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Pediatric Emergency Care Feb 2006Eliciting the red reflex is a useful clinical test that can be easily performed in the pediatric emergency room. A direct ophthalmoscope is the only tool needed to... (Review)
Review
Eliciting the red reflex is a useful clinical test that can be easily performed in the pediatric emergency room. A direct ophthalmoscope is the only tool needed to perform this test. The test is non-invasive, making it a quick screening tool for even the most apprehensive child. A normal red reflex can rule out intraocular pathology; an abnormal reflex can indicate need for urgent ophthalmologic referral. The differential diagnoses for an absent (or black) reflex; an abnormally sized, shaped or positioned reflex; leukocoria; as well as a non-homogenous reflex are listed.
Topics: Child; Eye Diseases; Humans; Ophthalmoscopy; Reflex; Reflex, Abnormal
PubMed: 16481935
DOI: 10.1097/01.pec.0000199567.87134.81 -
Pediatric Neurology Jul 2004The primitive reflexes and the postural reactions comprise one of the earliest, simplest, and most frequently used tools among child neurologists to assess the central... (Review)
Review
The primitive reflexes and the postural reactions comprise one of the earliest, simplest, and most frequently used tools among child neurologists to assess the central nervous system integrity of infants and young children. Infants with cerebral palsy have been known to manifest persistence or delay in the disappearance of primitive reflexes and pathologic or absent postural reactions. The clinical significance of asymmetric tonic neck reflex, Moro, palmar grasp, plantar grasp, Galant, Babinski, Rossolimo, crossed extensor, suprapubic extensor, and heel reflex, alone or in combination, as well as their contribution to the early diagnosis and differential diagnosis of cerebral palsy, have been demonstrated in a number of studies. Moreover, infants with 5 or more abnormal postural reactions have developed either cerebral palsy or developmental retardation as reported in a number of studies. Although a comprehensive neurologic examination in the context of a motor assessment instrument is preferable to an informal list of items, the combined examination of primitive reflexes and postural reactions should be considered by the child neurologist, as a simple but predictive screening test for the early identification of infants at risk for cerebral palsy. It is quick and easy to perform, both in nonhospital environments and in underdeveloped countries, where time and specific recourses are limited. The combined examination is also useful in developed countries because many developmental disorders such as cerebral palsy appear in nonrisk groups whereas others are not detected by metabolic screening programs.
Topics: Cerebral Palsy; Developmental Disabilities; Humans; Infant; Neurologic Examination; Posture; Reflex, Abnormal
PubMed: 15246484
DOI: 10.1016/j.pediatrneurol.2004.01.012 -
Neurology Aug 2020
Topics: Adult; Arm; Electromyography; Forearm; Humans; Male; Muscle, Skeletal; Reflex; Reflex, Abnormal
PubMed: 32641531
DOI: 10.1212/WNL.0000000000010182 -
Clinical Neurology and Neurosurgery Oct 2016As opposed to finger flexion response upon tapping the styloid process with absent brachioradialis reflex (inverted brachioradialis reflex), toe flexion response upon...
As opposed to finger flexion response upon tapping the styloid process with absent brachioradialis reflex (inverted brachioradialis reflex), toe flexion response upon patellar percussion with absent quadriceps reflex is a quite underrecognized neurological sign, and has been reported only once in the literature. Similar to the inverted brachioradialis reflex, this sign can also be useful for neurological localization. We hereby report a patient presenting with signs and symptoms of lumbar radiculopathy in the setting of an anterior epidural mass compressing the cauda equina at L2-L4, without evidence of myelopathy. Upon examination, the patient had bilateral absent quadriceps reflexes with a right toe flexor response when the right patella was percussed. An absent quadriceps reflex with distant toe flexor response is proposed as a lower extremity equivalent of the inverted brachioradialis reflex, likely localizing to L3-L4 levels. Spindle hypersensitivity due to lack of reciprocal inhibition from antagonist muscles is hypothesized as a possible underlying mechanism. Further observations should help clarify the most common underlying etiology (radicular vs. radiculomyelopathy). Neurologists should be able to recognize this sign, as it can be helpful for neurological localization.
Topics: Humans; Lumbar Vertebrae; Male; Middle Aged; Muscle Spindles; Neurologic Examination; Patella; Quadriceps Muscle; Radiculopathy; Reflex, Abnormal; Toes
PubMed: 27458829
DOI: 10.1016/j.clineuro.2016.06.018 -
Journal of Clinical Neuroscience :... Apr 2022An abnormal or absent superficial abdominal reflex (SAR) may be associated with an underlying spinal cord syrinx. The sensitivity of an abnormal or absent SAR and the...
