Diagnostic Tests for Adie syndrome
Adie syndrome Tests: Book Excerpts
- DIAGNOSTIC WORKUP - HYPOACTIVE REFLEXES
- History and physical examination - Deep tendon reflexes, hypoactive
- History and physical examination - Deep tendon reflexes, hyperactive
- History and physical examination - Doll's eye sign, absent [Negative oculocephalic reflex]
- History and physical examination - Deep tendon reflexes, hypoactive
- History and physical examination - Deep tendon reflexes, hyperactive
- Diagnostic Approach - Deep Tendon Reflex Abnormalities
- Physical assessment - Deep tendon reflexes, hypoactive
- Physical assessment - Deep tendon reflexes, hyperactive
- History and physical examination - Doll's eye sign, absent [Negative oculocephalic reflex]
- History and physical examination - Deep tendon reflexes, hypoactive
- History and physical examination - Deep tendon reflexes, hyperactive
Adie syndrome Diagnosis: Book Excerpts
- Ask the Following Questions - HYPOACTIVE REFLEXES
- Approach to the Diagnosis - HYPOACTIVE REFLEXES
- History and physical examination - Deep tendon reflexes, hypoactive
- History and physical examination - Deep tendon reflexes, hyperactive
- History and physical examination - Doll's eye sign, absent [Negative oculocephalic reflex]
- History and physical examination - Deep tendon reflexes, hypoactive
- History and physical examination - Deep tendon reflexes, hyperactive
- Differential Overview - Deep Tendon Reflex Abnormalities
- History - Deep tendon reflexes, hypoactive
- History - Deep tendon reflexes, hyperactive
- History and physical examination - Doll's eye sign, absent [Negative oculocephalic reflex]
- History and physical examination - Deep tendon reflexes, hypoactive
- History and physical examination - Deep tendon reflexes, hyperactive
- Approach to the Diagnosis - HYPOACTIVE REFLEXES
Diagnostic Tests for Adie syndrome: Online Medical Books
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HYPOACTIVE REFLEXES:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Focal hypoactive reflexes of the lower extremity require plane x-rays of the lumbosacral spine, a CT scan or MRI of the lumbosacral spine, and nerve conduction velocity and EMG studies. Dermatomal SSEP studies will occasionally show radiculopathy when EMGs are negative.
Hypoactive reflexes of one upper extremity can be worked up with x-rays of the cervical spine, MRI of the cervical spine, nerve conduction velocity studies, EMGs, and dermatomal SSEP studies. X-rays of the chest may be useful to rule out a Pancoast's tumor.
Diffuse hypoactive reflexes associated with other neurologic signs or symptoms require a neuropathy workup
. A serum B
12
and folic acid and possibly a Schilling test may need to be done to rule out pernicious anemia. An EMG and muscle biopsy may be done to rule out muscular dystrophy. A spinal tap will be helpful in cases of poliomyelitis and Guillain-Barré syndrome. If the hypoactive reflexes are part of a toxic metabolic or inflammatory disease of the nervous system, the workup will be similar to that of coma.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Deep tendon reflexes, hypoactive:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
After eliciting hypoactive DTRs, obtain a thorough history from the patient or a family member. Have him describe current signs and symptoms in detail. Then take a family and drug history.
Next, evaluate the patient's level of consciousness. Test motor function in his limbs, and palpate for muscle atrophy or increased mass. Test sensory function, including pain, touch, temperature, and vibration sense. Ask about paresthesia. To observe gait and coordination, have the patient take several steps. To check for Romberg's sign, ask him to stand with his feet together and his eyes closed. During conversation, evaluate speech. Check for signs of vision or hearing loss. Abrupt onset of hypoactive DTRs accompanied by muscle weakness may occur with life-threatening Guillain-Barré syndrome, botulism, or spinal cord lesions with spinal shock.
Look for autonomic nervous system effects by taking vital signs and monitoring for increased heart rate and blood pressure. Also, inspect the skin for pallor, dryness, flushing, or diaphoresis. Auscultate for hypoactive bowel sounds, and palpate for bladder distention. Ask about nausea, vomiting, constipation, and incontinence.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Deep tendon reflexes, hyperactive:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
After eliciting hyperactive DTRs, take the patient's history. Ask about spinal cord injury or other trauma and about prolonged exposure to cold, wind, or water. Could the patient be pregnant? A positive response to any of these questions requires prompt evaluation to rule out life-threatening autonomic hyperreflexia, tetanus, preeclampsia, or hypothermia. Ask about the onset and progression of associated signs and symptoms. Next, perform a neurologic examination. Evaluate the patient's level of consciousness, and test motor and sensory function in the limbs. Ask about paresthesia. Check for ataxia or tremors and for speech and visual deficits. Test for Chvostek's (an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in a patient who has hypocalcemia) and Trousseau's (a carpal spasm induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes in a patient who has hypocalcemia or hypomagnesemia) signs and for carpopedal spasm. Ask about vomiting or altered bladder habits. Make sure to take the patient's vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Doll's eye sign, absent [Negative oculocephalic reflex]:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
After detecting an absent doll’s eye sign, perform a neurologic examination. First, evaluate the patient’s level of consciousness (LOC), using the Glasgow Coma Scale. Note decerebrate or decorticate posture. Examine the pupils for size, equality, and response to light. Check for signs of increased ICP—increased systolic blood pressure, widening pulse pressure, and bradycardia.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Deep tendon reflexes, hypoactive:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
After eliciting hypoactive DTRs, obtain a thorough history from the patient or a family member. Have him describe current signs and symptoms in detail. Then take a family and drug history.
