXES THE CODES OF NEUROLOGY

reflexesneurologytaskindumankapak21432

EXAMPLES OF REFLEX CHANGES IDENTIFIED IN DISEASES

Dursun Ceylan

Kütahya Health Sciences University, Faculty of Medicine, Department of Neurology, Kütahya, Türkiye

Ceylan D. Examples of Reflex Changes Identified in Diseases. In: Duman T, editor. Reflexes The Codes of Neurology. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.243-253.

ABSTRACT

As in all diseases, history and physical examination are the most important factors in making the correct diagnosis despite all innovations.

Cerebrovascular Diseases: Acute Period: During this period, patients have flaccid paralysis. In the following period, spasticity is seen to emerge. Subacute Period: Increases in deep tendon reflexes may be observed during this period. Chronic Period: It is observed that primitive reflexes also occur in stroke cases where cerebral involvement is intense and especially the frontal lobes are affected.

Parkinson’s Disease: Increased deep tendon reflexes and hyperreflexia may be observed in the clinical follow-up of these patients. There are also studies showing that primitive reflexes are also seen in Parkinson’s patients.

Demans: In patients with upper motor neuron involvement, hyperreflexia, extensor plantar response, spasticity or pyramidal weakness can be seen in pathological processes. Another reflex change seen in dementia patients is primitive reflexes.

Medulla Spinal Cord Diseases: Spinal Cord Injuries: Spinal shock is observed in patients after spinal cord injuries. Spinal shock is defined as loss of motor and sensory function below the level of injury, loss of deep tendon reflexes and absence of sphincter reflexes. Autonomic dysreflexia is defined as baroreceptor-mediated bradycardia occurring at T6 or above, which controls blood pressure, and hypertension caused by sympathetic reflexes below the level of injury.

Peripheral Neuropathies: Neurologic examination reveals absence of distal reflexes, absence of vibration sensation and distal paresthetic complaints in the extremities.

Neurodegenerative Diseases: Multiple Sclerosis (MS): Since it is a disease group in which the central nervous system is affected, hyperreflexia and pathologic reflexes can be seen in neurological examination (Babinski and hoffman sign). Due to lesions involving the brain stem, decreased swallowing and gAg reflexes may be observed. Amyotrophic Lateral Sclerosis (ALS): hyperreflexia and spasticity are the main neurologic examination findings in this disease. Pathological reflexes are also observed in patients with upper motor neuron involvement. Huntington’s Disease: hyperreflexia and hypotonia are early signs of the disease.

Conclusion; Performing a complete neurological examination in all patient groups and recognizing the reflex changes correctly prevents wasting time in the diagnosis of the disease. This will also ensure that effective treatment can be given on time.

Keywords: Reflexes; Cerebrovascular disorders; Parkinson disease; Dementia; Spinal cord injuries

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