Download - Neuro clinics 57 hyper-reflexia
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Dr Pratyush Chaudhuri
Supported by Nirmal ClinicsScience comes first
Neuro Clinics 57
Hyper reflexia – Deep tendon reflexes
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• Renal Syndrome• Parkinson disease• Portal hypertension
• Malaria• Acute pesticide poisoning – xylene• hypernatremia
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Case 2
• 34 yrs old male• Had complained of headache during the
last 2 years• Recent c/o confusion at work• Loss of recent memory
• Profession - painter
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• Higher function – unable to perform simple graphic copying
• Ataxia• Cerebellar signs• hyperreflexia
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Laboratory findings
• Hb – 7gm%• Na/K/Cl/Ca = 150/4.9/111/3.0
• Sr Creat = 1.6• Urinary methylhippuric acid - elevated
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• Whats your diagnosis?
• This is Xylene poisoning.
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Post your comments , objections and suggestions on
• www.thinkoblique.blogspot.com• www.drpratyush.hpage.com
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Case 2
• 76 years old• Presented with c/o confusional state with
incontinence of urine since last 2 days• He has been diagnosed as a case of
parkinsons disease on syncapone during the last 6 months
• HT & Diabetic
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• Clinical examination reveals • Parkinson disease findings• Dementia on psychometric testing• Hyper-reflexia
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• Lab reports • Hypernatremia• Rest within normal limits
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• CT scan brain revealed diffuse cerebral atrophy
• What is your diagnosis?
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• Here the diagnosis for the exaggerated reflexes is hypernatremia.
• Cause for hypernatremia may be DI or dehydration.
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Case 3
• 17 yrs old male presented with c/o high grade fever with headache since last 2 days.
• He had severe chills with rigors during the fever.
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• Fever 103 F• Exagerated reflexes• Rest normal
• Peripheral smear – MP- Falciform
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• Remember falciform malaria causes endotoxic cerebral oedema
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Thank You!
• Next clinic- Examples of hypo-natremia