Hyporeflexia: Difference between revisions

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'''Hyporeflexia''' is the opposite of [[hyperreflexia]]: the presence of below normal or absent reflexes. It can be tested for by using a [[reflex hammer]]. [[Hyporeflexia]] is generally associated with a [[lower motor neuron]] deficit (lower motor neuron dysfunction) at the alpha motor neurons from the spinal cord to muscle; whereas, [[hyperreflexia]] is often attributed to [[upper motor neuron]] lesions (along the long motor tracts from the brain).
==Diagnosis==
=== Laboratory Findings ===
* [[Complete blood count]] ([[CBC]])
* [[Calcium]]
* [[Glucose]]
* [[Antinuclear antibody]] ([[ANA]])
* [[Rheumatoid factor]] ([[RF]])
* [[HIV]]
* [[Rapid plasma reagin]] ([[RPR]])
* [[Vitamin B12]] levels
* [[Thyroid function tests]]
* [[Heavy metal]] screen
* [[Hemoglobin A1c]]
* [[CK|Creatinine phosphokinase]] ([[CK]])
* [[Erythrocyte sedimentation rate]] ([[ESR]])
* [[Serum protein electrophoresis]] ([[SPEP]])
* Urine protein electrophoresis (UPEP)
=== Other Diagnostic Studies ===
* Nerve conduction studies
* [[Cerebrospinal fluid]] (CSF) analysis
==Differential Diagnosis==
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
* Brachial or lumbosacral plexopathy
* [[Cauda equina syndrome]]
* [[Guillain-Barre Syndrome]]
* Isolated peripheral nerve injury/dysfunction
* [[Lambert-Eaton Myasthenic Syndrome]]
* Motor neuron disease
* Multifocal motor neuropathy
* [[Myopathy]]
* [[Obesity]]
* [[Peripheral neuropathy]]
* Radiculopathy
* [[Spinal shock]]
__NOTOC__
__NOTOC__
{{Flatulence}}
{{Flatulence}}
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===Common Causes===
===Common Causes===
* [[Acetaminophen]]
 
* [[Albuterol ]]
* [[Biliary disease]]
* [[Caffeine]]
* [[Cystic fibrosis]]
* [[Clostridium difficile]]
* [[Diverticulitis]]
* [[Lisinopril]]
* [[Irritable bowel syndrome]]
* [[Intermittent bowel obstruction]]
* [[Malabsorption]]
* [[Obesity]]


===Causes by Organ System===
===Causes by Organ System===
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===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{columns-list|3|
 
