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HOFFMAN SIGN
I am a 47 year old female who three years ago herniated a disc at the T1-T2 level which was deforming the spinal cord.  I saw a neurosurgeon at the time who recommended physiotherapy but stated that I should contact a neurologist as he noticed that "Hoffman Sign", "Brisk Hyperreflexia" and Muscle twitching were present.  I have been under the care of a neurologist for the past year who has stated that it is "Fibromyalgia" and has prescribed duloxetine to control the symptons.  I understand that muscle twitching is a sympton of Fibromyalgia but is "Hoffman Sign" and "Hyperreflexia" also signs of this condition or is it due to another underlying condition.  Also the neurologist has recently mentionned that I have "clonus".  Is this also another sympton of fibromyalgia.  The duloxetine works to a certain degree but I still have problems with spasticity in my when I walk downstairs (they start shaking) along with numbness and tingling in the left side of my face.
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Hello Hoffman sign,clonus, hypereflexia   are  common symptoms of cervical mylepathy and exists in many patients of fibromyalgia. Tramadol  is often used to relieve fibromyalgia pain. Local injections into tender points may also be helpful.
Apart from duloxetine you can discuss regarding drugs like gabapentin,neurontin,carbamezapine for the numbness and tingling.Lifestyle modifications including regular exercise, good sleep habits help manage fibromyalgia symptoms.
Reference http://arthritis.about.com/od/fibromyalgia/p/fibro_facts.htm
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