脳神経内科医はハンマーで何を診ているのか？―神経学的診察―

抄録

Neurologist consider three things of the patient ; 1) where is the lesion?, 2) what is the lesion?, 3) What can I do for the patient? Neurological examination is important for localization of the lesion. If the localization of the lesion is decided, the quality of a pathological change which occurs there will be limited considerably.

A reflex hammer is a symbol of neurological examination. Neurologist needs to be skillful in tendon reflexes. Reliable methods of tendon reflexes depend on adequate reflex hammers, complete relaxation of the muscle, positioning of extremities, and an adequate stretch stimulus. The presence of hyporeflexia or hyperreflexia may indicate an underlying disease. Proper technique and interpretation of results are crucial to localize the lesion. The clinical significance of deviations in the activity of tendon reflexes from the normal depends on comparison with other tendon reflexes and particularly with the reflex of the corresponding muscle of the opposite side. Tendon reflexes are especially important in diagnosis of spinal diseases or peripheral nerve diseases.