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Woltman's sign (also called Woltman's sign of hypothyroidism or, in older references, myxedema reflex [1]) is a delayed relaxation phase of an elicited deep tendon reflex, usually tested in the Achilles tendon of the patient. Woltman's sign is named for Henry Woltman, an American neurologist. [2]
decreased motor control including decreased speed, accuracy and dexterity; altered muscle tone (hypotonia or hypertonia) – a decrease or increase in the baseline level of muscle activity; decreased endurance; exaggerated deep tendon reflexes including spasticity, and clonus (a series of involuntary rapid muscle contractions)
The term "deep tendon reflex", if it refers to the muscle stretch reflex, is a misnomer. "Tendons have little to do with the response, other than being responsible for mechanically transmitting the sudden stretch from the reflex hammer to the muscle spindle.
It can be detected through the use of a reflex hammer and is the opposite of hyperreflexia. [ citation needed ] Hyporeflexia is generally associated with a deficit in the lower motor neurons (at the alpha motor neurons from the spinal cord to a muscle), whereas hyperreflexia is often attributed to lesions in the upper motor neurons (along the ...
Typically, the first identifiable sign of vitamin E deficiency is areflexia, or the loss of deep tendon reflexes, like the patellar reflex. The usual progression is then to ataxic gait (which continues to progressively worsen) and then to a loss of dorsal column sensations (position and vibration).
Deep tendon reflexes: Reflexes: masseter, biceps and triceps tendon, knee tendon, ankle jerk and plantar (i.e., Babinski sign). Globally, brisk reflexes suggest an abnormality of the UMN or pyramidal tract, while decreased reflexes suggest abnormality in the anterior horn, LMN, nerve or motor end plate. A reflex hammer is used for this testing.
Particular clinical conditions require a specific approach. For instance, during the management of eclampsia, the magnesium infusion is stopped if urine output drops to less than 80 mL (in 4 hours), deep tendon reflexes are absent, or the respiratory rate is below 12 breaths/minute. A 10% calcium gluconate or chloride solution can serve as an ...
Signs and symptoms include exercise intolerance, muscle fatigue, muscle cramps, myalgia, delayed muscle relaxation (pseudomyotonia), proximal muscle weakness, delayed deep tendon reflexes (hyporeflexia) especially of the ankles, and a pseudoathletic appearance of hypertrophic calf muscles.