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Aims: The purpose of this study was to understand the frequency of reflex retention as well as the correlation between primitive reflex activity and scholastic performance. This quantitative correl...

Neonates present with a number of primitive reflexes that typically dissipate in later infancy. Persistence of such reflexes past infancy could indicate some type of developmental problem or compromised neurology and therefore might be predictably associated with various types of developmental disorders. The present review sought to summarize key studies investigating the persistence of primitive reflexes in individuals with cerebral palsy, attention-deficit/hyperactivity disorder, autism spectrum disorder, and other developmental disorders. Several studies have shown persistence of primitive reflexes in children with cerebral palsy, attention-deficit/hyperactivity disorder, and autism spectrum disorder. Persistence of primitive reflexes varies in relation to the type and severity of symptoms in cases of cerebral palsy and attention-deficit/hyperactivity disorder and with the presence of comorbid intellectual disability in children with autism spectrum disorder. Primitive reflexes have also been shown to persist in adults with Down syndrome. Assessing primitive reflexes may be useful for advancing the understanding and early detection of developmental disorders. Additional research should seek to clarify the relation between the persistence of primitive reflexes and the type and severity of developmental disorders, as well as seeking to identify possible reflex phenotypes. Persistence of primitive reflexes might signal some type of developmental or neurological problem and may negatively impact motor development and learning. Evidence-based interventions to address the persistence of primitive reflexes are lacking, and the development of these should be a research priority.

Objective The objective of this paper is to discuss the treatment of idiopathic toe-walking utilizing cognitive-motor dual-tasking and primitive reflex integration exercises. Methods An eight-year-old child with the previous diagnosis of autism spectrum disorder and idiopathic toe-walking presents for chiropractic care. The patient had previously received eight months of physical therapy in which his results plateaued after three months of care. Results On the initial visit, the child was evaluated for primitive reflexes. The patient retained the asymmetrical tonic neck reflex and palmer grasp. He was prescribed exercises to integrate these reflexes. In the second visit and onwards, the patient was tasked with walking while performing a cognitive or motor task. The patient’s performance of primitive reflex attenuation exercises significantly improved in form and timing, and the patient achieved proper gait mechanics with most interventions used. Conclusion Due to the limited number of visits, the patient was prescribed a cognitive task to help facilitate the retention of proper gait mechanics; however, these findings suggest that chiropractic management may prove useful in children who toe walk and that further investigation into treatment utilizing primitive reflex integration exercises for children with psychomotor delays is warranted. We suggest that the integration of primitive reflex testing for the chiropractor can yield many answers and serve as a valuable rehabilitation approach.

PurposeDevelopmental language disorder (DLD) is a developmental disorder where children fail to acquire language in the absence of a clear cause. Many studies have reported general motor deficits in children with DLD, but no studies have uncovered a cure. The purpose of our study is to better understand the underlying motor deficits in DLD, starting from uninhibited primary reflexes—which are the most basic stage of motor development. Knowledge of this motor–language relationship should lead to earlier and more targeted interventions in young children with DLD.MethodChildren with DLD (n= 75, age range: 4–10 years) and 99 age-matched typically developing (TD) children completed a nonword repetition test to assess DLD and six other tests to assess primitive reflexes.ResultsChildren with DLD demonstrated higher levels of persistent primitive reflexes compared to TD children. As the scores for neuromotor immaturity increased, nonword repetition test scores decreased (r= −.44,p< .01). Results indicated that TD children exhibited lower neuromotor immaturity (M= 7.63,SD= 3.75) compared to children with DLD (M= 13.51,SD= 4.47). All primitive reflexes (the Moro reflex, the symmetrical tonic neck reflex in flexion and in extension, the asymmetrical tonic neck reflex, the tonic labyrinthine reflex, and the Galant reflex) turned out to be statistically significantly different for the TD and DLD groups (p< .001). We also observed some differences between sexes.ConclusionsChildren with impaired language development underwent slower neuromotor development. However, further research is needed to determine whether motor intervention programs that inhibit primitive reflexes are helpful for children with DLD.

The presence of primitive (infant) reflexes in school-aged children as indicators of immaturity in neuromotor functioning has been associated with under-achievement in terms of reading, writing and...

Background: Persistence of primary reflexes can indicate poor neurological development and immaturity within the nervous system. As dyslexia is a neurodevelopmental disorder that involves more than just reading difficulties so it’s important to investigate primitive reflexes and balance functions in dyslexics. Aim of the Work: To assess balance functions, primitive reflexes in dyslexics. Subjects and Methods: The present study was conducted on 60 children divided into two subgroups. Control group consists of 20 normal children and study group consists of 40 children with dyslexia (diagnosed by Arabic Reading Screening test (ARST) and Modified Arabic Dyslexia Screening Test (MADST). Both study and control groups aged from 6 6/12 to 9 years old. They were subjected to clinical diagnostic tests for primitive reflexes and balance office tests (Romberg, unilateral stance, Fukuda stepping test, modified clinical test of sensory interaction in balance (mCTSIB). Results: The study group demonstrated poor balance measured with unilateral stance compared to control group. Sixty percent of the study group has retained primitive reflexes. Conclusions: Dyslexic children have poor balance compared to normal children and they have retained primitive reflexes supporting poor neurological development. Assessment of balance functions is recommended to be included within the test battery of dyslexics for better quality of life.

Objetivo. Caracterizar a pacientes con antecedente de prematuridad y de hasta un año de edad corregida, según evaluaciones asociadas a su actividad refleja primitiva.Metodología. Revisión retrospectiva y descriptiva de las historias clínicas de pacientes prematuros, sin patologías neurológicas u otras alteraciones graves o crónicas, asistentes a la consulta de Medicina Física y Rehabilitación en el marco del programa ‘Madre Canguro’ del Hospital La Victoria-Instituto Materno Infantil (Bogotá, Colombia), evaluando un conjunto de refle- jos primitivos. Los resultados se compararon con los valores reportados en la literatura en niños a término. Se analizaron los resultados en forma descriptiva.Resultados: La integración de los reflejos de succión, Galant, esgrimista, extensión cruzada y retirada, mostró retraso con relación a lo reportado en neonatos a término en algunos pacientes evaluados, si bien en la mayoría de casos revisados fue similar.Conclusión. Este estudio mostró similitud en la integración de la actividad refleja primitiva entre pacientes prematuros con edad corregida y los valores reportados en la literatura en niños a término, con algunos retrasos de integración en varios reflejos. Son necesarios estudios prospectivos con muestras poblacionalmente significativas que estudien estas diferencias potenciales.

