What does the presence of brisk reflexes indicate?

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Last updated: March 10, 2025View editorial policy

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From the Research

Brisk reflexes are a significant indicator of an upper motor neuron problem, suggesting reduced inhibition from the brain to the spinal cord, and may be associated with various conditions, including stroke, multiple sclerosis, and spinal cord injury, as noted in studies such as 1 and 2. When a doctor taps specific tendons with a reflex hammer, such as the knee or ankle, and observes a quicker or more pronounced muscle contraction than normal, this is considered a brisk reflex.

Key Points to Consider

  • Brisk reflexes can appear in various conditions, including:
    • Stroke
    • Multiple sclerosis
    • Spinal cord injury
    • Certain vitamin deficiencies like B12 deficiency
  • They may also be seen in anxiety states or as a normal variant in some individuals
  • While brisk reflexes alone don't necessarily indicate disease, when accompanied by other neurological symptoms like muscle weakness, coordination problems, or sensory changes, they warrant further medical evaluation
  • A neurologist typically assesses the pattern and distribution of reflex changes to determine their clinical significance, as discussed in 3 and 4

Clinical Significance

The presence of brisk reflexes is a crucial finding that requires careful consideration of the patient's overall clinical presentation.

  • It is essential to evaluate the patient's medical history, perform a thorough physical examination, and consider additional diagnostic tests to determine the underlying cause of the brisk reflexes
  • The study 2 highlights the importance of examining brainstem reflexes in patients with hyperekplexia and stiff-man syndrome, which can provide valuable insights into the underlying physiological mechanisms
  • In clinical practice, the assessment of brisk reflexes should be integrated with other diagnostic findings to guide treatment decisions and improve patient outcomes, as emphasized in 1 and 5

References

Research

Sporadic hyperekplexia due to self-limiting brainstem encephalopathy.

Neuropsychiatric disease and treatment, 2017

Research

Intrathecal baclofen therapy in patients with severe spasticity.

Acta neurochirurgica. Supplement, 2007

Research

Startle syndromes.

Handbook of clinical neurology, 2011

Research

A neurophysiological approach to brainstem reflexes. Blink reflex.

Neurophysiologie clinique = Clinical neurophysiology, 1999

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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