Annals of Indian Academy of Neurology
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Year : 2014  |  Volume : 17  |  Issue : 2  |  Page : 199-201

Intact thumb reflex in areflexic Guillain Barré syndrome: A novel phenomenon


1 Department of Neurology, KLES' Dr Prabhakar Kore Hospital and Medical Research Centre; Department of Neurology, KLE University's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
2 Department of Neurology, KLE University's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India

Correspondence Address:
Karkal Ravishankar Naik
Professor, Department of Neurology, KLE University's Jawaharlal Nehru Medical College and KLES' Dr Prabhakar Kore Hospital and Medical Research Centre, Belgaum, Karnataka - 590 010
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.132628

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Introduction: Areflexia is one of the cardinal clinical features for the diagnosis of Guillain Barré syndrome. However, some patients may have sluggish proximal muscle stretch reflexes. Presence of thumb reflex, a distal stretch muscle reflex has not been documented in Guillain Barré syndrome. Materials and Methods: We prospectively evaluated thumb reflex in Guillain Barré syndrome patients and age matched controls from April to September 2013. Results: There were 31 patients with Guillain Barrι syndrome in whom thumb reflex could be elicited in all (24 brisk, 7 sluggish), whereas all the other muscle stretch reflexes were absent in 29 patients at presentation and the remaining two had sluggish biceps and quadriceps reflexes (P = 0.001). Serial examination revealed gradual diminution of the thumb reflex (P < 0.001). Rapid progression of weakness was associated with early loss of the thumb reflex. Conclusion: Thumb reflex, a distal stretch reflex is preserved in the early phase of Guillain Barré syndrome.


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