This article discusses problems such as learning difficulties and behavioural problems that children may experience when they have retained primitive reflexes, which are typically only present in the first few months of life. The authors outline different types of primitive reflex present in infants and how each may affect a child when retained beyond the time when they are normally inhibited. Where relevant health professionals with expertise in this area are not available, children's nurses may need to assess and manage children with retained reflexes. This article explains how a nurse can assess a child for each primitive reflex and describes exercises that can be taught to a child and his or her parents to carry out at home to reintegrate the reflex.

Background: Primitive reflexes (PRs) are observed as an automatic response to a specific stimulus. They are vivid from intrauterine life to 6 months postnatal. The reactions are inhibited with the growing maturation of the central nervous system (CNS). In some cases, when the natural process of development is incorrect, PRs manifest later. The analysis of differentiation in gait parameters in children with persistent PRs is important for better understanding their specific behaviour and movement. This study’s aim was to investigate the influence of active PRs on the gait parameters of preschool children. Methods: There were 50 children examined, 30 girls and 20 boys. They were 3.5–6 years old. The children had persistent PRs in the trace form. Each child was examined by S. Goddard’s Battery Test. The acquisition of the spatial-temporal gait parameters was performed using a BTS G-SENSOR measurement instrument. Participants walked barefoot, in the most natural way for them, at a self-selected speed on a 5 m walkway, then turned around and went back. They performed this twice. Results: The reflex activity influences gait cycle duration (p = 0.0099), the left step length (p = 0.0002), the left double support phase (p = 0.0024), the right double support phase (p = 0.0258) and the right single phase. Difficulties in recreating the crawling pattern and GRASP reflex influence gait cadence (p < 0.05). The left GRASP reflex corresponds to step length (p < 0.05). The activeness of the symmetrical tonic neck reflex correlates with the right single support (p < 0.05). Conclusion: The presence of PRs affect walking gait in preschool children.

Psychomotor development in the first year of life is possible due to activity and then integration of primitive (neonatal) reflexes. The presence of active primitive reflexes (APRs) in preschool and school-aged children indicates neuromotor immaturity. Studies show dependencies between the preserved activity of primary reflexes and developmental problems such as learning difficulties (problems with reading, writing, reduced mathematics skills, and dyslexia), difficulties with coordination, and attention deficit. The primary purpose of this study is to present the activity of three tonic reflexes in a sample of 112 Polish children aged 4–6 in relation to their motor skills. The children were examined for the presence of the asymmetric tonic neck reflex (ATNR), symmetric tonic neck reflex (STNR), and tonic labyrinthine reflex (TLR). Motor performance was examined with the MOT 4–6. Statistical analysis shows an inverse correlation between the score in the test of reflexes and motor efficiency (MOT 4–6) at p &lt, 0.05 (−0.33). Children with increased reflex activity presented a lower level of motor efficiency. The multiple regression model showed that with the older age of the child and the decrease in the level of reflex activity, the motor skills of children improve. Thus, there is a need for early screening of primitive reflexes in children. Properly selected exercises and therapeutic activities aimed at integrating APRs in children with developmental difficulties can improve their motor skills, perceptual abilities, and emotional behavior.

Background: The Babkin Reflex belongs to the group of rarely defined and used primitive reflexes, being easily elicited in normal newborns during wakeful state particularly before feeding. To the best of our knowledge there have been no studies in India about the validity and usefulness of this reflex. Aim: The purpose of this study was to observe the consistency in duration of appearance and disappearance of the reflex in normal Term infants. Settings and Design: Hospital based, prospective, observational, longitudinal, single ethnicity study. Method: A prospective observational study was conducted to study the Babkin reflex in two thousand normal infants and also analyzed the average time of disappearance of the reflex. Descriptive statistics with rate were used. Results and Conclusion: In normal term infants, the Babkin reflex can be elicited from the time of birth, becomes increasingly suppressed with age, and disappears in the great majority by the end of the fifth month of age. Babkin reflex is surprisingly a fairly consistent primitive reflex which can be used as a screening reflex in all infants. Persistence of this reflex beyond 5 months of age mandates frequent neurological assessment.

Background and purpose Primitive reflexes may reoccur in various neurodegenerative diseases. However, little is known about their structural and functional correlates in the human brain. Notably, the neural mechanisms underlying a positive palmomental reflex (PMR) are poorly understood. As recent studies link Alzheimer's disease (AD)-related primitive reflexes to a dysfunction of the corticostriatal motor circuit (CMC), we conducted the present study to investigate functional and structural correlates of a positive PMR. We hypothesized an involvement of frontostriatal structures and an impairment of the CMC. Methods Using whole-brain resting-state functional connectivity (FC), hypothesis and FC result-based probabilistic tractography, and voxel-based morphometry analyses, we compared two groups of AD patients with either positive (n = 12) or negative PMR (n = 12). Results No significant differences in grey matter volume or structural connectivity (SC) could be observed between the PMR-positive and PMR-negative groups. In contrast, the PMR-positive group showed a decreased seed-to-voxel FC between the bilateral supplementary motor area and parts of the right-hemispherical caudate nucleus and thalamus and a decreased region of interest (ROI)-to-ROI FC between the left putamen and the left superior frontal gyrus. Conclusion Data suggest that dysfunction of the CMC reflected by decreased FC underlies a positive PMR in patients with AD. The lack of significant grey matter or SC differences might reflect that changes in FC appear before changes in SC in the structures of the CMC and brain atrophy.

Objective:To determine whether primitive reflexes serve as an indicator of dementia in adults with Down syndrome (DS), we collected neurologic examination data, cognitive and behavioral assessments, and clinical consensus diagnoses of dementia from 92 adults with DS.Methods:In a cross-sectional, observational study of a regional cohort, chi-square and Fisher’s exact tests examined individual reflexes across diagnostic group (No, Possible, or Probable Dementia). In 64 participants with all 8 reflexes assessed, the number of primitive reflexes was assessed as a predictor of diagnosis using age-controlled multinomial logistic regression and of performance on clinical assessments (Brief Praxis Test [BPT], Severe Impairment Battery [SIB], and the Dementia Questionnaire for People with Learning Disabilities [DLD] using age-adjusted linear regression.Results:Primitive palmomental, grasp, snout, and suck reflexes were more frequent in individuals with probable dementia, but all participants showed at least one primitive reflex. Multiple primitive reflexes in combination served as a better indicator of dementia, with each additional abnormal reflex tripling probability of Probable Dementia group membership controlling for age. Abnormal reflex count was not associated with direct assessment of cognition and praxis (SIB and BPT) but associated with informant ratings of cognitive and behavioral functioning (DLD).Conclusions:The presence of multiple reflexes serves as an indicator of dementia status in DS as a supplement to direct assessment of cognition and praxis. The reflex examination may serve as a tool in the multimethod evaluation for dementia in DS, as it appears unaffected by intellectual disability and language mastery.

