Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentWhen to Seek Care
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
When to Seek Care
Hyporeflexiais a lessened or weak response in skeletal muscle reflexes. It is a symptom of an underlying medical condition rather than a disorder itself. Typically, these are medical conditions related to the nervous system.When stimulated, your musclereflexesrespond in a specific way. For example, if a healthcare provider lightly taps your knee during a reflex test, your leg should move. If it moves only slightly, you may have hyporeflexia.Diagnosis and treatment of hyporeflexia will depend on its underlying cause.Anna Bizon / EyeEm / Getty ImagesSymptoms of HyporeflexiaThe main sign of hyporeflexia is when the reflexes don’t respond as they should when tapped or stimulated (typically in a medical examination). Depending on the cause, people with hyporeflexia may also experience:Decreased muscle toneDecreased muscle massMuscle weaknessYou may not know you have hyporeflexia, as it often develops gradually. As it progresses, you may have trouble grasping items, maintaining your posture, or walking.People don’t generally conduct reflex tests at home. If you notice your reflexes are weakened, consider any other symptoms you may be experiencing. If you have any concerns, contact your healthcare provider.Causes of HyporeflexiaHyporeflexia occurs when the reflex arc is damaged. The reflex arc is a type of brain circuit that relies on both sensory and motor nerves to signal the reflexes in the body.The communication pathway between the brain and the rest of the body can be affected. That means that nerve fibers,nerve cells, and the spinal cord can be damaged and result in hyporeflexia.Several health conditions that result from damage to nerves and other areas along the reflex arc can lead to hyporeflexia, including:PolyneuropathyHypothyroidismAmyotrophic lateral sclerosis(ALS)Guillain-Barré syndrome(GBS)Polyneuropathy is the failure ofperipheral nervesthroughout the body. When these nerves fail, the action of the reflex arc is hindered, leading to hyporeflexia. Some specific types of polyneuropathies that can lead to hyporeflexia includediabetic polyneuropathyand chronic inflammatorydemyelinatingpolyneuropathy(CIDP).Hypothyroidism, in which the thyroid gland does not produce enough thyroid hormone, can result in hyporeflexia. Woltman’s sign—a delayed relaxation of the ankle jerk reflex—is a sign of hypothyroidism.ALS develops when the motor neurons in the brain and spinal cord become damaged or destroyed. When that happens, hyporeflexia can occur because the communication between the reflexes and the brain is compromised.In GBS, the immune system mistakes nerves for dangerous pathogens and attacks them. This leads to nerve damage, eventually causing hyporeflexia.What Else Can Cause Hyporeflexia?Several other health disorders can lead to hyporeflexia, including:Injuries to the spinal cordLambert-Eaton myasthenic syndrome(LEMS): Can be associated with small cell lung cancerRadiculopathy: Compression of a spinal nerve rootDiagnosisHealthcare providers will conduct what is known as a deep tendon reflex (DTR) exam to determine if you have hyporeflexia. The exam uses a small rubber hammer-like object to lightly hit thereflexesto see how well they work. Reflexes can be found in the:KneesOutside of the elbowsAnkles and wristsChinThe DTR test is often used inneurological examinationsbecause the reflexes can be a helpful diagnostic aspect in determining neurological disease.Since there are many causes of hyporeflexia, other neurological tests will be conducted following the DTR, such as:Blood testsUrine testsMuscle and/or biopsyMagnetic resonance imaging (MRI)Electromyography (EMG)Nerve conduction velocity (NCV) testAnalysis of cerebrospinal fluidTreatmentThere is no single treatment option for people who develop hyporeflexia because the causes range significantly. For example, healthcare providers would treat ALS and diabetic polyneuropathy differently. The therapies chosen will be determined based on the condition as a whole and not on the symptoms of hyporeflexia.Potential ComplicationsWhen people with hyporeflexia have weakened or wasted muscles they may have trouble walking and be prone to falling, which can result in head injuries or bone fractures.Physical therapy may be beneficial for some people to improve muscle strength, balance, and coordination.When to See a Healthcare ProviderThere is a difference between hyporeflexia and having regularly weak reflexes. If you’ve never noticed that your reflexes were poor and the symptom is new, talk to your healthcare provider.They will conduct a reflex test to determine just how weak the reflexes are, alongside other possible neurological examinations. By doing so, they can decide if you need to see aneurologist.Book an appointment immediately if you notice the reflexes change alongside other symptoms, such as muscle weakness or wasting. While it’s not always a serious health condition, it may be a serious neurological disease. The sooner you see your healthcare provider, the better.SummaryHyporeflexia is not a disease but rather a symptom that occurs in several neurological disorders such as ALS, GBS, and polyneuropathy. Depending on the cause, other signs may be present alongside the weakened reflexes, such as muscle weakness or wasting.Since treating hyporeflexia relies heavily on uncovering a cause, you should see your healthcare provider if you notice changes in your reflexes. They can do the appropriate tests and refer you to a neurologist if necessary.
