Old 02-23-2008, 09:47 AM #1 (permalink)
New Member
 
Join Date: 2008
City: Borrego Springs
State: CA
Country: US
Diagnosed: 03/2008
Interest: I am a family member of someone with ALS/MND.
Posts: 60
juliesmile is on a distinguished road
juliesmile juliesmile is offline
New Member
Join Date: 2008
City: Borrego Springs
State: CA
Country: US
Diagnosed: 03/2008
Interest: I am a family member of someone with ALS/MND.
Posts: 60
juliesmile is on a distinguished road
Default Brisk reflexes

I've been picking up things here and there on this forum and I have a question on reflexes. In my husbands first exam with Neurologist, the Dr. notes that "Reflexes are A+ with the exception of left ankle jerk, which is absent." Then when we went for exam with 2nd opinion Dr. he said he wanted an MRI on his upper spine because although it wouldn't explain the foot drop it might account for the "Brisk reflexes". Both exams show toes downgoing with the Babinski test. Can someone clear up what this might mean. I read here somewhere that reflexes are brisk in ALS and absent in neuropathy. Can you have both. Or is ALS just a form of neuropathy? I'm confused.
juliesmile is offline  
Old 02-23-2008, 10:07 AM #2 (permalink)
Senior Member
 
Join Date: 2007
City: Richmondville
State: New York
Country: US
Diagnosed: 10/2007
Posts: 663
Blog Entries: 1
Marjorie R. Wilcox is on a distinguished road
Marjorie R. Wilcox Marjorie R. Wilcox is offline
Senior Member
Join Date: 2007
City: Richmondville
State: New York
Country: US
Diagnosed: 10/2007
Posts: 663
Blog Entries: 1
Marjorie R. Wilcox is on a distinguished road
Default reflexes

Rick has both brisk reflexes and absent ones. He was initially diagnosed with neuropathy and then after the EMG and blood tests, he was given the DX of familial ALS.
Marjorie R. Wilcox is offline  
Old 02-26-2008, 10:37 AM #3 (permalink)
Senior Member
 
Join Date: 2008
City: Anaheim
State: California
Country: US
Diagnosed: 08/2008
Interest: I have been diagnosed with ALS.
Posts: 531
tmasters is on a distinguished road
tmasters tmasters is offline
Senior Member
Join Date: 2008
City: Anaheim
State: California
Country: US
Diagnosed: 08/2008
Interest: I have been diagnosed with ALS.
Posts: 531
tmasters is on a distinguished road
Default

Hi Julie,

I'm not a doctor but I've done some research on this. This gets a little complicated.

In ALS there is a slow dying of both the "Upper Motor Neurons" (UMN) and "Lower Motor Neurons" (LMN). ALS is different in different people. In some cases UMN are the first to go, in others it's the LMN. To make a "clinically definite" diagnosis of ALS, the neurologist must detect both UMN and LMN symptoms in a few regions. This doesn't happen until the disease has progressed pretty far.

Your doctor was looking at reflexes because heighened or "brisk" reflexes are one of the main symptoms of UMN deterioration. Sometimes LMN shows a decreased reflex, but a more common symptom of LMN is muscle weakening and wasting.

Bottom line is, it doesn't tell you much by itself, but has to be understood within the context of all the other symptoms that the doctor is looking for.

-Tom
tmasters is offline  
Old 02-26-2008, 12:20 PM #4 (permalink)
Very Helpful Member
 
Join Date: 2007
City: philadelphia
State: pennsylvania
Country: united states
Interest: I am interested in learning about ALS/MND.
Posts: 1,232
crystalkk is on a distinguished road
crystalkk crystalkk is offline
Very Helpful Member
Join Date: 2007
City: philadelphia
State: pennsylvania
Country: united states
Interest: I am interested in learning about ALS/MND.
Posts: 1,232
crystalkk is on a distinguished road
Default

julie,

Toes going downward is normal. If he had the babinski the big toe goes up and the rest of the toes go up and fan out. It is another UMN sign.
crystalkk is offline  
Old 02-26-2008, 12:32 PM #5 (permalink)
New Member
 
