REFLEXES THE CODES OF NEUROLOGY

reflexesneurologytaskindumankapak21432

REFLEX EXAMINATION: PHYSIOLOGICAL AND PATHOLOGICAL FINDINGS

Aydan Köysüren

Kırşehir Ahi Evran University, Faculty of Medicine, Department of Neurology, Kırşehir, Türkiye

Köysüren A. Reflex Examination: Physiological and Pathological Findings. In: Duman T, editor. Reflexes The Codes of Neurology. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.43-57.

ABSTRACT

Reflex assessment provides objective data in neurological examination and allows the evaluation of disoriented or comatose patients as it is less dependent on the patient’s attention, cooperation or cognitive abilities.

A normal tendon reflex indicates proper functioning of the reflex arc and its regulating suprasegmental circuits. Disruption in these structures can lead to an abnormal reflex response . The examination of superficial and muscle stretch reflexes has the same purpose of differentiating upper motor neuron lesions from lower motor neuron lesions, though there are minor differences in examination and evaluation. Muscle stretch reflexes are reduced or absent in lower motor neuron involvement and hyperactive in upper motor neuron involvement, while superficial reflexes are diminished or absent in both cases.

Although various techniques are used in reflex examination, as a general principle, it is important to consider factors related to both patients and examiners, such as the selection and utilization of the reflex hammer, reinforcement maneuvers, observation of the reflex response, and appropriate positioning.

Reflexes are usually evaluated by comparing the right and left sides of the body or the lower and upper extremities. While the reflex examination constitutes a critical element of the neurologic assessment, it represents merely one aspect of the overall evaluation and should be interpreted in conjunction with other clinical findings.

Keywords: Reflex examination; Deep tendon reflexes; Superficial reflexes; Reflex grading; Reinforcement; hungup reflex; Inverted reflex; Penduler reflex

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