Spine and Back Health

Medical terms

08/08/2000

Question:

Could you please tell me the meaning of these terms. cervical spinal cord gliosis, positive hoffmans sign and clonus. What does a Dr. look for when the check reflexes? What is hyper-reflexia? Can these be explained so an uneducated person can understand?

Answer:

It can be difficult to make sense of medical records, incl. MRI or CT scan reports, operation or progress notes due to the specialized terminology used. Ideally, your doctors are taking time to explain yhese in "laymen`s terms" so you can better understand your condition. You can buy medical dictionaries ( Taber`s, Stedman`s) relatively cheaply that can help define these terms.
The words you asked about can be described as follows:
1) gliosis: this is a change in normal spinal cord tissue to one that has thinned or atrophied - sometimes w/ scar tissue related to trauma.
2)Positive Hoffman`s: this is a test of the reflexes in the fingers and thumb that can be a sign that there has been some damage to the spinal cord or brain areas that control normal reflexes and muscle tone.
3) Clonus: this is an abnormal reaction of the testing of muscle tone in the feet and ankles that can be caused by damage to some place higher in the spinal cord, like the neck, or brain. It is usually an involuntary bouncing of the feet once they been stretched upward at the ankles. It may last for a few beats or go on for quite a while.
4) Hyper-reflexia: this is an unusually brisk or "hyper" reaction of the tendon-muscle stretch response of the body at various places, incl. the ankles, knees, elbows, and sometimes the wrists, and thighs. It can be caused by injury along the spinal cord or brain ( which can even be narrowing with too much pressure at spots along the spine).
Reflexes are checked to see if they are abnormally strong ( hyperreflexia) or weak ( hyporeflexia or flaccid). These can give clues as to where the body ( and esp the nervous system) are experiencing problems to guide diagnostic tests. They can also help see if medications are helping abnormal muscle tone ( spasticity) that can be painful or interfering with functioning.
If you are having these problems, you may want to be referred to a spine surgeon to evaluate if this can be helped surgically. If you have had surgery, but this is an uncorrectable problem that remains, you may want to see a specialist that works with this medically. These include Physical Medicine and Rehabilitation ( PM&R) doctors - also called physiatrists, or maybe a Neurologist.
Good luck and thanks for the questions!

For more information:

Go to the Spine and Back Health health topic, where you can:

Read articles on this topic
Browse the previously asked questions
Ask your own question.

Response by:

James Plunkett, MD
Assistant Professor of Physical Medicine & Rehab.
Department of Physical Medicine & Rehabilitation
College of Medicine
University of Cincinnati