Woltman sign explained

Differential:	hypothyroidism or anorexia nervosa

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's sign is named for Henry Woltman, an American neurologist.^[2] __TOC__

Associated conditions

The delayed ankle jerks are associated with:^{[3] [4]}

• hypothyroidism;
• Huntington's disease;
• 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]

Notes and References

1. Houston CS. 1958. The diagnostic importance of the myxoedema reflex (Woltman's sign). Canadian Medical Association Journal. 78. 2. 108–112. 1829539. 13489635.
2. Web site: Woltman's sign of hypothyroidism. www.whonamedit.com.
3. Book: Dennis, Mark. Bowen, William Talbot. Cho, Lucy. Hyporeflexia/delayed ankle jerks. https://books.google.com/books?id=FIV-NYPRCzEC&pg=PA537. Mechanisms of Clinical Signs. 2012. Elsevier. 537. 9780729540759.
4. Kamath B. Marinella MA. Review of Clinical Signs: Woltman's Sign of Hypothyroidism. Hospital Physician. 2004. 40. 1. 31–32.
5. Chaney WC. 1924. Tendon reflexes in myxedema: a valuable aid in diagnosis. Journal of the American Medical Association. 82. 25. 2013–2016. 10.1001/jama.1924.02650510013005.
6. Web site: William Calvert Chaney, ancestry.com.
7. The Origin of Woltman's Sign of Myxedema (P05. 256). Burkholder D. Klaas J. Kumar N. Boes C. 2013. Neurology. 80. 7 Supplement. P05-256.