Next, evaluate the patient’s level of consciousness. Test motor function in his limbs, and palpate for muscle atrophy or increased mass. Test sensory function, including pain, touch, temperature, and vibration sensation. Ask about paresthesia. To observe gait and coordination, have the patient take several steps. To check for Romberg’s sign, ask him to stand with his feet together and his eyes closed. During conversation, evaluate his speech. Check for signs of vision or hearing loss. Abrupt onset of hypoactive DTRs accompanied by muscle weakness may occur in life-threatening Guillain-Barré syndrome, botulism, or spinal cord lesions with spinal shock.
Look for autonomic nervous system effects by taking vital signs and monitoring for increased heart rate and blood pressure. Also, inspect the skin for pallor, dryness, flushing, or diaphoresis. Auscultate for hypoactive bowel sounds, and palpate for bladder distention. Ask about nausea, vomiting, constipation, and incontinence.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Deep tendon reflexes, hyperactive:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
After eliciting hyperactive DTRs, take the patient’s history. Ask about spinal cord injury or other trauma and about prolonged exposure to cold, wind, or water. Could the patient be pregnant? A positive response to any of these questions requires prompt evaluation to rule out life-threatening autonomic hyperreflexia, tetanus, preeclampsia, or hypothermia. Ask about the onset and progression of associated signs and symptoms. Next, perform a neurologic examination. Evaluate level of consciousness, and test motor and sensory function in the limbs. Ask about paresthesia. Check for ataxia or tremors and for speech and visual deficits. Test for Chvostek’s sign (an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in patients who have hypocalcemia) and Trousseau’s sign (a carpal spasm induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes in patients who have hypocalcemia or hypomagnesemia) and for carpopedal spasm. Ask about vomiting or altered urination habits. Be sure to take vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Deep Tendon Reflex Abnormalities:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
Symmetrically hyperactive or hypoactive reflexes in the presence of downgoing toes are usually normal. A positive Babinski sign (upgoing toe) is always abnormal, signifying an upper motor neuron lesion, and is usually associated with spastic weakness and hyperreflexia. Lower motor neuron lesions are marked by hyporeflexia, flaccid weakness, atrophy, and twitching.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Deep tendon reflexes, hypoactive:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Evaluate the patient’s level of consciousness. Test motor function in his limbs, and palpate for muscle atrophy or increased mass. Test sensory function, including pain, touch, temperature, and vibration sense. Evaluate paresthesia. To observe gait and coordination, have the patient take several steps. To check for Romberg’s sign, ask him to stand with his feet together and his eyes closed. During conversation, evaluate speech. Check for signs of vision and hearing loss. Abrupt onset of hypoactive DTRs accompanied by muscle weakness may occur with life-threatening Guillain-Barré syndrome, botulism, or spinal cord lesions with spinal shock.
Look for autonomic nervous system effects by taking vital signs and monitoring for increased heart rate and blood pressure. Also, inspect the skin for pallor, dryness, flushing, and diaphoresis. Auscultate for hypoactive bowel sounds, and palpate for bladder distention. Ask about nausea, vomiting, constipation, and incontinence.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Deep tendon reflexes, hyperactive:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Perform a neurologic examination. Evaluate level of consciousness, and test motor and sensory function in the limbs. Check for ataxia or tremors and for speech and visual deficits. Test for Chvostek’s sign (an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in patients who have hypocalcemia), Trousseau’s sign (a carpal spasm induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes in patients who have hypocalcemia or hypomagnesemia), and carpopedal spasm. Be sure to record the patient’s vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Doll's eye sign, absent [Negative oculocephalic reflex]:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
After detecting an absent doll's eye sign, perform a neurologic examination. First, evaluate the patient's level of consciousness, using the Glasgow Coma Scale. Note decerebrate or decorticate posture. Examine the pupils for size, equality, and response to light. Check for signs of increased ICP—increased blood pressure, increasing pulse pressure, and bradycardia.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Deep tendon reflexes, hypoactive:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
After eliciting hypoactive DTRs, obtain a thorough history from the patient or a family member. Have him describe current signs and symptoms in detail. Then take a family and drug history.
Next, evaluate the patient's level of consciousness. Test motor function in his limbs, and palpate for muscle atrophy or increased mass. Test sensory function, including pain, touch, temperature, and vibration sense. Ask about paresthesia. To observe gait and coordination, have the patient take several steps. To check for Romberg's sign, ask him to stand with his feet together and his eyes closed. During conversation, evaluate speech. Check for signs of vision or hearing loss. Abrupt onset of hypoactive DTRs accompanied by muscle weakness may occur with life-threatening Guillain-Barré syndrome, botulism, or spinal cord lesions with spinal shock.
Look for autonomic nervous system effects by taking vital signs and monitoring for increased heart rate and blood pressure. Also, inspect the skin for pallor, dryness, flushing, or diaphoresis. Auscultate for hypoactive bowel sounds, and palpate for bladder distention. Ask about nausea, vomiting, constipation, and incontinence.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Deep tendon reflexes, hyperactive:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
After eliciting hyperactive DTRs, take the patient's history. Ask about spinal cord injury or other trauma and about prolonged exposure to cold, wind, or water. Could the patient be pregnant? A positive response to any of these questions requires prompt evaluation to rule out life-threatening autonomic hyperreflexia, tetanus, preeclampsia, or hypothermia. Ask about the onset and progression of associated signs and symptoms. Next, perform a neurologic examination. Evaluate the patient's level of consciousness, and test motor and sensory function in the limbs. Ask about paresthesia. Check for ataxia or tremors and for speech and visual deficits. Test for Chvostek's (an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in a patient who has hypocalcemia) and Trousseau's (a carpal spasm induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes in a patient who has hypocalcemia or hypomagnesemia) signs and for carpopedal spasm. Ask about vomiting or altered bladder habits. Be sure to take the patient's vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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