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Soleus H-reflex tests and clinical signs of the upper motor neuron syndrome.
  1. J H Koelman,
  2. L J Bour,
  3. A A Hilgevoord,
  4. G J van Bruggen,
  5. B W Ongerboer de Visser
  1. Department of Clinical Neurophysiology, Medical Centre, AZ-Amsterdam, The Netherlands.


    Soleus H-reflex tests are used for elucidating pathophysiological mechanisms in motor control. The cumulative vibratory inhibition of the soleus H-reflex, the ratio of the reflex to direct muscle potential (H to M ratio) and the recovery curve of the soleus H-reflex were studied in 38 patients with varying signs of the upper motor neuron syndrome for a possible relation with clinical features. The results were compared with those obtained from a group of healthy volunteers. The magnitude of vibratory inhibition decreased with increase of hypertonia. The H to M ratio increased as the activity of the tendon reflex was enhanced and correlated to a lesser degree with muscle tone. Both the H to M ratio and late facilitation of the soleus H-reflex recovery curve were elevated in clonus. The findings suggest that alterations in the results of soleus H-reflex tests relate to specific clinical features of the upper motor neuron syndrome. Possible pathophysiological implications are discussed.

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