Reflexeshyperreflexia

Reflexeshyperreflexia refers to hyperreflexia, the clinical finding of exaggerated or overactive deep tendon reflexes. It is a sign rather than a diagnosis and typically indicates increased excitability of the stretch reflex arc or loss of descending inhibition from the central nervous system.

Causes include upper motor neuron lesions such as stroke, spinal cord injury, multiple sclerosis, traumatic brain injury, and certain neurodegenerative disorders. Metabolic and systemic conditions — for example, hypocalcemia or thyrotoxicosis — and drug effects can also produce increased reflexes; serotonergic toxicity is a recognized cause of markedly heightened reflexes and clonus.

Clinical features are an unusually brisk response to tendon taps, often graded on a 0 to 4+ scale, and may be accompanied by clonus, spasticity, and pathologic reflexes such as an extensor plantar response (Babinski sign). Hyperreflexia can be focal or generalized depending on the underlying lesion.

Evaluation relies on neurological examination, history, and targeted testing to identify underlying causes. Electrophysiological studies (EMG/nerve conduction) and neuroimaging (MRI/CT) are used when structural lesions are suspected. Laboratory tests assess metabolic contributors.

Management focuses on treating the underlying condition and symptomatic control of spasticity when present. Options include physical therapy, oral muscle relaxants (e.g., baclofen, tizanidine), benzodiazepines, botulinum toxin for focal problems, and intrathecal baclofen for refractory generalized spasticity. Prognosis varies with the cause and severity of the primary disorder.