Hyperreflexia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hyperreflexia suggests an upper motor neuron dysfunction. Hyperreflexia usually has a positive Babinkski's sign and spasticity. Usually develops over a period of days to weeks (as opposed to immediate presentation).

Causes

Causes

Common Causes

Causes by Organ System

Cardiovascular Apoplexy, Portal hypertension, Preeclampsia, Stroke
Chemical/Poisoning Acute pesticide poisoning , Amitriptyline toxicity, Ammonium bifluoride, Amoxapine toxicity, Arizona bark scorpion poisoning , Black widow spider envenomation, Clomipramine toxicity, Desipramine toxicity , Fluoride , Imipramine toxicity, Lysergic acid diethylamide , Mescal poisoning , Metaldehyde , Molybdenum, Monoamine oxide inhibitor overdose, Nortriptyline toxicity , Protriptyline toxicity, Trimipramine toxicity
Dental No underlying causes
Dermatologic Sturge-weber syndrome
Drug Side Effect Artemether, Lumefantrin, Perphenazine, Phenothiazine antenatal infection
Ear Nose Throat Fara-chlupackova syndrome 
Endocrine Homocystinuria, Hyperthyroidism, Methylmalonic aciduria , Phenylketonuria, Thyrotoxicosis
Environmental No underlying causes
Gastroenterologic Hepatic coma, Reye's syndrome
Genetic Arthrogryposis, Baraitser brett piesowicz syndrome, Bickerstaff's brainstem encephalitis, Cerebral autosomal recessive arteriopathy , Chromosome 1, 1p36 deletion syndrome -, Chromosome 9q duplication , Coenzyme q 10 (coq10),, De barsy syndrome, Dihydropyrimidine dehydrogenase deficiency, Gamma-aminobutyrate transaminase deficiency, Gangliosidosis generalized gm1, Gaucher's disease, Glut-1 deficiency syndrome, Gm1 gangliosidosis , Hartnup's disease, Holoprosencephaly deletion , Homocystinuria, Lesch-nyhan syndrome, Mohr-tranebjaerg syndrome, Monosomy 1p36 , Neuraminidase deficiency , Neuronal intranuclear inclusion disease , Sialidosis , Smith-fineman-myers syndrome, Soto's syndrome , Wolman syndrome , Woods black norbury syndrome, Young mckeever squier syndrome
Hematologic Hypocalcemia, Intracranial bleeding, Subarachnoid hemorrhage
Iatrogenic Reye's syndrome
Infectious Disease Epidural abscess, Human t-lymphotropic virus type i (htlv-i) associated myelopathy, Malaria, Phenothiazine antenatal infection, Poliomyelitis, Rabies, Tetanus , Western equine encephalitis
Musculoskeletal/Orthopedic Ataxia spastic congenital miosis , Ataxia, Autonomic dysreflexia, Autonomic dystonia, Autosomal recessive spastic paraplegia, Bahemuka brown syndrome, Cerebellar ataxia, Cerebral palsy, Cerebro oculo skeleto renal syndrome, Cervical or thoracic myelopathy, Charcot-marie-tooth disease , Choreoathetosis, Choroido cerebral calcification syndrome , Congenital ichthyosis, Diomedi-bernardi-placidi syndrome , Dysequilibrium syndrome, Dysmorphism, Dystonia with cerebellar atrophy , Familial spastic paraparesis, Fitzsimmons-mclachlan-gilbert syndrome, Fitzsimmons-walson-mellor syndrome -, Friedreich's ataxia, General paralysis, Guillain-barré syndrome, Hyperexplexia , Mitochondrial protein-associated neurodegeneration, Neuropathy sensory spastic paraplegia , Paine syndrome , Parkinson's disease, Poliomyelitis, Richards-rundle syndrome, Roy-maroteaux-kremp syndrome , Rubinstein-taybi syndrome, Spastic paraparesis , Spastic spinal paralysis, Spinal cord injury, Spinal shock , Spinocerebellar ataxia, Tome-brune-fardeau syndrome 
