Utility of the H‐reflex in diagnosing polyneuropathy

• Published in: Muscle & nerve Vol. 60; no. 4; pp. 424 - 428
• Main Authors: Teigland, Oda H., Pugdahl, Kirsten, Fuglsang‐Frederiksen, Anders, Tankisi, Hatice
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.10.2019; Wiley Subscription Services, Inc
• Subjects: Achilles reflex; Achilles Tendon - physiopathology; Adult; Aged; Diagnosis; Diagnostic systems; Electrodiagnosis; Equivalence; Female; H-Reflex - physiology; Hoffman reflex; Humans; Male; Medical diagnosis; Middle Aged; Nerve conduction; nerve conduction studies; Neural Conduction - physiology; Polyneuropathies - diagnosis; Polyneuropathies - physiopathology; Polyneuropathy; Reflex, Abnormal - physiology; Reflex, Stretch - physiology; Reflexes; Sensitivity; Sensitivity and Specificity; diagnosis; Hoffman reflex; Achilles reflex; polyneuropathy; nerve conduction studies
• ISSN: 0148-639X; 1097-4598; 1097-4598
• DOI: 10.1002/mus.26639

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.