question on neurologic exams

[booshwa]

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Hey I have an easy question (easy for those in the know)...

what would you say that "peripheral reflexes were excessive and the muscles were hyperreponsive" means?

know any conditions that may cause this?

...any info would be a help cuz I can't find anything on it

 

[nutmegs]

use "hyperreflexia" to search. maybe upper motor neuron lesions/spastic paralysis. they have to have given you more to go on than that.

 

[booshwa]

well they didn't give me much beyond that...

patient is hyperkalemic...so I'm thinking that it may have something to do with abnormal membrane potentials within the skeletal muscular membranes

i've searched for "hyperreflexia" to no avail.

thanks for your help

 

[omarsaleh66]

hyperflexia deals with upper motor neuron lesions so the patient got problems in the brain or spinal cord. Its not peripheral nerves cuz that would give ur hypoflexive.

conditions that cause hyperflexia can be things like cerebral artery damage, amyotrophic lateral sclerosis, pernicous anemia, transections of the spinal cord (tumors), medulla lesions

maybe the dude's hyperkalemia screwed up his neurons and affecting his CNS??

gluck,

Omar

 

[the_equalizer]

isn't one of the symptoms of hyperkalemia actually peripheral hyperreflexia?

 

[goobernaculum]

hypereflexia and hyper-responsive muscles (I'm assuming the latter means that the muscles are spastic or increased in tone) are signs of upper motor neuron disorders.

Other than that, you can't really localize the lesion and make any other diagnostic steps unless you got more info.

 

[Kalel]

Originally posted by goobernaculum
hypereflexia and hyper-responsive muscles (I'm assuming the latter means that the muscles are spastic or increased in tone) are signs of upper motor neuron disorders.

Other than that, you can't really localize the lesion and make any other diagnostic steps unless you got more info.

Yup, upper motor neurons provide inhibitory signals. When there is an upper motor lesion, the neurons involved in reflexes are over-active because inhibitory signals are lost. That's the most common reason for hyper-reflexia; but the differential for hyperreflexia is very broad including everything from normal physiologic response to certain metabolic and endocrine disorders.

 

[nutmegs]

Originally posted by booshwa
well they didn't give me much beyond that...

patient is hyperkalemic...so I'm thinking that it may have something to do with abnormal membrane potentials within the skeletal muscular membranes

i've searched for "hyperreflexia" to no avail.

thanks for your help

yup yup... was thinking neuro and not physio : )

with hyperkalemia Em becomes less negative so the cell will depolarize more readily.

 

[pikachu]

Hyperkalemia causes prolonged depolarization of the muscle cell, which ultimately stops working as it becomes overstimulated. so hyperkalemia is usually associated w/ muscle weakness, decreased reflexes, and flaccid paralysis if it goes on long enough. The worst effects of hyperkalemia are seen in the heart, where it can cause fatal arrhythmias. (this is straight out of Harrison's)

one thing that could be associated with hyperkalemia is prolonged seizure activity (causes muscle breakdown and release of potassium into the blood). I guess you could create a scenario where a patient with a brain tumor/stroke or some other kind of central nervous system lesion has a prolonged seizure and becomes hyperkalemic but stays hyper-reflexic because of their CNS lesion. This is kind of a stretch though I think.

 

[ewing]

Originally posted by the_equalizer
isn't one of the symptoms of hyperkalemia actually peripheral hyperreflexia?

Thanks...now I can stop hunting those pesky zebras (well, unless they want a Diff. Diag.).