From the Guidelines
Absent deep tendon reflexes (DTRs) can be caused by various conditions, including peripheral neuropathies, spinal cord disorders, neuromuscular junction disorders, and other medical conditions, as noted in a study on Guillain-Barré syndrome 1. When evaluating a patient with absent DTRs, it is essential to consider the following potential causes:
- Peripheral neuropathies, such as diabetic neuropathy, Guillain-Barré syndrome, and chronic inflammatory demyelinating polyneuropathy
- Spinal cord disorders, including complete spinal cord transection below the reflex level, poliomyelitis, and advanced amyotrophic lateral sclerosis
- Neuromuscular junction disorders, like myasthenia gravis and Lambert-Eaton myasthenic syndrome
- Other conditions, such as hypothyroidism, vitamin B12 deficiency, and certain medications like benzodiazepines and anticonvulsants A comprehensive neurological examination, including sensory testing, muscle strength assessment, and evaluation of other neurological signs, is crucial in identifying the underlying cause of absent DTRs, as discussed in the context of plexopathy 1. Laboratory tests, such as blood glucose, thyroid function, vitamin B12 levels, and nerve conduction studies, can help determine the specific condition causing the absent reflexes, as mentioned in the management of systemic lupus erythematosus with neuropsychiatric manifestations 1. Treatment should focus on addressing the specific condition causing the absent reflexes, ranging from glycemic control in diabetes to immunotherapy in autoimmune disorders, with the goal of improving morbidity, mortality, and quality of life 1.
From the Research
Conditions for Absent Deep Tendon Reflexes (DTR)
There are no research papers provided that directly discuss the conditions for absent DTR. The studies available focus on neuropathic pain management after spinal cord injury, the efficacy and safety of pregabalin and gabapentin, and evidence-based recommendations for neuropathic pain treatment.
Related Studies
- The studies provided discuss the treatment and management of neuropathic pain after spinal cord injury, including the use of pregabalin and gabapentin 2, 3, 4, 5, 6.
- These studies do not mention the conditions for absent DTR, but rather focus on the pharmacological management of neuropathic pain.
- The absence of DTR may be related to neurological conditions, but this is not explicitly discussed in the provided studies.
Key Findings
- Pregabalin and gabapentin are effective in reducing neuropathic pain after spinal cord injury 3, 4, 6.
- The efficacy and safety of these medications vary, with pregabalin being more effective in some studies, but also having a higher risk of adverse events 3, 4.
- Evidence-based recommendations for neuropathic pain treatment include the use of selective serotonin-norepinephrine reuptake inhibitors, gabapentin, and topical lidocaine, among others 5.