1. PRIMITIVE REFLEXES
 Group of behavioural motor responses, found in normal early developmental stage
 With cortical maturation & myelination, they are normally suppressed
 Present as RELEASE PHENOMENA in frontal lobe lesion
REFERENCES: 1.paul.w.brazis ;5th
edition . 2. bickerstaff’s neurological examination 6th
edition. 3. Neurology of new born JOSEPH.J.VOLPE 5th
edition.
4. The grasp and other primitive reflexes ; J M Schott, M N Rossor ; J Neurol Neurosurg Psychiatry 2003;74:558–560
Dr. K.Sankar 2ND
Year PG Email : drkkshankar@gmail.com.
REFLEXES METHOD OF ELICITING RESPONSE SIGNIFICANCE
GRASP REFLEX
(normal in infants up to 4
months of age)
GROPING REFLEX
Apply deep pressure on patient’s palm over the area
between thumb & index finger using one’s index & middle
finger and draw them distally
Now , move one’s fingers over patient’s palm peripherally
towards his fingertips
The fingers will be held tightly
by the hand. In the first instance
(catching phase), the hold
increasing as the effort to draw
is increased.
In the 2nd
instance(strong
holding phase)the patients
fingers will flex strongly
• persists in mental
deficiency & birth
injuries
Reappears in tumours &
vascular accidents involving
contra lateral pre motor
cortex.
SUCKING &
ROOTING REFLEX
(strong & well synchronised
with swallowing at 34 wks of
life)
Touching the corner of the mouth Sucking movement of the lips
& deviation of the mouth in the
direction of stimulus
Reappears in advanced &
diffuse cerebral atrophy and
stuporous states
SNOUT REFLEX Applying gentle pressure over nasal philtrum Puckering of lips Present in frontal lobe lesion
PALMO MENTAL
REFLEX
Brisk stroking of patient’s palm with a blunt object Puckering of skin over chin on
same side
(brief contraction of ipsilateral
mentalis)
As a result of damage to
contralateral paracentral
cortical fibres
GLABELLAR TAP
( meyerson’s reflex or
nasopalpebral reflex)
Repeated slight tapping of the bridge or the root of the nose
with index finger from above & behind the patient’s head
Reflex blinking of both eyes
disappears after 4-5 taps
(habituation of polysynaptic
nociceptive reflex)-
negative glabellar tap sign
Persistent synchronous
blinking (failure of
habituation) – positive
glabellar tap
• Seen in early
parkinsonism
( non specific)
• Seen in diffuse frontal
lobe disease
CORNEO MANDIBULAR
REFLEX
(winking jaw phenomenon or
wartenberg’s reflex)
Touching the cornea of one eye
(stimulation of orbicularis oculi)
Horizontal movement of
mandible to opposite side (due
to action of external pterygoids)
Seen in supra nuclear lesion of
trigeminal nerve
• Acute coma (due to
structural lesion)
• Cerebrovascular
disease
• Multiple sclerosis
• Parkinson’s disease
• Amyotrophic lateral
sclerosis