The presence of active primitive reflexes (APRs) in healthy preschool children can be an expression of immaturity in the functioning of the nervous system. Their trace presence may not significantly affect the quality of child functioning. They may also undergo spontaneous and complete integration within the stages of child development. However, a higher level of active reflexes and their significant number can disturb sensory-motor development and lead to additional problems in a child&rsquo, s motor activities, social life, and education. The main purpose of this study was to examine the types of sensory disorders noticed by parents of children, if any, that accompany the presence of active primitive reflexes. The study was conducted in a group of 44 preschool children (aged 4&ndash, 6 years). The sensory profile of children was determined using Child Sensory Profile Cards, and Sally Goddard-Blythe tests were used to measure their primitive reflexes. The coefficient of determination (R-squared) indicated that the level of reflex activity was most strongly associated with sensory disorders such as dyspraxia, sensory-vestibular disorders, and postural disorders, at a level of p &lt, 0.005. The obtained research results show that the examination of non-integrated reflexes might be a screening tool for children of preschool age. Knowledge of the subject of reflexes and their impact on sensory-motor functions may contribute to more accurate diagnoses of the causes of problems and higher effectiveness of possible therapy.

Aim To make an electrophysiological demonstration of a possible jaw muscle afferents-oculomotor neural pathway that was proposed by our previous works on rats, which substantiates an early "release hypothesis" on pathogenesis of human Marcus Gunn Syndrome (MGS). Methods Extracellular unit discharge recording was applied and both orthodromic and spontaneous unitary firing were recorded in the oculomotor nucleus (III), and the complex of pre-oculomotor interstitial nucleus of Cajal and Darkschewitsch nucleus (INC/DN), following electric stimulation of the ipsilateral masseter nerve (MN) in rats. Results Extracellular orthodromic unit discharges, with latencies of 3.7±1.3 and 4.7±2.9ms, were recorded unilaterally in the III, and the INC/DN neurons, respectively. Spontaneous unit discharges were also recorded mostly in the INC/DN and less frequently in the III. Train stimulation could prompt either facilitation or inhibition on those spontaneous unit discharges. The inhibition pattern of train stimulation on the spontaneous discharging was rather different in the III and INC/DN. A slow inhibitory pattern in which spontaneous firing rate decreased further and further following repeated train stimulation was observed in the III. While, some high spontaneous firing rate units, responding promptly to the train stimuli with a short-term inhibition and recovered quickly when stimuli are off, were recorded in the INC/DN. However, orthodromic unit discharge was not recorded in the III and INC/DN in a considerable number of experiment animals. Conclusion A residual neuronal circuit might exist in mammals for the primitive jaw-eyelid reflex observed in amphibians, which might not be well-developed in all experimental mammals in current study. Nonetheless, this pathway can be still considered as a neuroanatomic substrate for development of MGS in some cases among all MGS with different kind of etiology.

BACKGROUND As early screening and diagnosis is very important in treatment and intervention of Autism Spectrum Disorder, we investigated the relationship between primitive reflexes and Autism Spectrum Disorder (ASD). METHODS Of 88 very low birth weight infants (

Background The incidence of cerebral palsy (CP) has increased due to better survival of high-risk babies. A simple assessment method is needed for the early detection of CP, which can be performed by general practitioners and pediatricians in daily practice. Objectives To assess motor delay, primitive and developmental reflexes, and cerebral ultrasound abnormalities as simple methods for early detection of CP in high-risk infants. We also aimed to evaluate the ease and consistency of the methods for use in daily practice, as well as determine risk factors associated with CP. Methods A prospective cohort study was done on 150 high-risk babies starting from the age of 4 months up to 12 months. We obtained subjects’ histories of motor ability and assessed primitive reflexes and postural reactions at the ages of 4, 6, 9 and 10 months. The diagnosis of CP was established at 6 and 12 months of age. We also determined Kappa test for inter-rater reliability between pediatric residents and pediatric neurologist. Results In 88.7% of subjects, CP was detected in the first 6 months. At 4 months, positive palmar reflex, head lag, and fisting were predictive of CP at 6 months of age. Motor delay, positive palmar grasp reflex, head lag, fisting, and absent protective extension reflex at 6 months were predictive of CP at 12 months. At 9 to 10 months, motor delays, absent protective extension reflex, and negative parachute reaction were predictive of CP at 12 months. Cerebral ultrasound abnormalities were predictive of CP at 6 and 12 months of age. Kappa test result was 0.9, indicating the ease and consistency of these methods for daily medical practice. Conclusion Cerebral palsy can be detected as early as the first 6 months of life. Assessment for motor delays, physical examination for asssessing primitive and developmental reflexes, and cerebral ultrasound can be used for this purpose.

Background and Purpose: The palmomental reflex (PMR) is a primitive reflex that might be released due to inhibition in adulthood. It has been associated with several neurodegenerative conditions. The aim of the present study was to evaluate the frequency of PMR in amyotrophic lateral sclerosis (ALS). Patients and Methods: Non-demented ALS patients (n = 179) were recruited. Two groups of disease controls were enrolled: (a) non-demented patients with other neurological disorders (NC; n = 86, mean age 60 ± 14 years); (b) healthy subjects, healthy controls (HC; n = 175, mean age 61 ± 12 years). PMR was elicited by a brisk stroke along the thenar eminence of the right hand with a key or a pen. Results: The PMR could be elicited in 46% of the ALS patients, compared to 29% of NC and 16% of HC (p < 0.001). A multivariate analysis showed that bulbar-onset and female gender are associated with an increased risk of PMR. Conclusion: We demonstrate a higher frequency of the PMR in ALS patients compared to NC or HC. Its expression increases with age, being higher in bulbar-onset patients. Given that the reflex circuit is located in the brain stem, its release due to inhibition might be associated to the presence of a cortico-bulbar tract dysfunction in ALS.

Reflexes are set motor responses to specific sensory stimuli. In newborns and young infants these primitive reflexes are an important assessment tool. Children with a distinctive reflex are difficult to treat. This includes a large category in which primitive reflexes are retained longer than necessary. Certain reflexes may not appear at appropriate age of development. Many neurological conditions are characterized by aberrations in reflex actions. However, there is scarcity of data for high-risk infants pertaining to this topic. Dental treatment becomes challenging in these individuals and sometimes due to lack of compliance even necessary emergency dental treatment is difficult to carry out.

