Tendon-reflex testing in chronic demyelinating polyneuropathy

We studied the tendon reflex (T-reflex) in 26 patients with acquired chronic demyelinating polyneuropathy (CDN), including 22 with chronic inflammatory demyelinating polyneuropathy (CIDP). In 7 patients reflexes were brisk or normal on clinical testing. The height adjusted T-reflex was abnormal in 25 (96%) cases, including 6 of 7 patients with brisk or normal reflexes on clinical testing. Mean latency (P < 0.01) and duration (P < 0.05) of the ankle and patellar tendon reflexes were significantly prolonged in the CIDP patients when compared to the controls. Mean latency in the CIDP patients was 152% of normal means. In 7 CIDP patients, the T-reflex latencies were prolonged beyond 150% of normal means. Thus, the T-reflex test is abnormal in a majority of patients with CDN, even in the presence of well-preserved clinical reflexes, and the T-reflex latency is a useful indicator of the presence of a demyelinating peripheral neuropathy in some patients.