question about reflexes
AnonymousJune 14, 2007 at 3:37 pm
Can anyone help me understand the significance of a lack of the “knee-jerk” reflex? (the Right & Left Post. Tibial, on the nerve conduction report – I think I’m understanding that to be the “knee-jerk” reflex).
I tried to do a search on conversations about reflexes, but I couldn’t track down this info, so sorry if I’m repeating questions…
The neuro told me that my nerve conduction report was all normal, and yet I don’t have this reflex (according to this test, and my GP found the same thing in her regular reflex testing in her office) This is normal? or only normal for someone who’s had GBS? Is this indicative of permanent, identifiable nerve damage?
AnonymousJune 14, 2007 at 3:48 pm
Good luck on getting the answer you want. We were told that it is no big deal if reflexes do not return, we werr told one can function well without them. My deduction is that they are a measurement tool to determine the state of part of one’s nervous system. My wife’s patella reflexes started coming back about 8 months post GBS dx the Drs. thought they would never come back.
June 14, 2007 at 3:58 pm
I am confused about reflexes too! Kevin has all of his reflexes back. (dx 9/06) I have been confused about the dx for some time now (GBS or CIDP) I wonder if the fact that he has all of his reflexes is indicative of gbs or cidp? Would a cidp patient be able to regain their reflexes in that short of a time? (9 months)? Thanks Dawn Kevies mom:o
AnonymousJune 14, 2007 at 6:32 pm
Just to be more help….not….I had a severe case in ’85 and reflexes came back within a year or two. Still have major tingling in feet and hands with stress or cold though- but I can kick at the doc with the best of them. (And naturally since reflexes are fine he glazes over the tingling part)
AnonymousJune 14, 2007 at 7:12 pm
Ha! Don’t we love the consistency of all this? 🙂
I had GBS 8 years ago – recovered quickly and I thought well. I’m one of the recent ones to begin to experience, years later, what I believe are residuals, though the neuro (as I guess is fairly typical) tells me that what I am experiencing has nothing to do with the GBS 8 years ago…
I’m not really sure if my reflexes have been gone all this time or not. I never needed to visit the neuro since my one check-up at 6 mo. after the initial GBS, and didn’t really pay any attention to my reflexes until now…
That’s why I’m trying to understand if lack of reflexes is any type of indication of what’s really happened to my nerves. My recent ncv shows “normal” for everything else – and it was taken while I was experiencing a sense of minor weakness and some tingling, gripping, aching, etc…
Edit: please excuse my bad grammar, ending every sentence with an elipsis! (or exclamation point! 😉 )
AnonymousJune 14, 2007 at 9:59 pm
a few years ago, when I thought I was ‘getting’ it again, the ER doc was concerned because of the lack of reflexes, however a few days later at the neuro (the one that said you recover from GBS and have no residuals :rolleyes: ) I was told my reflexes were fine….. need I say more :confused: .
AnonymousJune 16, 2007 at 11:18 am
Now here’s one for you. Once again, when I am very weak I have no reflexes at times. Other times I have hyper relexes? No doc, yet to explain. Go figure. I can’t figure out how they can just come and go and I guess noone ever will. thanks for posting. xoxoxo Roxie
AnonymousJune 27, 2007 at 10:08 pm
I was diagnosed in 2000 and still ahve no reflexes. It doesn’t seem like a big deal. It is kind of funny when you go in for back pain and they really think you have severe problems when they realize you have no reflexes at all. Then I tell them about my ’bout with GBS and they smile.
AnonymousJune 28, 2007 at 10:42 am
The purpose of reflexes is to protect tendons and other body parts from damage. Reflexes are not processed by the brain so they are much faster than anything else in your body. Most reflexes cause a relaxation of muscles when a tendon pulled tight recieves a blow. The relaxation prevents a tendon from tearing or snapping. Without reflexes, you are at a much greater risk to injury, and if you are injured, you are at a much greater risk for a more serious injury.
One thing I noticed when I didn’t have reflexes was that when I brushed against the burner on the stove, it wasn’t automatic to yank my hand back and the burn I would get was much more serious than it should have been.
