LAUSR

Introduction A surprisingly large battery of deep tendon reflexes (DTR) developed by many a stalwart, mostly between 1850 and 1950, contemplating on myriads of muscles throughout the body, has become largely extinct. The ones to survive the spoils of time, are the biceps, triceps, supinator, knee and ankle jerks. A few among the lost ones were not deserving an evolutionary death, but got ignored by the growing restlessness of clinicians due to a diminutive adherence to clinical examination. the objective is to look for signs of life in the pile of presumed dead DTRs. Methods Robert Wartenberg’s classic book on reflexes, published in 1945, with 465 precious references, was exhumed from the out-of-print graveyard. Results A need to bring DTRs back to the self were the following: 1. Babinski’s inversion of supinator jerk, with lack of elbow flexion, but with flexion of wrist and fingers, may suggest a C5-C6 lesion. 2. Babinski and Sable’s Paradoxical Triceps reflex with flexion of the elbow without the expected extension, may suggest a C7 lesion, or an UMN lesion such as CVA, due to relative hyperreflexia in flexor more than the extensor muscles of the upper extremity. 3. Rosolimo’s reflex: Hammering the Achilles tendon resulting in flexion of the toes, especially the lateral ones, may suggest hyperreflexia or an upper motor neuron involvement. In patients without an obvious extensor plantar response, this can be useful. 4. Guillain and Barre’s semitendinosus and semimembranosus reflex by striking the tendons or just the tibia, gives us a L5 reflex. We have a good S1 reflex-the ankle jerk. Conclusion A search of the lost wisdom, regarding a need for more useful clinical examination, can empower us with better DTR examination.