What can this reflex be associated with?

I am a 53 y.o. male currently being seen by my 4th neurologist.  I am hyperreflexic, have Babinksi sign on only one foot, suffer continual cramps, spasms, fasciculations in legs below knees (calf and ankle muscles) and periods of very stiff muscles.  I have had a clean EMG/NCV 2 years ago, good blood work and normal brain, cervical and lumbar MRI.  No lumbar puncture or muscle biopsy.  These symptoms have been ongoing for over 2 years.

I tune pianos for a living and have noticed a very odd reflex that none of the neurologists have commented on that I feel could be key to figuring out my problem.  When I strike a key with the fingers of my left hand, my adam's apple bobbles up and down.  This is very annoying as I am constantly striking piano keys throughout the day.

One neurologist, now recently retired, was of the opinion that I may have primary lateral sclerosis.  I have a sister that has multiple sclerosis, secondary progressive at this stage.

Have you ever heard of this finger-adam's apple response?

[Abhijeet Ghosh]

Dear Friend,
Many thanks for the post.
There are various reasons for Hyper-reflexia. Accurate examination and co-relating the same becomes most important.
However frequent change of doctors may not be a good idea.
The few prominent reason for Hyper-reflexia are -
1) Spinal Cord problem,
2) Drug Overuse.
3) Brain injury,
4) Electrolyte imbalance.

Spinal cord involvement is one of the main problem.But there can be many reasons, which will fit into this criteria ( like Multiple sclerosis / Viral Encephalitis / Lateral Sclerosis / etc.
However they need to be fully and properly co-related with MRI / Physical findings.
I would suggest you to go ahead with the investigation and as per his advice.

Regarding the Piano-Adam's apple issue, i have still not heard about this reflex. Your treating doctor, would be able to help you out of this.

I am not to specific in my answer as i have not examined you physically and hence am avoiding to give a pin-point answer.
But i am open for further discussions.
Regards.

Feel free to discuss more