Join Date: 2008
City: Borrego Springs
State: CA
Country: US
Diagnosed: 03/2008
Interest: I am a family member of someone with ALS/MND.
Posts: 60
juliesmile is on a distinguished road
juliesmile juliesmile is offline
New Member
Join Date: 2008
City: Borrego Springs
State: CA
Country: US
Diagnosed: 03/2008
Interest: I am a family member of someone with ALS/MND.
Posts: 60
juliesmile is on a distinguished road
Default

Hi Tom,

Thanks, it does get confusing. So let me see if I get this right. If my husband has atrophy in his left leg and an absent left ankle reflex, that might indicate some LMN issues. The brisk reflexes might indicate some UMN issues. The downgoing Babinski is a good sign though.
juliesmile is offline  
Old 02-26-2008, 03:31 PM #6 (permalink)
Senior Member
 
Join Date: 2008
City: Anaheim
State: California
Country: US
Diagnosed: 08/2008
Interest: I have been diagnosed with ALS.
Posts: 531
tmasters is on a distinguished road
tmasters tmasters is offline
Senior Member
Join Date: 2008
City: Anaheim
State: California
Country: US
Diagnosed: 08/2008
Interest: I have been diagnosed with ALS.
Posts: 531
tmasters is on a distinguished road
Default

Julie,

I just re-read your original post and I may have mis-lead you if you interpret "brisk" and "normal" reflexes as the same thing. The UMN symptom is actually heightened or exaggerated reflexes. This is what I thought you meant by "brisk" but now I'm not so sure since you also say "A+". If Steve has normal reflexes I would think this is a good sign also, not an indicator of any UMN decay.

-Tom
tmasters is offline  
Old 02-26-2008, 05:03 PM #7 (permalink)
New Member
 
Join Date: 2008
City: Borrego Springs
State: CA
Country: US
Diagnosed: 03/2008
Interest: I am a family member of someone with ALS/MND.
Posts: 60
juliesmile is on a distinguished road
juliesmile juliesmile is offline
New Member
Join Date: 2008
City: Borrego Springs
State: CA
Country: US
Diagnosed: 03/2008
Interest: I am a family member of someone with ALS/MND.
Posts: 60
juliesmile is on a distinguished road
Default

Tom,

Actually what I was saying is that on our first visit in Oct. Dr. noted Steve's reflexes were ...

"A+ with the exception of left ankle jerk which was absent" Does this mean at this point (Oct>) his reflexes good?

Then our 2nd opinion Dr. (Jan) his reflexes were "Brisk"

He seemed to go from A+ to having Brisk reflexes is a very short period of time.

I guess that's not really a question. Just an observation. Your explaination earlier was what I was looking for.

Thanks
juliesmile is offline  
Closed Thread

Tags
2nd opinion, als, confused, foot, foot drop, mri, neurologist, test, wanted



Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Reflexes DorDor Do I Have ALS? Is This ALS? 13 09-14-2012 02:42 AM
Reflexes Lorenzo1991 Do I Have ALS? Is This ALS? 2 12-20-2011 02:34 PM
Brisk Reflexes Kathylund Do I Have ALS? Is This ALS? 18 10-19-2011 11:54 AM
Reflexes Hayleywart Do I Have ALS? Is This ALS? 2 12-18-2009 11:32 AM
Reflexes Kewanee Do I Have ALS? Is This ALS? 10 08-14-2009 07:00 PM
Brisk reflexes or Anxiety? Sammantha General Discussion About ALS/MND 5 09-02-2008 08:01 PM
Does anyone understand the importance of "brisk" reflexes? rose General Discussion About ALS/MND 6 05-21-2008 08:07 AM
brisk reflexes myooshka Do I Have ALS? Is This ALS? 5 11-17-2007 10:41 AM
Reflexes kazzy General Discussion About ALS/MND 2 05-26-2006 12:46 PM


All times are GMT -5. The time now is 11:44 PM.

 

Who we are

"We are a volunteer-driven online community that originated in 2003. We are a resource for anyone affected by ALS and MND. We are a community of like-minded and compassionate individuals. Together we are the ALS Forum and together we build this online resource and online community."

 

Want to help?

Have you found our website helpful? Do you enjoy having a place to talk to people that are knowledgeable about ALS and MND? If you have found it helpful to chat with people at different stages of the ALS/MND journey we encourage you to get involved.

Copyright © 2016