No reflexes means you are going have to be that much more careful.
AnonymousJune 28, 2007 at 3:55 pm
Just to confuse things a little more, for the last 20 or so years my “knee jerk” reaction has been next to nil. About 8 or 9 years ago my legs began to go “down hill”. The numbness in the feet and legs started about 3 or 4 years ago. Finally in was diagnosed with ‘CIDP in Dec 2005.
Did the 20 year old “knee jerk” reaction problem mean anything or was it just one of those “things” that happen to some? Bets me. I just thought it had something to do with being 6’ 6″ tall. At the time it didn’t seem to cause any trouble except giving doctors fits during my annual physical. 🙂
AnonymousJune 29, 2007 at 4:28 pm
I wonder if the 20 year old knee reflex problem may have meant that you had CIDP for a whole lot longer than you had previously imagined. There just isn’t a whole lot of things that can go wrong with a reflex motion, it is the simplest movement the body has.
Blond, definitely. Dingy? I never thought of you like that.
Balance is an extremely complex thing. GBS can effect balance in a number of ways. Nerve pathways to the inner ear could be demyelinated causing your balance to be thrown off. GBS can effect the focus and aiming of your eyes which can cause spatial disorientation. And finally, when you are out of balance, your body uses fast twitch muscle fibers to correct your balance. Demyelination will affect fast twitch muscle fiber more than slow twitch muscle fibers because slow twitch muscles have thousands of nerve fibers servicing each muscle, while fast twitch muscles only have dozens of nerve fibers.
The bad news is since GBS attacks almost all nerves simultaneously, your balance problems are probably a combination of all the above causes. The good news is that there are balance exercises that you can do for 10 to 15 minutes a day that will help you. You may want to talk to a PT and see if they can develope a home exercise regime to help you out.
AnonymousJune 30, 2007 at 7:29 am
Well folks, I cannot stay away from this one, I have examined patient’s nervous systems for 40 years.
Reflexes are not a protective mechanism and have nothing to do with burning yourself.
The reflexes tested are the ankle, the triceps, the supinator (front of arm) and occasionally the jaw jerk, and typically the patella tendon at the knee.
A patella hammer is used to strike the relaxed tendon causing it to stretch the muscle, this stretch stimulates a small electric current which travels along a sensory nerve to the spinal cord, here a synapse, or switch, triggers a message down the motor nerve causing the whole muscle to contract so the leg jumps.
The tendency of Lee and Chrissy to burn is due to demyelination of the temperature sensitive fibres of the sensory nervous system.
Loss of balance in GBS/CIDP is not due to demyelination of the nerves to the semi-circular canals in the inner ear, disturbance here causes vertigo.
Your balance is maintained by position sensors in your limbs. When a neurologist examines you he asks you to close your eyes and asks if you can tell if he is pointing your great toe/thumb up or down thus assessing your position sense. Also co-ordination, he asks you to run your heel up and down the opposite shin and to touch the tip of your nose with your forefinger.
Walking requires both position sense and co-ordination to work well.
The American Association of Neurology defined CIDP when it was realised that it was not just chronic GBS.
i. Neuropathy affecting more than one limb.
ii. Duration greater than 8 weeks.
iii. Loss or reduction of tendon reflexes.
iv. Abnormalities in electrical conduction studies.
v. Confirmation by lumbar puncture or nerve biopsy.
From a practical point of view as Gene says it is no big deal whether they return or not, it does not effect the outcome.
As many do not fulfil all these requirements it shows how tough it is for the conscientious neurologist.
Sorry if it is a bit technical, but that’s neurology. DocDavid
AnonymousJuly 1, 2007 at 8:29 pm
Two years ago, when I last saw my neuro, I had gotten back the reflexes in my arms but not my legs. A few days ago when I brought my mom into the doctor, I asked him to check my reflexes, probably because of this post (I was just curious.) He said my arms were normal & my knees near normal. I am no better physically than I was two years ago, so my conclusions is that they mean nothing as far as recovery. It was fun to see my knees jerk again, however…
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