Woltman sign
Woltman's sign (also called Woltman's sign of hypothyroidism or, in older references, myxedema reflex[1]) is a delayed relaxation phase of an elicited deep tendon reflex, usually tested in the Achilles tendon of the patient.
| Woltman sign | |
|---|---|
| Differential diagnosis | hypothyroidism or anorexia nervosa |
Woltman's sign is named for Henry Woltman, an American neurologist.[2]
Associated conditions
The delayed ankle jerks are associated with:[3][4]
- hypothyroidism;
- several neurological symptoms;
- anorexia nervosa;
- extreme old age;
- beta-blockers or other drugs; and/or
- hypothermia.
History
In 1924,[5] William Calvert Chaney (1888–1965),[6] who worked under Henry Woltman at the Mayo Clinic, seems to have been the first to publish a description of the sign, but Woltman had no authorship and was not mentioned in Chaney's manuscript. The eponym "Woltman's sign of myxedema" was first published in 1956 at the time of Woltman's retirement.[7]
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References
- Houston CS (1958). "The diagnostic importance of the myxoedema reflex (Woltman's sign)". Canadian Medical Association Journal. 78 (2): 108–112. PMC 1829539. PMID 13489635.
- Woltman's sign of hypothyroidism, Who Named It?
- Dennis, Mark; Bowen, William Talbot; Cho, Lucy (2012). "Hyporeflexia/delayed ankle jerks". Mechanisms of Clinical Signs. Elsevier. p. 537.
- Marinella MA (2004). Kamath B (ed.). "Review of Clinical Signs: Woltman's Sign of Hypothyroidism" (PDF). Hospital Physician. 40 (1): 31–32.
- Chaney WC (1924). "Tendon reflexes in myxedema: a valuable aid in diagnosis". Journal of the American Medical Association. 82 (25): 2013–2016. doi:10.1001/jama.1924.02650510013005.
- William Calvert Chaney, ancestry.com
- Burkholder D; Klaas J; Kumar N; Boes C (2013). "The Origin of Woltman's Sign of Myxedema (P05. 256)". Neurology. 80 (7 Supplement): P05-256.
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