* 3-month infant
* Abdominal surgery
* [[Acarbose]]
* [[Acetaminophen]]
* [[Aerophagia]]
* [[Albuterol]]
* Alpha glucosidase inhibitors
* Alteration of intestinal motility
* [[Amebiasis]]
* [[Anal cancer]]
* [[Anxiety]]
* Apples
* [[Autosomal dominant polycystic kidney disease]]
* Beans
* [[Bexarotene]]
* [[Biliary disease]]
* [[Blastocystis]]
* Bowel fermentation
* Brussel sprouts
* [[Bupropion]]
* [[Butalbital]]
* Cabbage
* [[Caffeine]]
* [[Calcium carbonate]]
* [[Levodopa and Carbidopa]]
* Carbohydrate malabsorption
* Carbonated beverages
* [[Carcinoid tumors]]
* [[Colon cancer]]
* [[Celiac disease]]
* [[Cevimeline]]
* Chewing gum
* [[Chloral hydrate]]
* [[Cholesterolosis]]
* Chronic constipation in adults
* Chronic diarrhea in developed countries
* Chronic functional constipation and fecal incontinence in infants and children
* Chronic mesenteric ischemia
* [[Cirrhosis of liver]]
* [[Citalopram]]
* [[Clindamycin]]
* [[Clonorchis]]
* Clostridium difficile
* [[Codeine]]
* Colonic bacterial fermentation
* [[Crayfish]]
* [[Crohn's disease]]
* [[Cyclosporiasis]]
* [[Cystic fibrosis]]
* [[Denosumab]]
* [[Dientamoeba fragilis]]
* Dietary factors
* [[Disopyramide]]
* [[Diverticulitis]]
* [[Diverticulosis]]
* Dulaglutide
* Eating too quickly
* [[Eluxadoline]]
* [[Enteropathy-type intestinal T-cell lymphoma]]
* [[Etodolac]]
* [[Exenatide]]
* Fecal incontinence in infants and children
* [[Food allergies]]
* [[Gallbladder disease]]
* [[Gallbladder polyps]]
* [[Gallstone ileus]]
* [[Gallstones]]
* Gas-containing sodas
* Gastric intestinal metaplasia
* [[Gastroesophageal reflux disease]]
* Gastrointestinal toxicity of radiation therapy
* [[Giardiasis]]
* [[Glipizide]]
* [[Glucose-6-phosphatase deficiency]]
* [[Glycopyrrolate]]
* Gut fermentation
* Habitual air swallowing
* [[Hepatic Encephalopathy]]
* Herbal products
* High fibre diet
* High legume diet
* High-fiber diet
* [[Human chorionic gonadotropin]]
* [[Hookworm]]
* [[Hypersalivation]]
* Increased intake of fructose
* Increased intake of lactose
* Increased intake of sorbitol
* Intermittent bowel obstruction
* Intestinal bacterial overgrowth
* Intestinal motility disorders
* Intestinal obstruction
* Introducing solid foods and vitamin and mineral supplementation during infancy
* [[Irritable bowel syndrome]]
* Lactose intolerance
* [[Lactulose]]
* Lipase inhibitors
* [[Lisinopril]]
* [[Lithium]]
* [[Lobster]]
* [[Lovastatin]]
* Malabsorption
* [[Megestrol acetate]]
* [[Mesenteric ischemia]]
* [[Mesalazine]]
* [[Metformin]]
* Metorchis
* [[Midodrine]]
* [[Miglitol]]
* [[Modafinil]]
* [[Moxifloxacin]]
* [[Naproxen]]
* [[Nitrofurantoin]]
* [[Norfloxacin]]
* Normal in healthy individuals
* Normal infant
* Normal physical needs
* [[Nuts]]
* [[Obesity]]
* [[Octreotide]]
* [[Ofloxacin]]
* Onions
* [[Opisthorchiasis]]
* [[Pancreatic cancer]]
* [[Pancreatic disease]]
* [[Pancreatic insufficiency]]
* Peanuts
* [[Pneumatosis intestinalis]]
* [[Polyethylene glycol]]
* [[Pork]]
* Postoperative ileus
* [[Probiotics]]
* Prunes
* Raisins
* [[Human chorionic gonadotropin]]
* [[Human growth hormone]]
* [[Rifampicin]]
* [[Ritonavir]]
* Shellfish
* [[Short bowel syndrome]]
* Shrimp
* [[Simethicone]]
* [[Simvastatin]]
* Small bowel diverticular
* Small intestine bacterial infection
* [[Sotalol]]
* Stomach infection
* [[Sunitinib]]
* Swallowed air
* [[Tacrolimus]]
* [[Thalidomide]]
* [[Tolcapone]]
* [[Tramadol]]
* undigestible starches in fruits
* undigestible starches legumes
* [[Wallnuts]]
* Undigestible starches in vegetables
}}


==References==
==References==

Revision as of 01:43, 15 November 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Carlos A Lopez, M.D. [3]

