1.Wide range of normality in deep tendon reflexes in the normal population
Kheng Seang Lim, Yii Zhan Bong ; Yaw Lim Chaw ; Kean Teng Ho ; Kwang Kwok Lu ; Chin Hwan Lim ; Mei Ling Toh ; Chong Tin Tan
Neurology Asia 2009;14(1):21-25
Background and objective: Deep tendon reflexes are important physical signs in neurological
examination. Despite being an established technique clinically, there is lack of normality data in the
healthy population, especially among the elderly. This study aims to determine the range of normality
in deep tendon reflexes among the adults. Methods: The study subjects consisted of 176 healthy
volunteers. They were examined by trained assessors using standardized protocol. Results: Among the
commonly elicited deep tendon reflexes, isolated absent reflexes were found in up to 34.4% (supinator)
in the older group, and 12.5% (triceps) in the young adults, significantly higher in the older group.
Symmetrical absent reflexes was seen in up to 26.3% of supinator in the older group. Absent reflexes
of the entire limbs both sides were however, much less common particularly among young adults,
with 6.3% of the older group having absent reflexes in the entire lower limbs, and 2.5% in the entire
upper limbs. Isolated asymmetry in reflex was present in up to 17.0% (triceps). However, only 6.3%
had asymmetrical reflexes in the contiguous anatomical region.
Conclusion: Isolated absent or asymmetry deep tendon reflexes were common particularly in the
elderly.