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At least 19 recordsLinked to original sources

The grasp reflex of the foot and related phenomena in the absence of other reflex abnormalities following cerebral commissurotomy.

The grasp reflex of the foot and related pheonomena were examined in six subjects with no abnormalities of deep tendon or plantar (and related) reflexes 6 to 10 years after cerebral comissurotomy. In all subjects they were more marked on the same side as the more damaged hemisphere. These tonic phenomena seem to be facillitated by sitting and standing postures. Practical and theoretical implications of the tonic foot responses in the absence of similar phenomena of the hand are discussed.

Adult

Stapedius reflex abnormalities in multiple sclerosis.

Thirteen patients suffering from multiple sclerosis were analyzed by a Madsen ZO 70 electroacoustic bridge connected to an electronystagmograph through an impedance adaptor. Threshold, amplitude, decay and difference limen of intensity (DLI) of the stapedius reflex were examined for the frequencies 500, 1 000, 2 000 and 4 000 Hz. The difference between standard audiometric results and stapedius reflex data stresses the value of reflex measurements in assessing brain stem pathology.

Acoustic Stimulation

[Electromyographic and neurological aspects of leprosy. Study of 100 cases].

By the neurological, electromyographic, anatomopathological and bacterioscopic examinations of 100 pacients with leprosy the following conclusions have been drawn: There was a high incidence of reflex abnormalities. The proprioceptive reflexes were abnormal in 64.5% and the superficial reflexes in 70.8% of the cases. According to the topography of the segments examined, the deep reflexes showed the following abnormal values: 25.3% in the cephalic segment; 69.1% in the upper limbs and 74.5% in the lower limbs. Of the 2,289 reflexes investigated, abnormalities were found in 773 superficial reflexes (70.8%), while in relation to the proprioceptive reflexes the figures rose to 901 (64.5%). In the early stages of the infirmity, the reflexes were normal in 41.2% of the cases examined, and in all the stages of the evolution of the disease those numbers were always high. Also in the first stage, whose average duration was of 4.9 years, several alternations were noted, although there was a predominance of brisk reflexes (25.1%) over diminshed reflexes (17%), followed by hyperactive (8.6%) and absent reflexes (8%). In the final stage of the infirmity there was a decrease of normal reflexes, in contrast to absent and decreased reflexes, whose rates increased to 32.7% and 30.6% respectively. The disappearance of hyperactive reflexes and the clear decrease of brisk reflexes should also be noted. There was a high percentage of patients (31%) who suffered agression of the eighth nerve, 17 of which (54.8%) were found to suffer from neural deafness. The values related to hearing deficit were rarely in accordance with the histopathological and bacterioscopic positive results. The indexes of abnormalities found out in the examination of the fifth and of the seven nerve (7% and 5% respectively) were much lower in relation to the eighth nerve. These results are in contradiction with the ones stated in the literature. In some of the patients, hyperesthesia of the skin of the plantar region prognosticated the appearance of the infirmity. Among the objective changes, anesthesia of superficial sensibilities combined with deep hyperesthesia and anesthesia of superficial sensibilities with abolition of profound sensibilities were rarely observed. No case was found with exclusive alterations of deep sensibilities. Peripheral motor neuron lesions demonstrable by electromyography were observed in 82 patients (82%)...

Adult

Neurological manifestations of aging.

A group of 51 socially active, self-declared neurologically normal subjects ranging from 61 to 84 years of age were studied with a battery of clinical neurological examinations and a semiquantitative vibration perception test. None of the subjects showed a consistent pattern of neurological deficit that could be identified as pathological. On review of systems, the most frequent complaints were difficulty remembering names, numbness and tingling of fingers and toes, and headaches. In the neurological examination, the most commonly observed abnormalities were positive palmomental reflex, snout reflex, abnormalities in pursuit eye movements, convergence insufficiency, and minor mistakes in perception of light touch. There was no apparent trend of worsening of symptoms and signs with advancing age. In the semiquantitative testing of vibration perception, there was a slight trend toward worsening of vibration perception in the upper and lower extremities with advancing age. Motor abnormalities were absent, and there were relatively few subjects who showed reflex abnormalities. This study confirms the previously reported diminution of vibration perception with aging. Caution must be exercised before attributing myotatic reflex and motor abnormalities to the aging process alone.

Aged

Jamaica ginger paralysis. Forty-seven-year follow-up.