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning Polyethylene glycol
Dermatologic Carbohydrate malabsorption, malabsorption , HIV related malabsorption, intestinal tuberculosis, tropical sprue, whipple's disease
Drug Side Effect Acetaminophen, acarbose, acamprosate calcium, albuterol , bexarotene, bupropion, butalbital, calcium carbonate , levodopa and carbidopa, cevimeline, cidofovir, chloral hydrate, citalopram , clindamycin, codeine, denosumab, disopyramide, dolutegravir, dulaglutide , etodolac, exenatide, flurbiprofen, glipizide, glycopyrrolate, lactulose, lanreotide, lisinopril, lithium, lovastatin, medications, megestrol acetate, megestrol, meropenem, mesalazine, metformin, midodrine, misoprostol, miglitol, modafinil, moxifloxacin, naproxen, niacin, nitrofurantoin, norfloxacin, octreotide, ofloxacin, oxaprozin, pantoprazole, pergolide, polyethylene glycol, piroxicam, rabeprazole, Human chorionic gonadotropin, rifampicin, ritonavir, simethicone, simvastatin, sotalol, sunitinib, tacrolimus, tramadol, thalidomide, tolcapone, tolmetin, varenicline, vilazodone
Ear Nose Throat No underlying causes
Endocrine Pancreatic cancer, pancreatic disease, pancreatic insufficiency
Environmental No underlying causes
Gastroenterologic Abdominal surgery, aerophagia, alteration of intestinal motility, amebiasis, biliary disease, blastocystis, bowel fermentation, caffeine, carcinoid tumors, celiac disease, cholesterolosis, chronic constipation in adults, chronic diarrhea in developed countries, chronic functional constipation and fecal incontinence in infants and children, chronic mesenteric ischemia, cirrhosis of liver, crohn's disease, diverticulitis, diverticulosis, fecal incontinence in infants and children, gallbladder disease, gallbladder disorders, gallbladder polyps, gallstone ileus, gallstones, gastric intestinal metaplasia, gastroesophageal reflux disease, gastrointestinal toxicity of radiation therapy, giardiasis, hepatic encephalopathy in adults, hypersalivation, intermittent bowel obstruction, human growth hormone, intestinal bacterial overgrowth, intestinal motility disorders, intestinal obstruction, irritable bowel syndrome, lactase deficiency, metorchis, pancreatic carcinoma, pancreatic insufficiency, pneumatosis intestinalis, postoperative ileus, probiotics for gastrointestinal diseases, short bowel syndrome , small bowel diverticular, swallowed air, lactase deficiency, metorchis, pancreatic carcinoma, pancreatic insufficiency, pneumatosis intestinalis, postoperative ileus, probiotics for gastrointestinal diseases, short bowel syndrome, small bowel diverticular , swallowed air
Genetic Autosomal dominant polycystic kidney disease, cystic fibrosis, colon cancer , enteropathy-type intestinal T-cell lymphoma, glucose-6-phosphatase deficiency
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease Amebiasis, blastomycosis, clonorchis, clostridium difficile, colonic bacterial fermentation, cyclospora infection, dientamoeba fragilis, giardiasis, hookworm infection, metorchis, opisthorchis, small intestine bacterial infection
Musculoskeletal / Ortho Abdominal surgery
Neurologic Hepatic encephalopathy in adults
Nutritional / Metabolic Acarbose, apples, beans, bowel fermentation, brussel sprouts, cabbage, caffeine, malabsorption, carbonated beverages, chewing gum, chronic diarrhea in developed countries, crayfish, dietary factors, eating too quickly, food allergies, glucose-6-phosphatase deficiency, gut fermentation, herbal products, high fiber diet, high legume diet,increased intake of fructose, increased intake of lactose, increased intake of sorbitol, introducing solid foods and vitamin and mineral supplementation during infancy, lactase deficiency, lactulose, lobster, tropical sprue, traveler's diarrhea, mixed nuts, metabolic syndrome, obesity, onions, peanut, pork, prunes, raisins, shellfish, shrimp, undigestible starches in fruits, undigestible starches in vegetables, undigestible starches legumes
Obstetric/Gynecologic No underlying causes
Oncologic Colon cancer, anal cancer, carcinoid tumors, cirrhosis of liver, enteropathy-type intestinal T-cell lymphoma, pancreatic carcinoma
Ophthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric Aerophagia , anxiety
Pulmonary Pneumatosis intestinalis
Renal / Electrolyte Autosomal dominant polycystic kidney disease
Rheum / Immune / Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous 3-month infant due immature gut, aerophagia, eating too quickly, fecal incontinence in infants and children, habitual air swallowing, normal in healthy individuals, normal infant, normal physical needs, obesity


Causes in Alphabetical Order

References

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References

See also


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