Objectives The aim of the present study is to explore inter-rater reliability of primitive signs in a group of patients assessed for dementia. Patients and methods 97 patients admitted to our University Hospital for cognitive impairment were enrolled in the study. The mean age was 73.04 ± 8.68 (53 females and 44 males). All patients were examined by two cognitive neurologists in a blind fashion. The grasp reflex, the snout reflex, the glabella tap reflex and the palmomental reflex were elicited according to the current literature. Moreover, we add a stretch reflexes (the masseter reflex) to our battery. Results The most frequent primitive reflex was the palmomental reflex followed by the glabella tap, snout, and grasp. The inter-rater reliability was measured for each primitive reflex: grasp reflex (0.884) have a strong correspondence; the glabella tap (0.556), the palmomental (0.516) and the snout reflex (0.445) have otherwise a weak correspondence. The masseter reflex reaches a moderate agreement (0.662). All the measurements reached statistical significance (p Conclusion The results of the study show weak to substantial agreement for primitive signs and the masseter reflex as expressed by the low-to-high kappa values.

Clinicians are required to perform neurological examinations on infants to ensure they meet developmental milestones. A full neurological examination includes evaluating motor and sensory function, assessing the status of the cranial nerves, testing primitive reflexes, and atypical responses to further evaluate any developmental pathologies. The difficulty in maintaining infants' cooperation requires resourcefulness on the clinician's part to understand what is being tested and in what way to complete the examination. This literature will provide clinicians with guidance on the way to conduct a thorough neurological examination of infants. Clin. Anat. 32:770-777, 2019. © 2019 Wiley Periodicals, Inc.

Background: Diabetic neuropathy is the commonest complication of DM, affecting 47% patients with peripheral neuropathy. Rood’s Approach is a neurophysiological approach which is based on reflexes of central nervous system. Basic concept of Rood’s is that the motor patterns are developed from primitive reflexes through proper sensory stimuli to appropriate sensory receptors in normal sequential developmental pattern to improve motor performance. Objectives: The objectives of the study were as follows: 1. To find effect of rood’s approach in sensory abnormalities. 2. To find effect of rood’s approach in muscle weakness. Methods: Ethical clearance was obtained from the institutional ethical committee. A total of 23 diabetic neuropathy subjects were assessed and 20 were included in this study based on inclusion criteria, the individuals were allocated in one group: This group received Rood’s approach, depending upon patients’ condition either facilitatory or inhibitory techniques was given. Diabetic neuropathy was diagnosed using Michigan Neuropathy Screening Instrument Questionnaire and Pre- and post-test were done for assessing severity of diabetic neuropathy using Visual Analogue Scale (VAS), Quantitative Sensory Testing (QST) and Walking Impairment Questionnaire (WIQ) and the outcome measures were analysed after 3 months. Results: Within the group statistical analysis, Pre-Post VAS score was 6.43 ± 1.628 and was extremely significant, Pre-Post QST score was 1.900 ± 1.553 and result was extremely significant and Pre-Post WIQ score was 19.150 ± 2.978 was also significant. Conclusion: We found that facilitatory techniques of Rood’s Approach (Quick stretch and heavy joint compression) were effective in improving decreased sensations and improving motor performance in patients with painful diabetic polyneuropathy. We found that inhibitory techniques of Rood’s Approach (Maintained stretch and light joint compression) were effective in decreasing hypersensitivity in patients with painful diabetic polyneuropathy. We found significant improvement in pain measure (VAS), Sensory measure (Quantitative Sensory Testing) and Motor Performance Measure (Walking Impairment Questionnaire).

Introduction Retained primitive reflexes can disturb natural development and involve difficulties in social and educational children's life. They can also impact on psychomotor development. Mature responses in a child's psychomotor progress can only occur if the central nervous system itself has reached maturity. The process consist the transition made from brain stem reflex response to cortically controlled response. This study define the occurrence of primitive reflexes in healthy 4-6 years old children and analyze the impact of survived primitive reflexes on psychomotor development. Material and methods The study involved 35 participants aged 4-6 years healthy preschool children. The study tools were: primitive reflexes tests by Sally Goddard for children and Motor Proficiency - Test (MOT 4-6 test) in 18 tasks. Results Over a half (65%) preschool children had survived the primitive reflexes on the residual level. Eleven percent of them had no retained primitive reflexes. According to the psychomotor ability, 9% of the children were in the category of "altered development", 29% in "delayed development", 59% in "normal" and 3% in "very good development". The greater the severity of the reflex, the motor efficiency was lower (p < 0.05). Conclusions It seems reasonable to introduce reflexes integration therapy in children's with low psychomotor skills. Primitive reflexes routinely tested, can contribute to improved early psychomotor development in children with needs, thus preventing many difficulties which children can encounter within their social and school life.

The purpose of this study was to determine the diagnostic value of the palmomental reflex in order to identify frontal lesions in neurological outpatients.Two hundred twenty-six neurological patients with suspected intracranial lesion with an indication for magnetic resonance imaging (MRI) were included. All patients underwent the same MRI protocol. The reflex was elicited by trained and standardized nurses, and was evaluated by two neurologists. The evaluation was blind and independent. The test's accuracy was calculated. The Kappa coefficient was used to calculate the interobserver and intra-observer reliability.The interobserver reliability between neurologists was 0.53 with 93% of agreement (p0.001). The diagnostic accuracy measures were as follow: sensitivity of 19%, specificity of 93%, positive predictive value of 30%, negative predictive value of 88%, positive likelihood ratio of 2.7 and negative likelihood ratio of 0.87. The area under the curve was 0.56.The palmomental reflex is associated with frontal structural lesions but the sensitivity is low, indicating a high percentage of frontal lesions with a negative reflex. When the test is used on its own, it is insufficient to detect frontal damage.

Primitive reflexes is an automatic muscle reactions which are only present in the first few months, but can remain active in healthy children, thus, impacting on motor proficiency. There is little evidence how primitive reflexes influence on swimming skills acquisition by healthy children. The aim of the study is to examine how primitive reflexes influence swimming skills acquisition by healthy children. Subjects: two 7-year-old girls. Methods: Checklists by Oh et al., (2011) were used to evaluate swimming skill proficiency at swimming lesson 8 and 16. The results were represented as a percentage of the possible maximal score. The testing of the asymmetrical tonic neck reflex, the symmetrical tonic neck reflex, and the tonic labyrinthine reflex was done using Blythe’s, 5-point rating scale. The analysis was carried out using descriptive method. The first girl showed two reflexes at level 1, while the second girl demonstrated all tested reflexes at level 1, 2 and 3. The girl with less total score of reflexes (8%) achieved a better level of swimming proficiency (from 73% to 77%) than the girl with higher (25%) severity of these reflex (from 21% to 33%.). The obteined data evidence about influence of primitive reflexes on swimming skill acquisition by healthy children.

