TY - JOUR T1 - The medial hamstring (L5) reflex JF - Practical Neurology JO - Pract Neurol DO - 10.1136/practneurol-2020-002595 SP - practneurol-2020-002595 AU - Euripedes Gomes de Carvalho Neto AU - Matheus Ferreira Gomes AU - Mateus Damiani Monteiro AU - Barbara Maldotti Dalla Corte AU - Ana Maria Hoppe AU - Francisco Tellechea Rotta Y1 - 2020/09/14 UR - http://pn.bmj.com/content/early/2020/09/13/practneurol-2020-002595.abstract N2 - A 41-year-old man gave a 1-week history of very intense lower back pain, which radiated down the right posterolateral thigh, to the anterior tibia and the dorsum of the foot. He had previously undergone a renal transplantation. On examination, Lasègue’s sign was positive on the right. The medial hamstring reflex was absent on the right but normal on the left (figure 1 and online supplemental video). MR scan of lumbar spine showed a voluminous extruded disc herniation with compression of the descending right L5 nerve root (figure 2). Electromyography showed decreased recruitment of motor unit action potentials in the tibialis anterior and gluteus medius muscles (L5 myotomal pattern).Figure 1 Medial hamstring reflex elicited with the patient prone: The index finger, placed on the medial hamstring tendon above the knee joint, should be struck with a tendon hammer, looking for contraction of the medial hamstring muscles (semitendinosus and semimembranosus).Figure 2 MR scan of lumbar spine T2-weighted images: (A) sagittal and (B) axial, showing a … ER -