Not every patient with Hyperreflexia has myelopathy. Some people may have an overreactive nervous system and this presentation is normal for them. When you see hyperreflexia you should also check the Hoffman's reflex, Babinski reflex, Lhermitte's sign and clonus of the ankle.

Here is a Hoffman's video:    • "PERFECT" Hoffman's Sign with Paul Ma...  

Babinski video:    • Transverse Myelitis Paitient with Pos...  

Clonus video:    • Hyperreflexia, Clonus and a Positive ...  

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