The study was undertaken to perform a systematic review to investigate the diagnostic relevance of primitive reflexes (PR) such as Moro, Rooting, Sucking, Palmar, and Plantar/Babinski reflexes in high-risk newborns. A systematic literature search was carried out using different search engines between the years 1980 and 2018. There were 48 articles considered out of 61 articles, based on screening of the title and abstract. Finally, among 48 articles, a total of 8 articles were considered for the detailed review based on the inclusion criteria. The results of the selected articles on the different PRs have been discussed in the present study. Though most studies have evaluated the moro and the plantar reflex, every reflex considered in the study has been found to be affected in high-risk newborns and consequently, it is difficult to undermine the significance of any of these. All the studies reviewed highlighted the importance of assessing these reflexes in high-risk newborns and indicated that an abnormal reflex is an indication of a neurological abnormality. These findings indicate that the assessment of PRs should be included in the newborn screening protocol because they are not time consuming and can be performed easily with minimum or no tools. Future studies that are aimed at investigating the efficacy of these PRs in identifying children with developmental disabilities are essential.

In typical motor development progress in use of goal-directed actions and communicative gestures depends on the inhibition of several primitive reflexes, especially those that involve the hand or mouth. This study explored the relationship between the persistence of primitive reflexes that involve the hand or mouth and the motor repertoire in a sample of 12- to 17-month-old infants. Moreover, since children with Autism Spectrum Disorders (ASD) often have difficulty in performing skilled movements and show poor gesture repertoire, and since ASD represents the upper extreme of a constellation of traits that may be continuously distributed in the general population, we investigated the relationship between the persistence of primitive reflexes in the same sample of infants and the subclinical autistic traits measured in their parents. Results revealed that the persistence of the primitive reflexes correlated with motor repertoire irrespective of infant’s age, and it was greater among infants whose parents had more subclinical autistic traits. Our findings suggest that the persistence of primitive reflexes might alter the developmental trajectory of future motor ability and therefore their evaluation might be an early indicator of atypical development.

Several synthetic peptide manipulations during the time surrounding birth can alter the specific neurohormonal status in the newborn brain. This study is aimed at assessing whether intrapartum oxytocin administration has any effect on primitive neonatal reflexes and determining whether such an effect is dose-dependent.A cohort prospective study was conducted at a tertiary hospital. Mother-infant dyads who received intrapartum oxytocin (n=53) were compared with mother-infant dyads who did not receive intrapartum oxytocin (n=45). Primitive neonatal reflexes (endogenous, antigravity, motor, and rhythmic reflexes) were quantified by analyzing videotaped breastfeeding sessions in a biological nurturing position. Two observers blind to the group assignment and the oxytocin dose analyzed the videotapes and assesed the newborn's state of consciousness according to the Brazelton scale.The release of all rhythmic reflexes (p=0.01), the antigravity reflex (p=0.04), and total primitive neonatal reflexes (p=0.02) in the group exposed to oxytocin was lower than in the group not exposed to oxytocin. No correlations were observed between the dose of oxytocin administered and the percentage of primitive neonatal reflexes released (r=0.03; p=0.82).Intrapartum oxytocin administration might inhibit the expression of several primitive neonatal reflexes associated with breastfeeding. This correlation does not seem to be dose-dependent.

Background and purpose Although primitive reflexes (PRs) are inhibited during the first years of childhood, they may reappear with brain injury. PRs have been linked to frontal lobe dysfunction, but their precise topography has not yet been defined. The purpose of this study was to map which regions of the brain display a reduced glucose metabolism in patients with cognitive impairment and PRs. Methods A prospective study was conducted to evaluate PRs in a group of patients assessed due to suspected cognitive decline. Neurological and neuropsychological examinations and 18F-fluorodeoxyglucose positron emission tomography fused with computerized tomography were performed. Voxel-based brain mapping analysis by means of statistical parametric mapping was used to compare patients with and without PRs. Results The study included 99 patients (33 diagnosed with Alzheimer's disease, 33 on the frontotemporal dementia spectrum and 33 with other diagnoses). Mean age was 71 ± 9.7 years; time since symptom onset was 3.6 ± 2.9 years. At least one PR was observed in 43 cases (43.4% of the whole sample; 48.5% in the Alzheimer disease group, 63.6% in frontotemporal dementia and 18.2% in the group with other diagnoses). The group of patients with PRs exhibited a decreased cerebral metabolism in the bilateral superior frontal gyri (Brodmann area 6), bilateral putamina and thalami. Conclusions The presence of PRs was associated with hypometabolism at the superior frontal gyrus and putamen. This suggests that dysfunction in the corticostriatal motor circuit (supplementary motor area–putamen–thalamus) may constitute the anatomical basis of the recurrence of PRs.

Neurodevelopmental reflex testing is commonly used in clinical practice to assess the maturation of the nervous system. Neurodevelopmental reflexes are also referred to as primitive reflexes. They are sensitive and consistent with later outcomes. Abnormal reflexes are described as an absence, persistence, reappearance, or latency of reflexes, which are predictive indices of infants that are at high risk for neurodevelopmental disorders. Animal models of neurodevelopmental disabilities, such as cerebral palsy, often display aberrant developmental reflexes, as would be observed in human infants. The techniques described assess a variety of neurodevelopmental reflexes in neonatal rats. Neurodevelopmental reflex testing offers the investigator a testing method that is not otherwise available in such young animals. The methodology presented here aims to assist investigators in examining developmental milestones in neonatal rats as a method of detecting early-onset brain injury and/or determining the effectiveness of therapeutic interventions. The methodology presented here aims to provide a general guideline for investigators.

BACKGROUND: Primitive reflexes are stereotypic motor behavioral responses that are necessary for the normal development of infants. Retention of these reflexes is mostly pathological and can lead to developmental delays. Few reflexes are also seen in normal adults, and the influence of the retained reflexes on functional activities is evident. This study identified the effect of the asymmetric tonic neck reflex (ATNR) on handgrip. MATERIALS AND METHODS: One hundred adults within the age group of 18–25 were selected for the study. Handgrip strength was measured using hand-held dynamometer on the dominant hand in three different neck positions, neck in neutral, neck actively rotated to the right, and rotated to the left. Data collected were statistically analyzed to identify the difference between the three mean values. RESULTS: The Friedman test performed to analyze the handgrip strength between the groups of three head positions demonstrated a statistically significant difference, χ2 = 110.479, P = 0.000. Post hoc analysis with the Wilcoxon signed-rank tests was conducted with a Bonferroni correction applied, resulting in a significant level set at P < 0.017. There was a significant difference in the handgrip measured between the group of head rotated to the left with head in neutral (P = 0.000) and head rotated to the right and the left (P = 0.000), but failed to demonstrate a significant difference between the groups of head in neutral and head rotation to right (P = 0.041). The results of this study thus infer a significant increase in handgrip of the right hand when head is rotated toward the left side. CONCLUSION: The study identified that there is an increased handgrip power on the dominant side when the head is rotated to the opposite side. This can be attributed to the increased flexor tone due to the retained effects of ATNR. Effects of ATNR can be seen in normal adults while assessing handgrip strength. This must be taken into consideration while assessing the same during diagnostic, prognostic, and rehabilitation purposes.

