- Discussion:
- positive Hoffmann’s reflex reflects presence of an upper motor neuron lesion from spinal cord compression;
- is elicited by flipping either the volar or dorsal surfaces of the middle finger and observing the reflex
contration of the thumb and index finger;
- this sign is evidence by
upper motor neuron disease because here should normally be no reaction;
- positioning the neck in extension (sometimes flexion) may worsen the reflex;
- at or above the level of compression, upper extremity should be diminished or absent due to nerve root compression;
- in the report by Sung and Wang (Spine 2001), asymptomatic patients with a positive Hoffmann’s reflex were prospectively
studied with cervical radiographs and magnetic resonance imaging;
- to determine a relationship between a positive Hoffmann’s reflex and cervical pathology in asymptomatic patients
and to evaluate if further work-up was necessary in this patient population;
- 16 patients without cervical pain or radiculopathy and a positive Hoffmann’s reflex were prospectively studied
with cervical radiographs and magnetic resonance imaging;
- all 16 patients were asymptomatic;
- 14 patients (87.5%) demonstrated spondylosis on cervical radiographs;
- MRI showed pathologic findings in all 16 patients;
- 15 patients (94%) had cervical involvement with cord compression from a herniated nucleus pulposus;
- remaining patient had a T5-T6 thoracic disc with resultant compression;
Correlation Between a Positive Hoffmann’s Reflex and Cervical Pathology in Asymptomatic Individuals
Roger D. Sung, MD; Jeffrey C. Wang, MD.
Spine 2001 January;26(1):67-70
