Adductor T reflex abnormalities in patients with decreased patellar reflexes

• Published in: Muscle & nerve Vol. 40; no. 2; pp. 264 - 270
• Main Authors: Tataroglu, Cengiz, Deneri, Ersin, Ozkul, Ayca, Sair, Ahmet, Yaycioglu, Soner
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2009; Wiley
• Subjects: adductor reflex; Aged; Analysis of Variance; Biological and medical sciences; Diabetes. Impaired glucose tolerance; diabetic amyotrophy; diabetic lumbosacral radiculoplexus neuropathy; Diabetic Neuropathies - pathology; Diabetic Neuropathies - physiopathology; diabetic neuropathy; Diseases of striated muscles. Neuromuscular diseases; Electric Stimulation - methods; Electromyography - methods; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Functional Laterality - physiology; H reflex; H-Reflex - physiology; Humans; lumbar radiculopathy; Male; Medical sciences; Middle Aged; Muscle, Skeletal - physiopathology; Neural Conduction; Neurologic Examination; Neurology; Patella - physiopathology; Radiculopathy - pathology; Radiculopathy - physiopathology; Reaction Time - physiology; Reflex, Abnormal - physiology; Reflex, Stretch - physiology; T reflex; Endocrinopathy; Human; Nervous system diseases; Tendon reflex; lumbar radiculopathy; Amyotrophy; Motor system disorder; diabetic neuropathy; Diabetes mellitus; H reflex; H-Reflex; T reflex; Motor neuron; Neuropathy; Striated muscle disease; Needle electrode; diabetic amyotrophy; adductor reflex; Diagnosis; Lumbosacral; Neurological disorder; diabetic lumbosacral radiculoplexus neuropathy; Tendon
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.21299

The adductor reflex (AR) is a tendon reflex that has various features that differ from other tendon reflexes. This reflex was tested in different disorders presenting with diminished patellar reflexes such as diabetic lumbosacral radiculoplexus neuropathy (DLRPN), L2–L4 radiculopathy, and distal symmetric diabetic neuropathy (diabetic PNP). The AR and crossed‐AR (elicited by tapping the contralateral patellar tendon) were recorded using concentric needle electrodes. Additionally, the patellar T reflex (vm‐TR) and vastus medialis H reflex (vm‐HR) were recorded using surface electrodes. AR was recorded in only one out of eight patients with DLRPN, but it was recorded in 21 out of 22 patients with L2–L4 radiculopathy (95.5%). Of these reflexes, only AR showed prolonged latency in the L2–L4 radiculopathy group. The latencies of AR, vm‐TR, and vm‐HR were prolonged in patients with diabetic PNP. We conclude that AR can be useful in the differential diagnosis of some lower motor neuron disorders that present with patellar reflex disturbance. Muscle Nerve 40: 264–270, 2009