Hyporeflexiais a lessened or weak response in skeletal muscle reflexes. It is a symptom of an underlying medical condition rather than a disorder itself. Typically, these are medical conditions related to the nervous system.
When stimulated, your musclereflexesrespond in a specific way. For example, if a healthcare provider lightly taps your knee during a reflex test, your leg should move. If it moves only slightly, you may have hyporeflexia.
Diagnosis and treatment of hyporeflexia will depend on its underlying cause.
Anna Bizon / EyeEm / Getty Images
Symptoms of Hyporeflexia
The main sign of hyporeflexia is when the reflexes don’t respond as they should when tapped or stimulated (typically in a medical examination). Depending on the cause, people with hyporeflexia may also experience:
You may not know you have hyporeflexia, as it often develops gradually. As it progresses, you may have trouble grasping items, maintaining your posture, or walking.
People don’t generally conduct reflex tests at home. If you notice your reflexes are weakened, consider any other symptoms you may be experiencing. If you have any concerns, contact your healthcare provider.
Causes of Hyporeflexia
Hyporeflexia occurs when the reflex arc is damaged. The reflex arc is a type of brain circuit that relies on both sensory and motor nerves to signal the reflexes in the body.
The communication pathway between the brain and the rest of the body can be affected. That means that nerve fibers,nerve cells, and the spinal cord can be damaged and result in hyporeflexia.
Several health conditions that result from damage to nerves and other areas along the reflex arc can lead to hyporeflexia, including:
Polyneuropathy is the failure ofperipheral nervesthroughout the body. When these nerves fail, the action of the reflex arc is hindered, leading to hyporeflexia. Some specific types of polyneuropathies that can lead to hyporeflexia includediabetic polyneuropathyand chronic inflammatorydemyelinatingpolyneuropathy(CIDP).
Hypothyroidism, in which the thyroid gland does not produce enough thyroid hormone, can result in hyporeflexia. Woltman’s sign—a delayed relaxation of the ankle jerk reflex—is a sign of hypothyroidism.
ALS develops when the motor neurons in the brain and spinal cord become damaged or destroyed. When that happens, hyporeflexia can occur because the communication between the reflexes and the brain is compromised.
In GBS, the immune system mistakes nerves for dangerous pathogens and attacks them. This leads to nerve damage, eventually causing hyporeflexia.
What Else Can Cause Hyporeflexia?Several other health disorders can lead to hyporeflexia, including:Injuries to the spinal cordLambert-Eaton myasthenic syndrome(LEMS): Can be associated with small cell lung cancerRadiculopathy: Compression of a spinal nerve root
What Else Can Cause Hyporeflexia?
Several other health disorders can lead to hyporeflexia, including:Injuries to the spinal cordLambert-Eaton myasthenic syndrome(LEMS): Can be associated with small cell lung cancerRadiculopathy: Compression of a spinal nerve root
Several other health disorders can lead to hyporeflexia, including:
Healthcare providers will conduct what is known as a deep tendon reflex (DTR) exam to determine if you have hyporeflexia. The exam uses a small rubber hammer-like object to lightly hit thereflexesto see how well they work. Reflexes can be found in the:
The DTR test is often used inneurological examinationsbecause the reflexes can be a helpful diagnostic aspect in determining neurological disease.
Since there are many causes of hyporeflexia, other neurological tests will be conducted following the DTR, such as:
There is no single treatment option for people who develop hyporeflexia because the causes range significantly. For example, healthcare providers would treat ALS and diabetic polyneuropathy differently. The therapies chosen will be determined based on the condition as a whole and not on the symptoms of hyporeflexia.
Potential ComplicationsWhen people with hyporeflexia have weakened or wasted muscles they may have trouble walking and be prone to falling, which can result in head injuries or bone fractures.Physical therapy may be beneficial for some people to improve muscle strength, balance, and coordination.
Potential Complications
When people with hyporeflexia have weakened or wasted muscles they may have trouble walking and be prone to falling, which can result in head injuries or bone fractures.Physical therapy may be beneficial for some people to improve muscle strength, balance, and coordination.
When people with hyporeflexia have weakened or wasted muscles they may have trouble walking and be prone to falling, which can result in head injuries or bone fractures.
Physical therapy may be beneficial for some people to improve muscle strength, balance, and coordination.
When to See a Healthcare Provider
There is a difference between hyporeflexia and having regularly weak reflexes. If you’ve never noticed that your reflexes were poor and the symptom is new, talk to your healthcare provider.
They will conduct a reflex test to determine just how weak the reflexes are, alongside other possible neurological examinations. By doing so, they can decide if you need to see aneurologist.
Book an appointment immediately if you notice the reflexes change alongside other symptoms, such as muscle weakness or wasting. While it’s not always a serious health condition, it may be a serious neurological disease. The sooner you see your healthcare provider, the better.
Summary
Hyporeflexia is not a disease but rather a symptom that occurs in several neurological disorders such as ALS, GBS, and polyneuropathy. Depending on the cause, other signs may be present alongside the weakened reflexes, such as muscle weakness or wasting.
