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No Patellar Reflex (knee-jerk)


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#1 mama2alex

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Posted 04 September 2010 - 01:25 PM

We saw an LLMD last week and are starting on Rifampin on Tuesday (after the long weekend) b/c of a positive Bartonella lab. We're doing more testing while waiting to see ds10's response to the new antibiotic, including CBC and tests for viruses, molds, and rechecking vitamin D.

The LLMD did a pretty thorough physcial exam, which I appreciated. The one thing that popped out to me was that when he tapped my son's knee's with the little hammer, nothing happened. We both looked at each other, then he tried again - nothing. I didn't ask what this could mean, because I was worried what the answer would be and didn't want my son to hear something scary. The doctor didn't say anything, but then checked his feet by drawing a tongue depressor or something down the bottoms of his feet, and thankfully, he definitely felt it.

I looked this up on Wikipedia and it says lack of patellar reflex is called Westphal's Sign. It can indicate the following:

"Westphal's sign has a clinical significance used in determining neurodisorders or diseases such as:
-receptor damage, peripheral nerve disease, involving the dorsal(sensory)columns of the spinal cord and cerebellar lesions
-lesions present within the motor cortex of the brain or the pyramidal tracts which it combined with muscular spasms
-complete interruption of sensory and/or motor impulse transmission in the femoral nerve"

I'm wondering if anyone else has seen this in their child (or themselves) and what it means.


#2 justinekno

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Posted 04 September 2010 - 02:15 PM

My son has a rather weak knee jerk response when tapped by the hammer. Our neurologist has done the tongue depressor thing and he always responds to it. Our neurologist has never given any indication that this is something to be concerned with. Although he's the same dr who said my son would outgrow his tics so who knows. Interesting definition though. Hmmm.

We saw an LLMD last week and are starting on Rifampin on Tuesday (after the long weekend) b/c of a positive Bartonella lab. We're doing more testing while waiting to see ds10's response to the new antibiotic, including CBC and tests for viruses, molds, and rechecking vitamin D.

The LLMD did a pretty thorough physcial exam, which I appreciated. The one thing that popped out to me was that when he tapped my son's knee's with the little hammer, nothing happened. We both looked at each other, then he tried again - nothing. I didn't ask what this could mean, because I was worried what the answer would be and didn't want my son to hear something scary. The doctor didn't say anything, but then checked his feet by drawing a tongue depressor or something down the bottoms of his feet, and thankfully, he definitely felt it.

I looked this up on Wikipedia and it says lack of patellar reflex is called Westphal's Sign. It can indicate the following:

"Westphal's sign has a clinical significance used in determining neurodisorders or diseases such as:
-receptor damage, peripheral nerve disease, involving the dorsal(sensory)columns of the spinal cord and cerebellar lesions
-lesions present within the motor cortex of the brain or the pyramidal tracts which it combined with muscular spasms
-complete interruption of sensory and/or motor impulse transmission in the femoral nerve"

I'm wondering if anyone else has seen this in their child (or themselves) and what it means.


Justine

#3 sf_mom

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Posted 04 September 2010 - 03:24 PM

We had a similar response with DD.... very weak response but the bottom of her feet were o.k.

-Wendy




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