Results of the vestibular tests using vectoelectronystagmography in relation to the type of alteration in the caloric reflex test in each age group Age Group/ Caloric reflex test Range Normal Abnormal n/% n/% G1(n=9) 7/78.00 2/32.00 20-39 years G2 (n=8) 7/87.50 1/1.50 40-49 years G3 (n=10) 7/70.00 3/30.00 50-59 years G4 (n=11) 6/54.50 5/45.50 60-69 years G5 (n=6) 4/67.00 2/33.00 70-99 years Total (n=44) 31/70.45 13/29.55 Age Group/ Type of abnormal in the caloric reflex test Range Hyperreflexia Hyporeflexia
Areflexia n/% n/% n/% G1(n=9) 1/50 1/50.00 0/0.00 20-39 years G2 (n=8) 0/0.00 1/100.00 0/0.00 40-49 years G3 (n=10) 0/0.00 2/66.50 1/33.50 50-59 years G4 (n=11) 0/0.00 5/100.00 0/0.00 60-69 years G5 (n=6) 0/0.00 2/100.00 0/0.00 70-99 years Total (n=44) 1/2.27 11/25.00 1/2.27 Table 2.
He was areflexic in the legs with either hyporeflexia
(biceps and supinator reflexes) or areflexia (triceps reflexes) in the arms.
Decreased muscle tone with hyporeflexia
or areflexia is typical, although normal or hyperactive reflexes may be seen in some cases.
Peripheral neuropathy is the most frequent neurological manifestation; it appears with paresthesias and numbing of the feet and legs, accompanied by hyporeflexia
, alteration in superficial sensitivity with boot distribution and compromise of vibratory sensitivity; it is then developed similarly in the hands, along with distal weakness of lower limbs, as with the case presented (1).
Neurologic problems develop due to premature death of nerve cells and are seen in nearly 20% of patients with XP, more commonly in groups XPA and XPD.5 The problems include loss of fine motor control, rigidity, ataxia, spasticity, hyporeflexia
or areflexia, chorea, motor neuron signs or segmental demyelination, sensorineural deafness and progressive mental retardation.
palpitation, 8-10% limb extremity pains, 4-6% hyporeflexia
and hyperrefkexia, 12-16% disturbance in smell and taste and 7-8% neurasthenia.
Following the increased incidence of GBS associated with the swine flu vaccination program in the United States in 1976, the ad hoc committee of the National Institute of Neurological and Communication Disorders and Stroke proposed a set of clinical diagnostic criteria for GBS which required the presence of universal areflexia or hyporeflexia
as well as progressive motor weakness in more than one limb in 1978, which were later reaffirmed in 1981 and 1990.
Saccrococcygeal spinal cord injury can produce hypalgesia, hypotonia and hyporeflexia
of the perineum, tail and anus or total analgesia and paralysis of those structures.
(26), (27) It is characterized by severe fatigue, weakness in the proximal muscles, especially at the lower extremities, and hyporeflexia
and is the result of a decreased acetylcholine release at the presynaptic neuromuscular junction and cholinergic autonomic endings.
Group I (stage I HIE) included 16 newborn infants who have hyperalertness, hyperreflexia and tachycardia, Group II (stage II HIE) included 19 newborn infants who have lethargy, hyporeflexia
, bradycardia, hypotonia, weak suckling & Moro reflexes and convulsions and Group III (stage III HIE) included 28 newborn infants who have stupor, profound hypotonia, hypothermia, absent suckling & Moro reflexes, apnea and frequent seizures with or without coma.
Children with leukemia who develop lower motor neuron lesion manifested as hypotonia, hyporeflexia
or diminished power are usually diagnosed to have peripheral neuropathy due to vincristine; a vinca alkaloid chemotherapeutic agent used in all phases of therapy.
Diagnosis of muscular dystrophy usually beggins with the clinical suspicion that has proven to be very sensitive and has high positive predictive value.8 The usual clinical features of myopathy include predominantly proximal muscle weakness that is symmetrical, increases progressively; there is exercise intolerance, muscle hypotonia, muscle hyporeflexia
and calf - muscle hypertrophy.