Diminished Reflexes, Hyporeflexia

CLINICAL DIAGNOSTIC MANUAL

Hyporeflexia refers to a reduction in the response of deep tendon reflexes, indicating an issue in the peripheral nerve pathway or spinal cord, which disrupts the transmission of signals between muscles and the central nervous system.

This condition can be a sign of various neurological and muscular pathologies. Careful assessment of diminished reflexes is crucial to identifying the underlying cause and providing appropriate treatment.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Sensory neuropathy	Numbness, tingling, loss of sensation, “glove and stocking” distribution	Medical history, neurological examination, symmetrical symptoms	EMG, nerve conduction studies, blood tests
Motor neuropathy	Muscle weakness, atrophy, fasciculations, loss of reflexes, “glove and stocking” distribution	Medical history, neurological examination, symmetrical symptoms	EMG, nerve conduction studies, blood tests
Primary muscle disease	Progressive muscle weakness, muscle pain, atrophy, myopathy	Medical history, physical examination, signs of myopathy	Elevated CPK, muscle biopsy, genetic studies
Cerebellar disease	Ataxia, intentional tremor, dysmetria, incoordination, balance disturbances	Medical history, neurological examination, ataxic gait	Brain MRI, cerebellar coordination tests
Posterior root injury of C7-C8	Loss of sensation in the middle and little fingers, possible weakness in intrinsic hand muscles	Medical history, neurological examination, radicular pain	Cervical MRI, nerve conduction studies
Posterior root injury of C5-C6	Loss of sensation in the shoulder and lateral part of the arm, possible weakness in the deltoid and biceps	Medical history, neurological examination, radicular pain	Cervical MRI, nerve conduction studies
Posterior root injury of L3-L4	Loss of sensation in the anterior and medial thigh, possible weakness in the quadriceps	Medical history, neurological examination, radicular pain	Lumbar MRI, nerve conduction studies
Posterior root injury of S1-S2	Loss of sensation in the posterior thigh and leg, possible weakness in calf muscles	Medical history, neurological examination, radicular pain	Lumbar MRI, nerve conduction studies