Neurologic Amyotrophic lateral sclerosis , Angelman syndrome , Ataxia spastic congenital miosis , Ataxia, Athetosis, Autonomic dysreflexia, Autonomic dystonia, Autosomal recessive spastic paraplegia, Bahemuka brown syndrome, Baraitser brett piesowicz syndrome, Bickerstaff's brainstem encephalitis, Brain tumour, Brainstem lesions, Cerebellar ataxia, Cerebral autosomal recessive arteriopathy , Cerebral lesions, Cerebral palsy, Cerebro oculo skeleto renal syndrome, Cervical or thoracic myelopathy, Charcot-marie-tooth disease , Choreoathetosis, Choroido cerebral calcification syndrome , Chromosome 1, 1p36 deletion syndrome -, Chromosome 9q duplication , Coenzyme q 10 (coq10),, Compressive myelopathy, Congenital ichthyosis, Dermatoleukodystrophy, Diomedi-bernardi-placidi syndrome , Dysequilibrium syndrome, Dysmorphism, Dystonia with cerebellar atrophy , Encephalopathy progressive , Epidural abscess, Epileptic encephalopathy, Familial spastic paraparesis, Fara-chlupackova syndrome , Fitzsimmons-mclachlan-gilbert syndrome, Fitzsimmons-walson-mellor syndrome -, Friedreich's ataxia, Fryns macrocephaly, General paralysis, Guillain-barré syndrome, Haas-robinson syndrome , Head trauma, Hepatic coma, Human t-lymphotropic virus type i (htlv-i) associated myelopathy, Hydrocephalus, Hyperexplexia , Hypomyelination and congenital cataract, Infantile diplegia, Intracranial bleeding, Lesch-nyhan syndrome, Leukoencephalopathy, Macrogyria, Meningitis, Mental retardation, Microcephaly , Migraine , Mitochondrial protein-associated neurodegeneration, Mohr-tranebjaerg syndrome, Multiple sclerosis, Neuronal intranuclear inclusion disease , Neuropathy sensory spastic paraplegia , Oculorenocerebellar syndrome, Olivopontocerebellar atrophy , Ovarioleukodystrophy, Paine syndrome , Pallidopyramidal syndrome , Parkinson's disease, Phenylketonuria, Polymicrogyria, Polyneuropathy, Primary lateral sclerosis, Progressive alcoholic dementia, Richards-rundle syndrome, Rubinstein-taybi syndrome, Seemanova-lesny syndrome, Segawa syndrome, Serotonin syndrome, Serotoninergic syndrome , Severe brain trauma, Smith-fineman-myers syndrome, Soto's syndrome , Spastic paraparesis , Spastic spinal paralysis, Spinocerebellar ataxia, Sturge-weber syndrome , Subarachnoid hemorrhage, Syringobulbia, Tetanus , Tome-brune-fardeau syndrome , Wells jankovic syndrome , Western equine encephalitis
Nutritional/Metabolic Gaucher's disease, Haas-robinson syndrome , Hartnup's disease, Hypernatraemia, Sialidosis
Obstetric/Gynecologic Preeclampsia
Oncologic Brain tumour, Brainstem lesions
Ophthalmologic Hypomyelination and congenital cataract, Oculorenocerebellar syndrome
Overdose/Toxicity Alcohol withdrawal, Dexedrine overdose, Doxepin toxicity, Lithium overdose, Monoamine oxide inhibitor overdose, Nortriptyline toxicity , Progressive alcoholic dementia, Ritalin overdose
Psychiatric Anxiety
Pulmonary No underlying causes
Renal/Electrolyte Electrolyte disorders, Electrolyte imbalance, Fanconi syndrome, Hypernatraemia, Renal syndrome
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma Cervical or thoracic myelopathy, Head trauma, Severe brain trauma, Spinal cord injury, Spinal shock 
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


Laboratory Findings

Electrolyte and Biomarker Studies

MRI and CT

  • CT scan for suspected intracranial lesions
  • MRI is a better measure for hyperreflexia

Other Diagnostic Studies

Treatment

Acute Pharmacotherapies

Surgery and Device Based Therapy

References


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