Hoffmann’s Sign

Published September 22, 2026 Read time 2 min read Readers 21

What is the Hoffmann’s Sign Used For?

It is a neurological reflex test used to detect upper motor neuron lesions and corticospinal tract dysfunction

Position the subject’s relaxed hand ensuring dorsiflexion at the wrist and partial flexion of the fingers.
Hold the subject’s partially extended middle finger between your index and middle finger, ensuring you stabilize the proximal IP joint.
Perform a sharp and forceful flick of your thumb, making contact with the nail of the subject’s middle finger.
The subject’s finger will flex immediately followed by relaxation.

The presence of Hoffmann’s sign is characterized by flexion and adduction of the thumb and flexion of the index finger.
A positive Hoffmann’s sign is suggestive of corticospinal tract dysfunction localized to the cervical segments of the spinal cord.
Negative result: The thumb and index finger do not move or stay still.

Upper motor neuron problem: It shows an overactive reflex (hyperreflexia) caused by damage to the central nervous system pathways that normally control and calm down reflexes.
Common causes: Cervical myelopathy (compressed spinal cord in the neck from arthritis or disc issues), multiple sclerosis, or other brain and spinal cord conditions.
False positives: Up to 3% of healthy people without any nerve disease can test positive, meaning the test alone does not confirm a diagnosis and requires further imaging like an MRI.