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Qualitative H-reflex testing in Huntington's disease

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Summary

The occurrence of H-reflexes over both the anterior tibial muscle and the thenar muscle on both sides was investigated in 15 patients suffering from Huntington's disease, 8 clinically inconspicuous offspring, and 30 healthy normal controls. The following results were obtained:

  1. 1.

    An obvious H-reflex over the anterior tibial muscle was found in 12 of 15 patients; there was no H-reflex in only 3 patients.

  2. 2.

    After stimulation on the median nerve there was an H-reflex in 12 of 13 patients investigated.

  3. 3.

    In 5 of 8 clinically inconspicuous offspring there was an H-reflex after peroneal [4] or median [5] nerve stimulation.

  4. 4.

    In 30 normal controls, 1 displayed a weak H-reflex over the anterior tibial muscle; 9 showed a weak H-reflex after median nerve stimulation.

  5. 5.

    The possibility is discussed that an abnormal H-reflex might be an early sign of central reflex disinhibition in otherwise asymptomatic offspring.

Zusammenfassung

Das Vorkommen von H-Reflexen im M. tibialis anterior und Thenar beidseits wurde an 15 Patienten mit Chorea Huntington, 8 klinisch unauffälligen Nachkommen und 30 Normalpersonen untersucht. Es fand sich

  1. 1.

    bei 12 von 15 Patienten im M. tibialis anterior beidseits ein eindeutiger H-Reflex, nur bei 3 Choreapatienten war kein H-Reflex nachweisbar

  2. 2.

    bei 12 von 13 untersuchten Choreapatienten ein- oder beidseitig ein H-Reflex nach Medianusreizung

  3. 3.

    bei 5 von 8 klinisch unauffälligen Nachkommen ein eindeutiger H-Reflex nach Reizung des N. peronaeus (4) bzw. Medianus (5)

  4. 4.

    bei 1 von 30 Normalpersonen ein schwacher H-Reflex über dem M. tibialis anterior bzw. bei 9 von 30 Normalpersonen ein schwacher H-Reflex nach Medianusreiz.

Es wird diskutiert, ob ein abnormer H-Reflex im N. peronaeus bei sonst gesunden Huntingtonnachkommen auf eine zentrale Reflexenthemmung bei beginnender Chorea Huntington hinweisen kann. Der alleinige Nachweis nach Medianusreizung ist wegen seines Vorkommens in ca. 30% der Normalpersonen dafür nicht verwertbar.

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Authors and Affiliations

  1. Neurologische Universitätsklinik mit Abteilung für Neurophysiologie, Hansastr. 9, Freiburg, Federal Republic of Germany

    G. Oepen & W. Hillesheimer

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  1. G. Oepen
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  2. W. Hillesheimer
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Dedicated to Heinrich Oepen on the occasion of his 60th birthday

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Oepen, G., Hillesheimer, W. Qualitative H-reflex testing in Huntington's disease. Arch Psychiatr Nervenkr 230, 221–226 (1981). https://doi.org/10.1007/BF00344447

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