Approximately 1 in 150 cases of WNV is severe and may present with high fever, nuchal rigidity, headache, hyporeflexia
, and significant neurological deficits including altered mental status, confusion, seizures, visual changes, diffuse muscle weakness to paralysis, and coma (CDC, 2004e; Sejvar et al.
One of their patients had hyperreflexia while another had hyporeflexia
with extensor plantar response4.
Patients were classified into the following groups according to the degree of preoperative caloric paresis: Group 1, normoreflexia, caloric paresis between 0 and 12%; Group 2, hyporeflexia
, caloric paresis between 12% and 99%; and Group 3, areflexia, caloric paresis is 100%, there was no response.
Hind limbs weakness, episodic spasticity of forelimbs, plantigrade positioning, impaired jumping, flaccid paresis associated to hyporeflexia
, dysphagia, respiratory distress, lethargy, and mental depression have been described (ASH et al.
Acute motor axonal neuropathy (AMAN) is a type of GBS accompanied by peripheral axonal involvement where acute motor paralysis, loss of reflex or hyporeflexia
, insignificant sensory loss, and albumino-cytologic disproportion in cerebrospinal fluid are seen with no demyelinating findings in electromyography (EMG).
2) Ross syndrome is characterized by Adie's pupil, hyporeflexia
, and anhidrosis.
Our patient had hyporeflexia
throughout the disease course.
Most case-patients also had hyporeflexia
or areflexia (73%, n = 11) and hypotonia of the arms (60%, n = 9) and legs (80%, n = 12).
Direction of Ascending Ascending neuromuscular paralysis Ataxia Present Absent Deep tendon reflexes Hyporeflexia Hyporeflexia
progressing to progressing to areflexia areflexia Babinski sign Absent Absent Sensory loss None Mild Meningeal signs Absent Rarely present Ophthalmoplegia May be present in Absent (external & North American TP.
A neurologic examination revealed flaccid quadriparesis and hyporeflexia
Evidence from two prospective infant cohorts shows an effect between prenatal DDE levels and hyporeflexia
at 1 month of age (Rogan et al.