An abnormal or absent superficial abdominal reflex (SAR) may be associated with an underlying spinal cord syrinx. The sensitivity of an abnormal or absent SAR and the relationship to Chiari malformation type I (CM-I) or syrinx morphology has not been studied. We aimed to describe the relationship between SAR abnormalities and syrinx size, location, and etiology. Children who underwent brain or c-spine MRI over 11 years were reviewed in this retrospective cohort study. Patients with idiopathic and CM-I-associated syringes (axial diameter ≥ 3 mm) were included. Clinical examination findings (including SAR) and imaging characteristics were analyzed. Of 271 patients with spinal cord syrinx, 200 had either CM-I-associated or idiopathic syrinx, and 128 of these patients had SAR-evaluation documentation. Forty-eight percent (62/128) had an abnormal or absent reflex. Abnormal/absent SAR was more common in patients with CM-I-associated syrinx (61%) compared with idiopathic syrinx (22%) (P < 0.0001). Abnormal/absent SAR was associated with wider syringes (P < 0.001), longer syringes (P < 0.05), and a more cranial location of the syrinx (P < 0.0001). Controlling for CM-I, scoliosis, age, sex, cranial extent of syrinx, and syrinx dimensions, CM-I was independently associated with abnormal or absent SAR (OR 4.2, 95% CI 1.4-14, P < 0.01). Finally, the sensitivity of SAR for identifying a patient with syrinx was 48.1%. An abnormal/absent SAR was present in most patients with CM-I-associated syrinx but in a minority of patients with idiopathic syrinx. This has implications for pathophysiology of CM-I-associated syrinx and in guiding clinical care of patients presenting with syrinx.
Topics: Arnold-Chiari Malformation; Child; Humans; Magnetic Resonance Imaging; Reflex, Abdominal; Reflex, Abnormal; Retrospective Studies; Scoliosis; Syringomyelia
PubMed: 35114475
DOI: 10.1016/j.jocn.2021.12.037 -
Muscle & Nerve Oct 2019An absent Hoffman (H)-reflex, the electrophysiological equivalent of the Achilles reflex, is assumed to be one of the first detectable signs of polyneuropathy (PNP). In...
INTRODUCTION
An absent Hoffman (H)-reflex, the electrophysiological equivalent of the Achilles reflex, is assumed to be one of the first detectable signs of polyneuropathy (PNP). In this study we compare the H- and Achilles reflexes in patients with suspected PNP to evaluate the diagnostic utility of the H-reflex.
METHODS
Data from clinical examination and nerve conduction studies (NCS) were analyzed in patients with suspected PNP.
RESULTS
The PNP diagnosis was confirmed by follow-up in 209 patients. The sensitivities of the H- and Achilles reflexes were similar (70.3% vs 71.8%), whereas the H-reflex had higher specificity (85.2% vs 70.5%) (P < .001). Adding H-reflex to the NCS protocol increased the diagnostic sensitivity from 80.9% to 87.6%.
DISCUSSION
The H-reflex is a sensitive method that could provide added value to standard NCS in PNP diagnosis. The simplicity and high specificity make it superior to its clinical equivalent, the Achilles reflex.
Topics: Achilles Tendon; Adult; Aged; Electrodiagnosis; Female; H-Reflex; Humans; Male; Middle Aged; Neural Conduction; Polyneuropathies; Reflex, Abnormal; Reflex, Stretch; Sensitivity and Specificity
PubMed: 31325167
DOI: 10.1002/mus.26639 -
Canadian Journal of Anaesthesia =... Sep 1991
Topics: Bradycardia; Heart; Humans; Neural Pathways; Reflex, Abnormal; Trigeminal Nerve
PubMed: 1914051
DOI: 10.1007/BF03008444 -
American Practitioner and Digest of... Dec 1948
Topics: Humans; Reflex, Abnormal
PubMed: 18103260
DOI: No ID Found -
Acta Neurochirurgica Dec 2009
Topics: Afferent Pathways; Heart; Humans; Prospective Studies; Reflex, Abnormal; Trigeminal Nerve; Vagus Nerve
PubMed: 19468673
DOI: 10.1007/s00701-009-0390-6 -
Developmental Medicine and Child... Feb 1985
Topics: Child Development; Humans; Reflex; Reflex, Abnormal
PubMed: 3979668
DOI: 10.1111/j.1469-8749.1985.tb04532.x