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Utility of the H-reflex in diagnosing polyneuropathy

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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.

Original languageEnglish
JournalMuscle & Nerve
Pages (from-to)424-428
Number of pages5
Publication statusPublished - Oct 2019

    Research areas

  • Achilles reflex, Hoffman reflex, diagnosis, nerve conduction studies, polyneuropathy

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