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jkb1023jb

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Had a question regarding asymmetrical hyperreflexia.

I was referred by my GP to a neurologist for brisk reflexes on one side of my body. I've had weird fasics, perceived weakness, etc. since 2001 and seen three neuros in that time (EMG, NCV, MRI, etc.). First of which threw the ALS suggestion at me in our first visit. All tests negative. My recent neuro visit found a asymmetrical hyperreflex on my knee. Did the whole run of the mill tests again, all negative. Told me I had BFS and sent me on.

He said brisk reflex didn't appear like it did upon our first meeting. My question is this, for anyone who has been told about the asymmetrical hyperreflexia before. Could that have been just an aberration? Are reflexes that fickle, where they can show hyperreflexive one time and not the other?

Thanks for any advice you can give. I've lurked on the boards for years following a friend's ALS diagnosis, and again after my first neuro in 2001 scared me with the possibility of ALS. I can't say enough about the compassion and bravery on this board that PALS have. My prayers go out to anyone affected or living with this horrible disease.
 
Did the GP refer you to a neuro just because you had a brisk knee reflex? Or did you ask to go to a neuro?

Reflexes and their perception by the tester can change - it is subjective to some degree. I am clinically normal, but a reflex is hard to elicit in my left arm. My GP nor neurologist even think anything of it. There are a lot of things that can change your reflexes for brief periods of time or longer term, so if you don't have any other clinical symptoms of anything I would let it go.

And, twitches are not a symptom of anything.
 
They can be absolutely fickle. Anxiety can cause hyper reflexia, although that would be less likely to be asymetrical. Subjectivity by the examiner is a huge factor. They can also be there one day and gone the next. I have some spastic catches, that seem to come and go. Hyperreflexis that is worse sometimes, with no explaination.

Its also just common for some people to have absolutely no reflexes in some places, which is normal for them and has no sinister underlying reason.

Just another confusing thing in the "stew" of neurology.

Aly
 
Thanks for the responses. I'm just trying to understand how I can get the asymmetrical tag from my GP, who suggested that I see another neuro, and then get that same finding from the neuro in the initial visit. He was adamant in my followup that he didn't see the same thing. Just confusing. I don't quite understand all the neuro lingo.
 
I think after 11 years of these symptoms, whatever is going on is not ALS. In that limb affected by hyperreflexia you experience the twitching and percieved weakness as well?
 
Yes, the same limb with the hyperreflex gives me issues. I am weaker on that side and always have been for as long as I can remember. But I haven't progressed much at all in 11 years. Just kind of confused about the reflex. Everything I've read about asymmetrical brisk reflexes points to bad things. Just weird that it was seen twice on different occasions and not the third.
 
If you have all symptoms confined just to one limb, I think you can - after nearly 1 years - rule ALS out. In the worst case there is a MND variant called monomelic amyotrophy, which affects just one limb and does not progress.
 
If a neurologist told you that you have BFS, I'd be doing the "Happy Dance" if I were you!

What's a little hyperreflexia with a few twitches thrown in?

Smile! It's a good day to have BFS!
 
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