Aim Primitive reflexes can reappear with diseases of the brain, particularly those affecting the frontal lobes. Most studies on primitive reflexes have reported an association between such reflexes and brain damage, and the clinical symptoms of dementia. These reflexes can also be present during eating; however, their effects on eating function are difficult to evaluate. The purpose of the present study was to identify the frequency at which primitive reflexes reappear in elderly people, and to determine the effects that such reflexes have on eating function, nutritional status and prognosis. Methods We followed 121 nursing home residents for 6 months. All patients required long-term care and were examined for the presence of a sucking reflex, snout reflex and phasic bite reflex for baseline measures. Demographic characteristics, physical and cognitive function, and nutritional status were obtained from chart reviews, interviews with nurses, and a brief physical examination at baseline and incidence of aspiration pneumonia during the study period. Results The sucking reflex was confirmed in 31 patients (25.6%), snout reflex in 15 patients (12.3%) and phasic bite reflex in 28 patients (23.1%). One or more of these reflexes was identified in 38 patients (31.4%). A relationship between the presence of a primitive reflex and nutritional status was shown. An association with the presence of these reflexes and the development of aspiration pneumonia during 6 months was also confirmed. Conclusions The appearance of primitive reflexes appears to be associated with the risk of malnutrition and developing aspiration pneumonia. Geriatr Gerontol Int 2014; 14: 190–197.

Ozet: Serebral palsi cocukluk caginin en sik gorulen fiziksel engellilik durumudur. Beynin yeniden organizasyon ve plastisite potansiyelinin en yuksek oldugu yasamin erken doneminde belirti verir. Bu nedenle, gelisimsel sorunlarin erken tanimlanmasi, sonuclari onemli olcude iyilestirebilecek multidisipliner rehabilitasyon yaklasimlarinin zamaninda yapilmasi icin kritik bir oneme sahiptir. Serebral palsi icin ozgun bir tani yontemi yoktur, serebral palsi tanisinda anamnez ve norolojik muayene bulgulari esas alinir. Ilkel refleksler ve postural reaksiyonlarin muayenesi erken cocukluk doneminde santral sinir sistemi butunlugunun degerlendirilmesinde en erken, en basit ve en sik kullanilan yontemlerden biridir. Serebral palsili bebeklerde ilkel reflekslerin devam ettigi veya kaybolmasinin geciktigi, postural reaksiyonlarin anormal oldugu veya gorulmedigi bilinmektedir. Ilkel refleksler ve postural reaksiyonlarin serebral palsi ve gelisimsel gerilikteki klinik onemi bir dizi calismada gosterilmistir. Asimetrik tonik boyun refleksi, Moro, palmar ve plantar yakalama refleksi, Galant, Babinski, Rossolimo, capraz ekstansor, suprapubik ekstansor ve topuk refleksinin tek basina veya birlikte gorulmesinin, ayrica 5 veya daha fazla anormal postural reaksiyon varliginin serebral palsinin erken tanisi veya ayirici tanisina katkida bulundugu bildirilmistir. Serebral palsi icin riskli bebeklerin erken tanimlanmasinda anamnez ve ayrintili norolojik muayeneye ek olarak ilkel refleksler ve postural reaksiyonlarin birlikte degerlendirilmesi basit ancak ongoru degeri olan tarama testi olarak dusunulmelidir. ANAHTAR KELIMELER: serebral palsi, erken tani, ilkel refleksler, postural reaksiyonlar PRIMITIVE REFLEXES AND POSTURAL REACTIONS IN THE EARLY DIAGNOSIS OF CEREBRAL PALSY Abstract: Cerebral palsy is the most common physical disability of childhood and manifests early in life, during which time the brain has the greatest potential for reorganization and plasticity. Therefore, early identification of developmental challenges is crucial for timely multidisciplinary rehabilitation interventions that can greatly improve outcomes. It’s not a specific diagnostic method for cerebral palsy, diagnosis of cerebral palsy based primarily on anamnesis and findings of neurological exam. The exam of primitive reflexes and postural reactions are the one of the earliest, simplest, and most frequently using methods for assess the central nervous system integrity in early childhood. Infants with cerebral palsy have been known to exhibit persistence or delay in the disappearance of primitive reflexes and abnormal or absent postural reactions. The clinical significance of primitive reflexes and postural reactions in the cerebral palsy or developmental retardation has been demonsrated in a number of studies. Asymmetric tonic neck reflex, Moro, palmar and plantar grasp, Galant, Babinski, Rossolimo, crossed extensor, suprapubic extensor and heel reflex, alone or combination, and also 5 or more abnormal postural reactions have been reported as their contribution to the early diagnosis and differential diagnosis of cerebral palsy. In addition to anamnesis and comprehensive neurologic examination, the combined evaluation of primitive reflexes and postural reactions should be considered as a simple but predictive screening test for the early identification of infants at risk for cerebral palsy. KEYWORDS: cerebral palsy, early diagnosis, primitive reflexes, postural reactions

WOS: 000389053000033 PubMed ID: 27966319 Background/aim: This study aimed to define the frequency of a primitive reflex, the buccopalpebral reflex (BPR), and its association with the clinical situation in patients with Parkinson disease. Materials and methods: Between May 2010 and May 2011, 222 patients, 115 with Parkinson disease and 107 patients without any sign of neurodegenerative disease, were included in the study. All included patients were examined for BPR and snout reflex and were also evaluated with the Mini Mental State Examination. All patients with Parkinson disease were classified with the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Score to determine their clinical severity. Results: Sixteen patients with Parkinson disease (13.9%) had a BPR (+) and 4 patients in the control group (3.7%) (P < 0.001). The UPDRS score, UPDRS daily life activities score, and UPDRS motor system score were all higher in the group with BPR (+). All patients with a BPR also had a positive snout reflex. Conclusion: BPR is more frequent in patients with Parkinson disease than in patients without a neurodegenerative disease.

