Spinal Cord Test-Hoffmann's sign

[speedygodzilla]

I was watching Mystery Diagnosis, one of my favorite shows on the Health Channel. The patient was having a wide variety of symptoms (Headache, N/V, blur vision, dizziness, etc) and ended up having a herniated disk. When that was repair the problems got better for awhile but came back even worse than before. The doctor did a head to toe exam and also did a Hoffmann's sign, it show that it was a neurological issue, doctor order a CT with contrast on her head. It showed a tumor protruding on her cranial nerves (thus being what was casing all the odd symptoms).

I have never heard of this test before, my question, is this something that gets used in the field? It is a easy and quick spinal cord test and would be an easy thing to perform, so why not make it part of the head to toe exam?

Here is a url to wikipedia on the test:

http://en.wikipedia.org/wiki/Hoffmann's_sign

[captainstandup]

I would love to pretend I knew what Hoffman's Sign was prior to your post, but honestly, I had no clue. As to your question regarding its use in the field. I believe any information that can be gained as early as possible is worthy of the effort. With this said we must remain cognizant of the need for "economy of time" and attend to rapid triage and transport when indicated. Finally to utilize a "test" such as that to elicit Hoffman's Sign it is necessary to have some practical application of the process and expected results along with a clear understanding of the implications of positive and negative results. Many prehosital providers will not have this opportunity.

[EMS Solutions]

Thanks for the link to see the details. I also was not aware of this.

" It is also known as the finger flexor reflex.

The test involves tapping the nail or flicking the terminal phalanx of the third or fourth finger. A positive response is seen with flexion of the terminal phalanx of the thumb."

It is similar to what I initially thought it was

me rolling my eyes

me flexing a different finger

me driving my car and flexing a finger

All also well known Hoffman signs.

I do agree though that time is an issue, and testing for these signs and others may not always be prudent with patients in the field. You may even find that if you start doing this and telling doctors of your +- Hoffmann's sign, they may have no idea either and start flexing their own fingers.

As far as it being easy, many things are easy in the field and not done correctly. So I suppose if this was part of a head to toe exam then you would have to take this into the whole picture and not use it as a stand alone sign.

[JPINFV]

Now if there was only a way to test for the Throckmorton's Sign prehospitally.

[steph1030]

thats a very informative post thanks i am sure noone would know this info unless they were /are a neuroologist or neurosurgeon so this was actually worht the time to read thanks

[ERDoc]

Now if there was only a way to test for the Thromburton's Sign prehospitally.

Are you thinking Throckmortons sign?

[JPINFV]

Are you thinking Throckmortons sign?

Yea.. :oops:

[DwayneEMTP]

Are you thinking Throckmortons sign?

Did you mean Throckmorton's sign?

(Sorry Doc, I don't get that many "one-up" (No pun intended) opportunities with my little pea brain...have to take 'em where I can get 'em.)

Dwayne

[JPINFV]

^

Well, it's better than a Throckmortons' sign.

[ERDoc]

Did you mean Throckmorton's sign?

(Sorry Doc, I don't get that many "one-up" (No pun intended) opportunities with my little pea brain...have to take 'em where I can get 'em.)

Dwayne

:bootyshake:

With much love Dwayne!