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Case report
Approach to exaggerated startle reflex: a case of hyperekplexia minor
  1. Haris Hakeem1,
  2. Ramsha Khurshid2,
  3. Fowzia Siddiqui1 and
  4. Danish Ejaz Bhatti3
  1. 1 Neurology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
  2. 2 Neurophysiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
  3. 3 Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA
  1. Correspondence to Dr Haris Hakeem; dr.harishakeem{at}


A broad set of conditions may present with an exaggerated startle reflex in clinics. This, combined with the overall rarity of these disorders, may pose diagnostic uncertainty in the mind of the treating physician. Herein, we report a case of a patient who presented to us with the complaint of exaggerated startle reflex and outline a simple approach towards characterisation of these disorders.

  • movement disorders (other than Parkinsons)
  • clinical neurophysiology

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  • Contributors FS, HH and RK were part of the team that saw the patient. HH floated the idea of writing the case report to which DEB agreed. HH and RK prepared the initial draft which was reviewed, critiqued and edited by DEB and FS. All authors have read and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.