In 1930, thousands of Americans were poisoned by an illicit extract of Jamaica ginger ("jake") used to circumvent the Prohibition laws. A neurotoxic organophosphate compound, triorthocresyl phosphate (TOCP), had been used as an adulterant. The earliest reports were of peripheral neuritis, but later it was evident that an upper motor neuron syndrome had supervened. This TOCP poisoning apparently involved various cell groups and tracts in the spinal cord; the lesions was not peripheral at all. We interviewed 11 survivors of the illness residing in eastern Tennessee. Four were carefully examined. The principal findings showed the spasticity and abnormal reflexes of an upper motor neuron syndrome. One patient had mild disease, despite typical findings, and had lived a normal life.

Aged

An investigation of the correlation between abnormal patterns of ocular microtremor and an abnormal pupil reflex in neurological patients.

Twenty-two patients and 7 normal subjects at the Burdenko Institute of Neurosurgery, Moscow, have taken part in an investigation in which the direct light reflex to a brief flash, and the high-frequency microtremor of the eyes, have been recorded. The direct pupil reflex recordings obtained with a flash of 20 msec duration and 100 lux intensity at the plane of the pupil were registered from the right eye of each patient. Ocular microtremor recordings were obtained simultaneously from both eyes of 20 of the patients. A set of criteria of abnormality of ocular microtremor, as judged by visual examination of the records, is proposed by the authors. Abnormality of the pupil reflex is assessed in terms of the amplitude, latent period, and time course of the contraction and relaxation phases of the reflex. A strong correlation has been found between the occurrence of an abnormal ocular tremor record and an abnormal pupil reflex. On the basis of this correlation, the authors propose that ocular tremor recordings may be used in diagnosis as sensitive indicators of brain-stem dysfunction.

Brain Diseases

Abnormal postural reflex activity and voice usage deviations in cerebral palsy.

A relationship is considered between abnormal postural reflex activity and its effect on vocal processes in infants and very young children having cerebral palsy. Neurodevelopmental treatment concepts are interpreted as they may apply to evaluation and intiial management of hypertonic children who exhibit voice usage deviations. Interdisciplinary team function in the areas of physical therapy, occupational therapy, and speech pathology is suggested.

Cerebral Palsy

Oesophageal reflex responses: abnormalities of the enteric nervous system in patients with oesophageal symptoms.

An intraluminal balloon was used to study the peristaltic reflex, which is mediated by the intrinsic nerves of the oesophagus. Serial balloon distension was performed in nine asymptomatic volunteers and 133 patients with oesophageal symptoms. Eight of the volunteers had a normal response with proximal stimulation and distal inhibition of motility. Only 42 patients (31.6 per cent) had a normal response. The commonest abnormal response (39.1 per cent) was some form of failure of the distal inhibitory reflex. Other patterns of abnormality were an unresponsive oesophagus (15.8 per cent) with no motility change during balloon inflation, or spasm (13.5 per cent) proximal to the balloon. These alterations of secondary peristaltic activity suggest that there are abnormalities of the intrinsic (enteric) nerves of the oesophagus. Different abnormalities were found in patients with similar symptoms. Awareness of this difference might allow a more rational approach to treatment. This hypothesis was tested in a small pilot study treating functional dysphagia with cisapride. Three of nine patients had marked symptomatic improvement within 4 weeks and all three had an unresponsive oesophagus. The remaining six patients, who had failure of distal inhibition or a normal response, did not improve.

Adult

[Localization of level of lesions in internuclear ophthalmoplegia through assessment of masseter and blink reflex].

The masseter and blink reflexes were investigated in 100 patients with internuclear ophthalmoplegia due to multiple sclerosis (58 patients) or lacunar brainstem infarction (42 patients). In unilateral internuclear ophthalmoplegia, 38 of 60 patients (63.3%) had masseter reflex abnormalities, two patients (3.3%) showed changes of the blink reflex R1 component, and 13 patients (21.7%) combined alterations of the masseter reflex and the blink reflex R1 component. 46 (86.8%) of these 53 patients with electrophysiological abnormalities had unilateral changes, which were ipsilateral to the medial longitudinal fasciculus lesion in 42 patients (91.3%). In bilateral internuclear ophthalmoplegia, 24 of 40 patients (60.0%) had abnormalities of the masseter reflex, two (5.0%) showed changes of the blink reflex R1, and nine (22.5%) combined alterations of the masseter reflex and the blink reflex R1 component. 20 (57.1%) of these 35 patients with electrophysiological abnormalities had bilateral changes. Thus, masseter reflex abnormalities indicating midbrain lesions were seen in 63.3% and 60.0%, respectively, of unilateral and bilateral internuclear ophthalmoplegia. Blink reflex R1 component changes with or without impairment of the masseter reflex indicating rostral pontine to midpontine lesions occurred in 25.0% and 27.5%, respectively. These figures correspond to the results of postmortem examinations and to theoretical considerations based on the length of the medial longitudinal fasciculus.

