Reflex Loss

[Shely-Heider]

    
      Re: Reflex Loss
    


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Posted by ccf neuro M.D.* on February 14, 1998 at 15:36:50:

In Reply to: Reflex Loss posted by Shelly Heider on February 12, 1998 at 11:42:52:
  I have a C5-6 fusion with an incomplete spinal cord lesion.  I also have Brown Sequard syndrome.  A diagnosis of FM has been made along with peripheral neuropathy.  We are still looking for the cause of the PN.
  I have hyper-reflexes due to the level of cord injury.  Recently, I have lost the upper and lower extremity reflexes.  My neuro. is looking for a cause at this time.  Approx. 1 1/2 years ago this happened and they returned to their hyper state after approx. 6 months.  I was a patient at Mayo. and was told to return if it happened again.  They had no answers at that time.
  Please provide me with some direction.  I know this is a complicated case but I feel if I research the possibilities, my MD's will be able to look into them.
  I have been referred to as a Project.  I need to find an MD that will take the time to help me find and answer and some long term relief.
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Hello Shelly,

You have an interesting and not entirely uncommon problem, namely that you have have two problems, one of which is affecting the so-called "upper motor neurons", which are nerve fibers that go from the brain down the spinal cord to a second set of nerves called the "lower motor neurons" which sre the nerve fibers that run from the spinal cord to the actual muscles in your arms and legs. If the upper motor neuron fibers are damaged or disrupted, this causes the normal inhibiting nerve impulses constantly flowing through them to be blocked, and the lower motor neurons get overactive, and your reflexes become exgerrated. On the other side of the coin, if damage occurs to either the lower motor neuron fibers or to another set of nerve fibers that conduct sensation FROM the muscles and skin TO the spinal cord, the reflexes can instead become DIMINISHED. Peripheral neuropathy is the most common condition that affects and damages precisely these sorts of fibers. Whether your reflexes are too jumpy or overactive as opposed to underactive or even missing depends on the balance between the competing effects of the upper motor neuron fibers being damaged and the other nerve fibers being damaged. Your peripheral neuropathy may have progressed to a point that it has dimished your reflexes so much that it is even able to "override" the effects of the Brown-Sequard spinal cord injury's effects on the reflexes. Such a change does definitely warrant reevaluation, as it does indicate some sort of new damage or change most likely in the way the nerves are functioning, and I think your being concerned about the change is quite appropriate. It will definitely take someone who is willing to be patient and sort out things, as you seem to have both a preexisting problem, and the new problem, and this is never easy to do. If you are anywhere near the Cleveland area, we would of course be happy to provide you with such an evaluation. If you are closer to the Mayo Clinic (you mentioned you've been there once before), the physicians there are certainly more than capable of providing such an evaluation as well. Our appointment number is 1-800-223-2273 extension 45559. I would suggest one of the doctors in our neruomuscular section for a case such as yours. Mayo has such a section as well. Good Luck!! Remember that the information we provide on the forum is intended for general informational purposes only and that the actual diagnosis and treatment of your specific medical condition should be strictly in conjunction with your treating physician(s). We hope you find the information helpful.