Hoffman’s Sign, also commonly known as the Hoffman Response or The Hoffman Reflex is a type of muscle stretch reflex that can aid in your assessment of patients experiencing neurologic distress.  

How to Test a Patient for the Presence of the Hoffman Reflex

In order to test your patient for the presence of Hoffman’s Sign, instruct the patient to relax his/her wrist and fingers. With their middle finger slightly bent, take control of the distal portion between your thumb and index finger.  Briskly apply pressure down on the patients nail until you cause their finger to “flick”.  If this maneuver causes the patient’s index finger and thumb to flex, this is said to be a positive Hoffman’s Sign.  If no response is observed, this is said to be a negative Hoffman’s Sign.  The video below illustrates this procedure.

Please note that the patient in the video above is imitating a positive response for educational purposes.

What Does Hoffman’s Reflex Indicate?

A positive Hoffman’s sign may be clinically insignificant if it occurs bilaterally and/or fits the clinical picture.  If the sign occurs unilaterally, it typically indicates the dysfunction of an upper motor neuron.  Upper motor neuron insults can be caused by Traumatic Brain Injury (TBI), Spinal Cord Injury (SCI), and Stroke (ischemic and hemorrhagic).

If your’e interested in neurology, you don’t want to miss the Brainwaves Podcast.  Their podcast and site is packed with interesting and relevant content for all provider levels.

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References

Russell S, Triola M. The Precise Neurological Exam. The Precise Neurological Exam. [accessed 2016 Dec 21]. http://informatics.med.nyu.edu/modules/pub/neurosurgery/