A STUDY OF THE ANKLE JERK IN MYXEDEMA*

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Abstract
SLOWNESS of movement is one of the prominent symptoms of patients who have myxedema. It is observed not only in voluntary movements, but also in the response of the tendon reflexes. As a simple test of this aspect of the disease, observation of the speed of muscular movement elicited by the tendon reflexes, particularly those of the biceps and Achilles tendons, has proven to be useful in diagnosis. Usually a definite slowing of the reflex response can be observed in patients with myxedema during the routine clinical examination At the Mayo Clinic, use of this test as an aid in the diagnosis of myxedema began at least thirty years ago when it was recognized that myxedema was probably the only condition in which a characteristic “delayed relaxation” of the tendon reflexes was observed. Graphic records to demonstrate this were not made until 1924, when Chaney (1) reported measurements of the duration of the ankle jerk in patients with myxedema and other conditions. He found that the reflex response was prolonged in patients with myxedema, but not in patients with low basal metabolic rates associated with certain other conditions. During treatment of myxedema, the response returned to normal. Similar observations were reported by Harrel and Daniel (2) in 1941

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