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.
Keywords: Achilles reflex; Hoffman reflex; diagnosis; nerve conduction studies; polyneuropathy.
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