Since treating hyporeflexia relies heavily on uncovering a cause, you should see your healthcare provider if you notice changes in your reflexes. They can do the appropriate tests and refer you to a neurologist if necessary.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Price RS, Cucchiara BL.Hyperreflexia and hyporeflexia.Decision-Making in Adult Neurology.2021:68-71. doi:10.1016/B978-0-323-63583-7.00034-5Iwasaki Y, Fukaya K.Woltman’s sign of hypothyroidism.N Engl J Med. 2018;379(14):e23. doi:10.1056/NEJMicm1713796Amyotrophic lateral sclerosis. In: Bissonnette B, Luginbuehl I, Engelhardt T. eds.Syndromes: Rapid Recognition and Perioperative Implications, 2e. McGraw Hill; 2019.van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, van Doorn PA.Guillain-Barré syndrome: pathogenesis, diagnosis, treatment and prognosis,Nat Rev Neurol.2014;10(8):469-482. doi:10.1038/nrneurol.2014.121University of Iowa Hospitals and Clinics.How do spinal cord injuries affect the body?Talbot D, Briggs, Gozzard.The association between Lambert-Eaton myasthenic syndrome and small cell lung carcinoma.ITT. 2013;2:31-7. doi:10.2147/ITT.S31971ALS Association.ALS symptoms and diagnosis.National Institute of Neurological Disorders and Stroke.Neurological diagnostic tests and procedures.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Price RS, Cucchiara BL.Hyperreflexia and hyporeflexia.Decision-Making in Adult Neurology.2021:68-71. doi:10.1016/B978-0-323-63583-7.00034-5Iwasaki Y, Fukaya K.Woltman’s sign of hypothyroidism.N Engl J Med. 2018;379(14):e23. doi:10.1056/NEJMicm1713796Amyotrophic lateral sclerosis. In: Bissonnette B, Luginbuehl I, Engelhardt T. eds.Syndromes: Rapid Recognition and Perioperative Implications, 2e. McGraw Hill; 2019.van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, van Doorn PA.Guillain-Barré syndrome: pathogenesis, diagnosis, treatment and prognosis,Nat Rev Neurol.2014;10(8):469-482. doi:10.1038/nrneurol.2014.121University of Iowa Hospitals and Clinics.How do spinal cord injuries affect the body?Talbot D, Briggs, Gozzard.The association between Lambert-Eaton myasthenic syndrome and small cell lung carcinoma.ITT. 2013;2:31-7. doi:10.2147/ITT.S31971ALS Association.ALS symptoms and diagnosis.National Institute of Neurological Disorders and Stroke.Neurological diagnostic tests and procedures.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Price RS, Cucchiara BL.Hyperreflexia and hyporeflexia.Decision-Making in Adult Neurology.2021:68-71. doi:10.1016/B978-0-323-63583-7.00034-5Iwasaki Y, Fukaya K.Woltman’s sign of hypothyroidism.N Engl J Med. 2018;379(14):e23. doi:10.1056/NEJMicm1713796Amyotrophic lateral sclerosis. In: Bissonnette B, Luginbuehl I, Engelhardt T. eds.Syndromes: Rapid Recognition and Perioperative Implications, 2e. McGraw Hill; 2019.van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, van Doorn PA.Guillain-Barré syndrome: pathogenesis, diagnosis, treatment and prognosis,Nat Rev Neurol.2014;10(8):469-482. doi:10.1038/nrneurol.2014.121University of Iowa Hospitals and Clinics.How do spinal cord injuries affect the body?Talbot D, Briggs, Gozzard.The association between Lambert-Eaton myasthenic syndrome and small cell lung carcinoma.ITT. 2013;2:31-7. doi:10.2147/ITT.S31971ALS Association.ALS symptoms and diagnosis.National Institute of Neurological Disorders and Stroke.Neurological diagnostic tests and procedures.
Price RS, Cucchiara BL.Hyperreflexia and hyporeflexia.Decision-Making in Adult Neurology.2021:68-71. doi:10.1016/B978-0-323-63583-7.00034-5
Iwasaki Y, Fukaya K.Woltman’s sign of hypothyroidism.N Engl J Med. 2018;379(14):e23. doi:10.1056/NEJMicm1713796
Amyotrophic lateral sclerosis. In: Bissonnette B, Luginbuehl I, Engelhardt T. eds.Syndromes: Rapid Recognition and Perioperative Implications, 2e. McGraw Hill; 2019.
van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, van Doorn PA.Guillain-Barré syndrome: pathogenesis, diagnosis, treatment and prognosis,Nat Rev Neurol.2014;10(8):469-482. doi:10.1038/nrneurol.2014.121
University of Iowa Hospitals and Clinics.How do spinal cord injuries affect the body?
Talbot D, Briggs, Gozzard.The association between Lambert-Eaton myasthenic syndrome and small cell lung carcinoma.ITT. 2013;2:31-7. doi:10.2147/ITT.S31971
ALS Association.ALS symptoms and diagnosis.
National Institute of Neurological Disorders and Stroke.Neurological diagnostic tests and procedures.
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