Adult

The effect of induced hyperthermia on the blink reflex in multiple sclerosis.

In 76 patients with multiple sclerosis, the blink reflex was elicted electrically at normal body temperature and during induced hyperthermia to observe the effect on conduction within the reflex pathway through the brainstem. Special attention was directed to 31 patients with electrophysiologic evidence of reflex slowing, presumably because of demyelination in the reflex pathway. Hyperthermia did not induce any significant changes in mean reflex latency, amplitude, or duration in either the overall group of 76 or in the 31 patients with baseline blink reflex abnormalities. While the mean reflex latency did not change, 13 (33 percent) of 39 abnormal R1 responses from the 31 patients changed by 1.5 msec or more during hyperthermia, whereas change of similar magnitude was noted in only three (3 percent) of 90 normal R1 responses.

Body Temperature

Area specific reflexes from normal and supernumerary hindlimbs of Xenopus laevis.

Two area specific reflexes elicited by natural stimulation of different regions of the hindlimbs of Xenopus laevis have been identified. Light or intense mechanical stimulation of the foot evokes reflex activity in the ipsilateral knee flexor nerve; moderate pressure applied to the calf evokes reflex activity predominantly in the ipsilateral knee extensor nerve. The reflex responses have been recorded electrophysiologically to overcome the limitations of behavioral observations for determining the presence of activity in particular muscles. Normal area specific reflexes are elicited in the normal ipsilateral hindlimb by stimulation of grafted supernumerary hindlimbs innervated either by hindlimb (lumbar) or by non-limb (thoracic) spinal cord segments. The area specific reflexes can be elicited only if the limb is grafted to a host younger than stage 54-55 of Nieuwkoop and Faber ('56), the stage at which reflex movements are first observed behaviorally. Abnormal reflex responses are evoked by stimulation of supernumerary limbs innervated by either thoracic or lumbar segments when the limb buds are grafted to older larvae. Supernumerary forelimbs grafted at early stages and innervated by either thoracic or lumbar spinal cord segments generally fail to elicit area specific reflex responses in the normal hindlimb. Single-unit recordings of afferent fibers supplying the normal and supernumerary hindlimbs show that each limb receives a separate nerve supply. No evidence for branched afferent fibers has been found. The implications of these results for theories of neuronal specification are discussed, particularly the hypothesis that peripheral tissues are able to specify the central actions of afferent fibers that innervate them.

Animals

[Adie's syndrome from a neurological standpoint (author's transl)].

The findings in 22 examinations of tonic pupils, 15 of which presented Adie's syndrome, are described. The neurological and chemical as well as liquor analyses are normal except for the well known tendon reflex anomalies. Neurophysiologically, in 7 of 10 examinations mild disruptions in the sensory nerve conduction velocity were observed. The literature of the last 10 years, where it is of interest from a neurological standpoint and where it relates to the site of damage or to the origin of the tendon reflex abnormalities in Adie's syndrome, is discussed. Adie's syndrome is interpreted as damage to the peripheral nervous system in a polyneuropathic form.

Adie Syndrome

Adult metachromatic leukodystrophy. I. Clinical manifestation in a female aged 44 years, previously diagnosed in the preclinical state.

In a 5-year follow-up of a case of adult metachromatic leukodystrophy, already diagnosed in the preclinical stage, the development of the symptoms of this disease could be studied in detail: initially, lack of drive, emotional lability and depressive mood. At the same time, pain in the arms and beginning gait disturbance. Later, impairment of memory and concentration, disorientation, inadequate behavior and progression of gait disturbance. Finally spastic atactic gait with small steps and dyspractic components, coordination disturbances with writing dysfunction, fast dysarthric speech, hyperkinetic activity, compulsory emotional outbursts and progressive dementia. Only minor neurological signs such as reflex abnormalities. In the EEG, slight slowing of frequencies compared to earlier tracings. Increasing diminution of nerve conduction velocity in the lower limbs. Only minor increase of CSF protein (51 mg%). In spite of normal vision, evoked visual potentials abnormal, response of optical and electrical blink reflexes delayed. Imperfect filling of gallbladder. No significant quantitative changes of the biochemical parameters compared with the findings made 5 years earlier (excretion of urinary sulfatides, diminished activity of arylfulfatase A in urine and leukocytes).

Adult