<P> The Hoffmann's reflex test itself involves loosely holding the middle finger and flicking the fingernail downward, allowing the middle finger to flick upward reflexively . A positive response is seen when there is flexion and adduction of the thumb on the same hand . </P> <P> A positive Hoffmann's reflex and finger jerks suggest hypertonia, but can occur in healthy individuals, and are not useful signs in isolation . In cerebellar diseases, the reflexes may be pendular, and muscle contraction and relaxation tend to be slow, but these are not sensitive or specific to cerebellar signs . </P> <P> Hoffmann's sign is often considered the upper limb equivalent of the Babinski's sign test Hoffmann's reflex is often erroneously confused with Babinski's . However the two reflexes are quite different, and should not be equated with each other . </P> <P> A positive Babinski sign is considered a pathological sign of upper motor neuron disease except for infants, in whom it is normal . Whereas, a positive Hoffmann's sign can be present in an entirely normal patient . A positive Hoffmann's sign in the normal patients is more commonly found in those who are naturally hyper - reflexive (e.g. 3 + reflexes). A positive Hoffmann's sign is a worrisome finding of a disease process if its presence is asymmetrical, or has an acute onset . </P>

What does a negative hoffman's test mean