Hello!

I have a question about reflexes. You can read my whole history in my first post if you're curious about the background to this question...

I saw a new neurologist a couple weeks ago. He isn't sure what's going on with me, but he did note that I have asymmetrical reflexes in my knees. The left one is normal (quite bouncy) and the right one barely moves at all. He tried them several times, looked puzzled, then moved on. When he was done the neuro exam he tried my knee reflexes again with the same result as before. The right one is definitely much weaker than the left though it's not absent. He said he didn't know what to make of that considering the rest of my exam was normal.

Based on my symptoms, the neurologist said I didn't really fit the profile of any of the neurological syndromes or diseases he typically sees. I have multisystem involvement and it seems that my neuropathic symptoms are related to an underlying autoimmune disease. My bloodwork indicates that I have one, but the markers that show up are not specific and we don't know yet which disease I have.

I will be doing a new brain/spine MRI soon - the one from last year was normal, but the neurologist wants to see if there have been any changes. I'm also doing a sleep study and wearing a Holter Monitor to rule out cardiac issues. We will consider a new NCV/EMG depending on the results of the other tests. I have one in June and it didn't show anything, but I have little to no neuropathy over the summer so I don't find that surprising.

Anyway, I was pleased with my appointment but wished I'd asked the neurologist what the asymmetry of my reflexes could mean. Lately my right leg has been the one that is numb more often, but it's not weak. I looked up some information about reflexes today and it said that asymmetry in the knee reflexes is a lower motor neuron sign and usually pathological... not sure what to make of that though. Anyone?

Get a second opinion re the reflexes. 4 years ago when I barley had PN symptoms I ended up in bangkok hospital and the nuero surgeon there couldn't get a reflex from either knee except a very mild one in my left.

fast forward and my new neuro was about to test and I said dont worry they dont work. But they did! Dont ask me why the first nuero couldnt get a reaction, all very odd

--the lower back imaging is essential, as asymmetrical reflexes could indicate compression on the spine or nerve roots that is greater on one side. This could exist independently of any other conditions you might have that are contributing to neural symptoms, and be additive to them.

Here is a list of possible causes for depressed or absent knee reflexes:
http://en.diagnosispro.com/different...34856-154.html

Don't get alarmed... some of them are frightening.

Reflex can vary a lot it seems. I don't have mine done anymore because it sends me in a huge flare but when I did sometimes they could get one and sometimes not. If I was tense etc it threw off the result. That is why they want you to be relaxed which is impossible for me when someone wants to get near my pain. I am not saying you should not look more into this just my experience. None of the doctors I have seen have been concerned with lack of one if they did not get it etc. Again not saying you should not look into it more.
When is your next apt? Could you call the nurse even at the office and ask your question if concerned?

Thanks! My next appointment is at the end of April with the neurologist. I believe I'll see him at the sleep clinic next week when I got for the sleep study though. I don't know I'm concerned enough to call for clarification. I was really just curious. Since I still don't have a cause for my PN diagnosed I look at these little abnormalities as clues, I guess.

Thanks! I imagine when I get the brain/spine MRI done (I don't have a date for it yet) the imagining of the lumbar spine will be enough to show the kind of nerve compression you're talking about?

Thank you. I'll ask my family doctor to check my reflexes the next time I'm in to see her for something. I do remember that while I was pregnant the midwife checked those reflexes because very brisk reflexes are a sign of preeclampsia. She could barely find mine at all - I can't remember if it was just the right that gave her problems or both. She said it wasn't a big deal because what she was concerned about were overly reactive reflexes anyway! Just remembering that now though... it was 2 years ago.

Thank you. I will look through it. And try not to get alarmed.