The Free Achilles Reflex in Hypothyroidism and Hyperthyroidism

The Achilles tendon reflex as an index of thyroid function

“…In some series the patients have been selected because the diagnosis was beyond doubt and those with borderline abnormalities have deliberately been excluded (Lawson, 1958;Sherman et al, 1963;Mann, 1963). In one series many of the hypothyroid patients were selected for the test because their reflexes were thought to be clinically prolonged by the referring physician (Robson et al, 1965).…”

“…The value of the Achilles tendon test is further limited by a number of conditions which may prolong the reflex time such as oedema (Harrell & Daniel, 1941;Abraham et al, 1966), diabetes mellitus (Beardwood & Schumacher, 1964), sarcoidosis (Richards, 1962), neurosyphilis (Simpson, Blair & Nartowicz, 1963a), myasthenia grawis and schizophrenia (Simpson et al, 1963b), hypokalaemia (Carr et al, 1963), peripheral vascular disease (Galpin & O'Brien, 1964), normal puerperium (Reinfrank et al, 1967), sprue (von Binswanger, Studer & Wyss, 1961 and pernicious anaemia (Nuttall & Doe, 1964). Some drugs may shorten the reflex time, namely amphetamine, ACTH, cortisone, oestrogens and salicylates (Lawson, 1958), adrenaline (Goldberg, 1962;Avera & Overholt, 1962) as well as thyroid hormones. Bromides and antithyroid drugs may lengthen the time (Lawson, 1958).…”

“…Not until 40 years later was this prolongation recorded graphically (Chaney, 1924); the converse shortening of the reflex time in thyrotoxic patients was first demonstrated in 1929 (Fournier). Subsequently a number of workers using various recording devices have measured the tendon reflexes in patients with thyroidal dysfunction (Harrell & Daniel, 1941 ;Lambert et al, 1951;Lawson, 1958;Gilson, 1959;Sharpe, 1961 ;Fogel et al, 1962;Fejer & Kun, 1963;Sherman, Gold-G berg & Larson, 1963;Smart & Robson, 1963; Moulopoulas, Koutras & Kralios, 1964;Reinfrank et al, 1967).…”

“…Today two main techniques are used, the photomotogram (Gilson, 1959) and the kinemometer (Lawson, 1958). In the former the movement of the sole of the foot, after percussion of the Achilles tendon, interrupts a light path which transmits a signal via a photo-electric transducer to an electrocardiographic (ECG) machine and writes a tracing as shown in Fig.…”

Diurnal Variations of the Achilles Tendon Reflex-Time

“…For recording ART the method of Lawson (1958) was used with our modifications (Zamrazil, Váña, Nëmec & Kühnl, 1968), and the SP interval (contraction and approximately half of relaxation time) was evaluated statistically (Nuttal & Doe, 1964). The ART was recorded on both sides and the average of four readings was taken (after eliminating the two extreme values from a total of six recordings).…”