Particularly important postnatal developmental reflexes that diminish in later stages of development are Moro reflex and Galant reflex that belong among the so-called primitive reflexes. According to current evidence persistence of the primitive reflexes is related to certain specific neuropsychiatric disorders. According to current knowledge there is no evidence whether these reflexes play a role in Attention Deficit and Hyperactivity Disorder (ADHD). To develop these findings we have tested a hypothesis whether ADHD children in the school age (8-11 years) will have higher level of persisting primitive reflexes Moro and Galant compared to a control group of children of the same age. Results of this study show that ADHD children have high occurrence of primitive reflexes compared to the control group, which indicates that ADHD symptoms may present a compensation of unfinished developmental stages related to diminishing Moro and Galant reflexes. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normalni tabulka"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

Background The presence of primitive reflexes (PRs) may have diagnostic or prognostic value in the evaluation of cognitive impairment. Objective We hypothesized that the presence of preoperative PRs would predict the development of postoperative delirium and that the emergence of PRs postoperatively would be positively associated with the emergence of delirium. Methods Patients participating in a larger study on the prophylaxis of postoperative delirium were evaluated for the presence of six PRs (grasp reflex [left and right], palmomental reflex [left and right], glabellar tap, and snout reflex), preoperatively and postoperatively. The presence of PRs was then correlated with the development of delirium. Results Of the 79 patients studied, 29% (n = 23) developed delirium during the postoperative period. The preoperative presence of one PR did not predict the development of delirium, but the only patient with >1 PR preoperatively went on to develop delirium in the postoperative period. Similarly, having one frontal release sign in the postoperative period did not correlate with delirium, while the appearance of more than one PR was associated with a greater likelihood of delirium. Of the 11 patients who had two or more frontal release signs during one postoperative examination, six (55%) developed delirium. Of the five patients who showed three or more frontal release signs, 4 (80%) developed delirium. Conclusion Our study is the first to investigate the relationship between the appearance of PRs and the development of delirium. We have provided some evidence that PRs are associated with acute CNS dysfunction.

A Randomized Controlled trial was done on 30 (CP) children of age range 6 mon to 2 y with an objective to see the efficacy of Neurofacilitation of Developmental Reaction (NFDR) approach over Neurodevelopmental Therapy (NDT) for integration / modification of early motor behavior (Primitive Reflexes) in Cerebral Palsy (CP). The baseline evaluation was done for tone, postural reactions and GMFM. The subjects were randomly allocated to two groups. With group A, NFDR and group B, conventional approach (NDT) was used for 3 mon followed by re-evaluation. Between groups analysis was done and p value was found to be significant. It was concluded that NFDR approach is more effective than NDT for integration / modification of early motor behavior in children with CP.

BACKGROUND Numerous physiological changes occur in the nervous system with increasing age. On clinical neurological examination, such changes may be misinterpreted as pathology in the nervous system. The objective of this article is to provide a review of the clinical neurological findings that may be caused by normal ageing. MATERIAL AND METHODS The present manuscript is based on a non-systematic search in PubMed as well as on the clinical experience of the authors. RESULTS Cognitive functions are usually fairly well preserved in old age, apart from executive functioning, psychomotor speed and episodic memory, which are reduced with increasing age. Physiological changes related to increasing age include, in particular, vertical eye movements (upwards), vibration sense, Achilles reflexes, primitive reflexes and motor speed. Muscle power is reduced by 20-40% in healthy individuals aged over 70 years. INTERPRETATION A correct diagnosis based on findings in the neurological examination cannot be made without knowledge of how ageing affects the physiology of the nervous system. However, the evidence regarding physiological changes in the nervous system is limited, and more research is needed in this field.

The grasp reflex is one of the primitive reflexes frequently observed in neurodegenerative diseases. However, quality of life and treatment of the grasp reflex are neglected in the literature. Following two brief case vignettes of patients seen recently who experienced disability from a grasp reflex, we briefly review its phenomenology, anatomy-physiology and epidemiology in neurodegenerative movement disorders, and assess the limited current literature regarding the quality of life and treatment.

UMMARY The results of reflex/motor activity interactions in 177 normal infants are evaluated. The asymmetrical tonic neck reflex, tonic labyrinthine reflex-supine, and Moro reflexes were assessed for each child at birth and at intervals up to 12 months. Ages of rolling prone to supine, rolling supine to prone, and sitting alone were elicited from parents. The effects of the primitive reflexes on early motor activity were assessed, and statistically significant correlations were demonstrated between decreased reflex activity and the emergence of motor milestones. The distinctive association of reflex activity with motor function suggests the interaction of several reflexes (a primitive reflex profile) rather than the influence of isolated reflex activity. Such patterns support the hypothesis that decreasing primitive reflex activity is associated with the onset of volitional motor activity in normal infants. RESUME Les resultats des interactions de l'activite reflexe et motrice chez 177 nourrissons normaux ont eteevalues. Le reflexe tonique asymetrique du cou, le reflex tonique labyrinthique de supination et le reflexe de Moro ont ete apprecies pour chaque enfant a la naissance et a intervalles reguliers jusqu a 12 mois. Les âges de retournement du ventre sur le dos, du dos sur le ventre et de l'atteinte de position assise independante ont ete obtenus des parents. Les effets des reflexes archaiques sur les activites motrices precoces ont ete apprecies et des correlations significatives ont ete revelees entre la regression de l'activite reflexe et l'apparition des reperes de progres moteur. La distinction de l'activite reflexe d'avec la fonction motrice suggere l'interaction de plusieurs reflexes (profil de reflexe archaique) plutot que l'influence d'une activite reflexe isolee. De telles dispositions favorisent l'hypothese que la decroissance de l'activite reflexe archaique est associee au debut de l'activite motrice volontaire chez les nourrissons normaux. ZUSAMMENFASSUNG Bei 177 gesunden Kindern wurden die Untersuchungsergebnisse uber Interaktionen zwischen Reflex/motorischer Aktivitat ausgewertet. Bei jedem Kind wurden der asymmetrische tonische Nackenreflex, der tonische Labyrinthreflex in Ruckenlage und der Moro Relfex bei der Geburt und in Intervallen bis zum Alter von 12 Monaten beurteilt. Altersangaben uber die Fahigkeit sich vom Rucken auf den Bauch zu drehen und vom Bauch auf den Rucken und allein zu sitzen wurden von den Eltern ubernommen. Es wurden die Auswirkungen der primitiven Reflexe auf die fruhe motorische Aktivitat beurteilt und signifikante Korrelationen zwischen dem Nachlassen von Reflexaktivitat und dem Auftreten von Meilensteinen in der motorischen Entwicklung gefunden. Die deutliche Assoziation von Reflexaktivitat zu Motorfunktion weist auf die Interaktion mehrerer Reflexe hin (ein primitives Reflexprofil) und weniger auf den Einflus isolierter Reflexaktivitat. Solche Muster stutzen die Hypothese, das das Zuruckgehen primitiver Reflexaktivitat verbunden ist mot dem Beginn willkurlicher Motorbewegungen bei gesunden Kindern. RESUMEN Se han evaluado los resultados de las interacciones reflejomotoras en 177 lactantes normales. Fueron evaluados los reflejos tonico asimetrico del cuello, el tonico laberintico en supino y el de Moro en cada nino, al nacer y a a intervalos hasta los doce meses. A partir de lo dicho por los padres se anoto tambien la edad en que el nino inicio el volverse de prono a supino y de supino a prono, y la sedestacion. Se evaluaron los efectos de los reflejos primitivos sobre la actividad motora precoz y se observaron correlaciones significativas entre la disminucion de la actividad refleja y la aparicion de los hitos motores. La asociacion distintiva entre la actividad refleja y la funcion motora sugiere la interaccion de diversos reflejos (perfil reflejo primitivo), mas bien que la influencia de la actividad de un solo reflejo. Estos esquemas apoyan la hipotesis de que la disminucion de la actividad refleja primitiva va asociada con el inicio de la actividad motora volitiva en los lactantes normales.

