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Hoffmann's Sign Hoffman's sign means upper motor neuron injury. 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. via @neurologiabr #Hoffmanns #Sign #Reflex #Positive #Abnormal #clinical #video #neurology #physicalexam