Are asymmetrical slow deep tendon reflexes a cause for concern?

Dear Ask The Doctor: I saw a pain management doctor yesterday, and was advised to see a neurologist because my reflexes are asymmetrical -- upper body "too happy" and lower body absent or very sluggish. My neurologist is on vacation. Is this something that needs to be done right away, or is it okay to wait a few weeks?

Dear Candace: No, it does not to be done right away, but in the view of the finding, I strongly recommend you to get an appointment with your internal medicine doctor, because not only neurological factor intervene in having slow deep tendon reflexes but some other metabolic causes that should be ruled out as for example thyroid problems, diabetes. Hypoactive deep tendon reflexes (DTRs) are abnormally diminished muscle contractions that occur in response to a sudden stretch induced by sharply tapping the muscle’s tendon of insertion. Symmetrically reduced reflexes may be normal. Elderly patients may have reduced DTRs because of a decrease in the number of nerve axons and demyelination of axons (the nerve cords).