Hoffmann’s reflex - Clinical Methods

 - positive Hoffmann’s reflex reflects presence of an upper motor neuron lesion from spinal cord compression;
 - is elicited by flipping either the volar or dorsal surfaces of the middle finger and observing the reflexcontration of the thumb and index finger;
- positioning the neck in extension (sometimes flexion) may worsen the reflex;
- at or above the level of compression, upper extremity should be diminished or absent due to nerve root compression;
- in the report by Sung and Wang (2001), asymptomatic patients with a positive Hoffmann’s reflex were prospectively studied with cervical radiographs and magnetic resonance imaging;
          - to determine a relationship between a positive Hoffmann’s reflex and cervical pathology in asymptomatic patients and to evaluate if further work-up was necessary in this patient population;
          - 16 patients without cervical pain or radiculopathy and a positive Hoffmann’s reflex were prospectively studied with cervical radiographs and magnetic resonance imaging;
          - all 16 patients were asymptomatic;
          - 14 patients (87.5%) demonstrated spondylosis on cervical radiographs;
          - MRI showed pathologic findings in all 16 patients;
          - 15 patients (94%) had cervical involvement with cord compression from a herniated nucleus pulposus;
          - remaining patient had a T5-T6 thoracic disc with resultant compression