Hoffmann's sign

Hoffmann's sign

In medicine, Hoffmann's sign, named after the German neurologist, Johann Hoffmann [WhoNamedIt|synd|3740] [P. Hoffmann. Über eine Methode, den Erfolg einer Nervennaht zu beurteilen. Medizinische Klinik, March 28, 1915b, 11 (13): 359-360.] (born 1857, Rheinhesse; died 1919, Heidelberg), is a finding elicited by a reflex test which verifies the presence or absence of problems in the corticospinal tract. It is also known as the finger flexor reflex.

The test involves tapping the nail or flicking the terminal phalanx of the third or fourth finger. A positive response is seen with flexion of the terminal phalanx of the thumb.

Relation to Babinski sign

Hoffmann's sign is often considered the upper limb equivalent of the Babinski's sign [cite journal |author=Harrop JS, Hanna A, Silva MT, Sharan A |title=Neurological manifestations of cervical spondylosis: an overview of signs, symptoms, and pathophysiology |journal=Neurosurgery |volume=60 |issue=1 Supp1 1 |pages=S14–20 |year=2007 |pmid=17204875 |doi=10.1227/01.NEU.0000215380.71097.EC] because it, like the Babinski sign, indicates upper motor neuron dysfunction. [New York University School of Medicine. Deep Tendon Reflexes. URL: [http://endeavor.med.nyu.edu/neurosurgery/reflexes.html http://endeavor.med.nyu.edu/neurosurgery/reflexes.html] . Accessed November 27, 2005.] Mechanistically, it differs considerably from the Babinski which is also known as the plantar reflex; Hoffmann's sign involves a monosynaptic reflex pathway in Rexed lamina IX of the spinal cord, normally fully inhibited by descending input. The pathways involved in the plantar reflex are more complicated, and different sorts of lesions may interrupt them. This fact has led some neurologists to reject strongly any analogies between the finger flexor reflex and the plantar response.

References

ee also

*Babinski's sign
*Cervical spondylosis

External links

* [http://www.emedicine.com/NEURO/topic564.htm Cervical Spondylosis: Diagnosis and Management] - emedicine.com
* [http://www.emedicine.com/asp/dictionary.asp?exact=Y&keyword=Hoffmann+sign Hoffmann sign] - Stedman's Dictionary
* [http://depts.washington.edu/neurosur/spine_center/images/hoffman-1.mov] link of the exam performed with a positive Hoffman's sign


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