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Published on: June 16, 2022
Utility of the H-reflex in diagnosing polyneuropathy
Oda H Teigland1, Kirsten Pugdahl1, Anders Fuglsang-Frederiksen1
1Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
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.
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