Objectives Although vascular parkinsonism (VP) occurs frequently in the elderly, its clinical features have not been investigated in detail, particularly in comparison with Parkinson's disease (PD). The goal of this study is to clarify the diagnostic value of pathological reflexes in differentiating between VP and PD. Patients and methods In 132 patients with PD and 55 with VP, pathological reflexes, including snout reflex (SR), palmomental reflex (PMR), corneomandibular reflex (CMR), jaw reflex (JR), Hoffmann reflex (HR), and extensor plantar response (EPR), were evaluated. Results The percentage of each pathological reflex elicited in two groups (VP:PD) was as follows: SR (78:30), PMR (53:26), CMR (9:6), JR (33:12), HR (29:11), and EPR (25:8). The prevalence of pathological reflexes, except for CMR, was significantly higher in the VP patients than in the PD patients. In particular, SR and PMR were more frequent than upper motor neuron signs in the VP patients. The sensitivity and specificity of either SR or PMR for VP were 84% and 82%. Conclusion Snout and palmomental reflexes are useful tools in the differentiation between VP and PD.

Objective: To describe 3 cases of patients with alcohol dependence whose primitive reflexes resolved upon initiation of acamprosate 666 mg 3 times daily. Case Summaries: A 57-year-old man had a long-standing history of alcohol dependence and a prominent snout reflex. The snout reflex resolved within 24 hours of starting treatment with acamprosate. A 45-year-old man with a long history of alcohol dependence had both a snout and a grasp reflex. These reflexes were present throughout 3 admissions for alcohol detoxification and continued until the end of his third admission, when he elected to begin treatment with acamprosate. Within 24 hours of starting treatment, the snout and grasp reflexes were absent. A 55-year-old man who drank heavily for 35 years presented with both a snout and a grasp reflex on admission. These persisted throughout his detoxification until the day after he had begun treatment with acamprosate. His primitive reflexes remained resolved through the next 4 days until discharge. All 3 of these patients remained on acamprosate at discharge. Discussion: Alcohol dependence is a common, debilitating disorder. One of the difficulties in treating alcohol dependence is its adverse effect on the brain, as higher aspects of cortical function necessary to maintain abstinence are eroded by alcohol. Acamprosate is a drug intended to help prevent relapse among patients with alcohol dependence. Unexpectedly, acamprosate may resolve primitive reflexes—a neurologic finding that suggests cognitive impairment—among patients with alcohol dependence. Conclusions: Acamprosate may relieve snout and grasp reflexes among patients with alcohol dependence.

The presence of primitive and postural reflexes at key stages in development provide reliable indicators of maturity in the functioning of the Central Nervous System. Primitive reflexes are tested routinely at birth and in the first few weeks of postnatal life but are not re-assessed at a later age as a matter of course. This paper examines the functions and effects of three primitive reflexes, explaining how abnormal primitive reflexes can predispose a child to allergy, anxiety, coordination problems and subsequent learning and behavioral challenges including inattention. © Copyright 2005 Pearblossom Private School, Inc.–Publishing Division. All rights reserved.

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.

In daily clinical practice we noticed that patients with intellectual impairment spontaneously flex the elbow within a few seconds of the forearm being manipulated during routine examination of spasticity of the muscles in the upper extremities. We termed this phenomenon elbow flexion response (EFR), and prospectively studied it in 229 patients who underwent in-hospital rehabilitation following brain damage. Evaluation of each patient included EFR, patient profile, ability to communicate, scores on three parameters from various intelligence tests, scores on seven parameters testing primitive reflexes, and scores on three parameters describing personality. We investigated for relationships among these parameters. Consequently, although EFR rarely have a statistical association with the varied profiles of patients, patients with bilateral lesion or bilateral paresis demonstrated significantly more marked EFR than those with unilateral lesion or unilateral paresis. Patients with involvement of the frontal lobe showed significantly more marked EFR than those without damage in this area. Elbow flexion responses occurred significantly more frequently in relation with lower scores on intelligence and occurred with significantly higher frequency in conjunction with the more marked appearance of conventional primitive reflexes. Therefore, we conclude that EFR have a strong association with intelligence and with the existence of frontal lobe lesion, and their mode of clinical presentation parallels that of primitive reflexes particularly that of the grasp reflex. We propose that EFR could be referred as a variation of the grasp reflex occurring in the more proximal or axial part of the body.

The paper aims to show that the children with learning diabilities have a high level of unconstrained primitive reflexes and that their undeserved suffering also comes from the increased presence of instinctive reflexive movements. This qualitative study is conducted with 20% of the children with learning disabilities 6-10 years old,in the city of Vlora,Albania. Also their cognitive development is held “as hostage” by stumbling power of the reflexive movements for the creation of new nerve pathways and schemes. The study is represented by a rich references with contemporary information on the role of primitive neurological reflexes in utero, in the first years of life and the non-integration consequences within their biological time. The study primarily measured the primitive retained reflexes in children in the study. As an instrument for measuring primitive reflexes, the study used "home test" developed by Sally Goddard Blythe. Measurements were made in just eight primitive reflexes based on the work of Petter and Sally Goddard Blythe; Moro, Rooting, Sucking, ATNR, TLR, Handheld, Galant, and STNR. Data were collected from the measurements on the type and percentage of the retained primitive reflexes. It was proven that children with learning disorders have a high level of retained primitive reflexes compared to other children. The findings of this study lead to the need for scientific research to inhibit the primitive reflexes at a young age, but also when they are present beyond their biological age.