Hyporeflexia

Hyporeflexia is the opposite of hyperreflexia: the presence of below normal or absent reflexes. It can be tested for by using a reflex hammer. Hyporeflexia is generally associated with a lower motor neuron deficit (lower motor neuron dysfunction) at the alpha motor neurons from the spinal cord to muscle; whereas, hyperreflexia is often attributed to upper motor neuron lesions (along the long motor tracts from the brain).

Laboratory Findings

 * Complete blood count (CBC)
 * Calcium
 * Glucose
 * Antinuclear antibody (ANA)
 * Rheumatoid factor (RF)
 * HIV
 * Rapid plasma reagin (RPR)
 * Vitamin B12 levels
 * Thyroid function tests
 * Heavy metal screen
 * Hemoglobin A1c
 * Creatinine phosphokinase (CK)
 * Erythrocyte sedimentation rate (ESR)
 * Serum protein electrophoresis (SPEP)
 * Urine protein electrophoresis (UPEP)

Other Diagnostic Studies

 * Nerve conduction studies
 * Cerebrospinal fluid (CSF) analysis

Differential Diagnosis
In alphabetical order.


 * Brachial or lumbosacral plexopathy
 * Cauda equina syndrome
 * Guillain-Barre Syndrome
 * Isolated peripheral nerve injury/dysfunction
 * Lambert-Eaton Myasthenic Syndrome
 * Motor neuron disease
 * Multifocal motor neuropathy
 * Myopathy
 * Obesity
 * Peripheral neuropathy
 * Radiculopathy
 * Spinal shock

Treatment

 * Treat underlying etiologies
 * Plasmapheresis
 * Intravenous immunoglobulin (IVIG)
 * Physical therapy