Upper & Lower Motor Neurone Testing

• Upper & Lower Motor Neurone Testing - Reflexes:

  • Asses the integrity of the afferent and motor connections as well as the general sensitivity of the nervous system
  • Evidence of Hyperreflexia indicates a problem within the CNS assessing for an Upper motor Neurone lesion
  • Hyporeflexia is indicative of an lower motor neurone lesion
• Upper & Lower Motor Neurone Testing - Reflexes:

  • Patient relaxed needs to be relaxed
  • Target muscle on slight stretch
  • Strike the tendon or your thumb over tendon
  • A number of repetitions can be needed
  • Not always a big movement so will need to have the muscle visible to see it contracting
  • If you are having difficulty can add Teeth clenching or grip fingers together and try to pull apart
  • Must compare between sides
• Upper & Lower Motor Neurone Testing - Knee Jerk (Quadriceps) L3 Reflex:

  • Patient to be seated
  • Knee should be in 90 degrees with the quadriceps relaxed
  • Locate the patella tendon and strike firmly with the reflex hammer
  • Look for contraction of the quadriceps with associated knee extension movement
• Upper & Lower Motor Neurone Testing - Reflexes:

  • Hyperreflexia (too much movement/reflex) indicates a problem within the CNS assessing for an Upper motor Neurone lesion
  • Hyporeflexia (too little movement/reflex) is indicative of an lower motor neurone lesion
• Upper & Lower Motor Neurone Testing - Ankle Jerk (Achilles) S1 Reflex:

  • Patient in prone with foot off the bed or in standing with knee resting on plinth
  • Holding the foot move it into plantar grade or slight dorsiflexion
  • Using the reflex hammer strike the Achilles tendon
  • Look for a muscle contraction in the muscle belly and associated ankle plantar flexion