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Frontal Release Signs
Frontal release signs are primitive reflexes traditionally held to be a sign of disorders that affect the frontal lobes. The appearance of such signs reflects the area of brain dysfunction rather than a specific disorder which may be diffuse, such as a dementia, or localised, such as a tumor. One reflex thought to have good localizing value is the palmar grasp reflex which usually signifies damage to the frontal lobe of the opposite side. The glabellar reflex or "glabellar tap" is present in individuals with extrapyramidal disorders such as Parkinson's disease. These reflexes are believed to be "hard-wired" before birth, and are therefore able to be elicited in the newborn. As the brain matures, certain areas (usually within the frontal lobes) exert an inhibitory effect, thus causing the reflex to disappear. When disease processes disrupt these inhibitory pathways, the reflex is "released" from inhibition and can be elicited once again, hence the term "frontal release sign". ...
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Primitive Reflexes
Primitive reflexes are reflex actions originating in the central nervous system that are exhibited by normal infants, but not neurologically intact adults, in response to particular stimuli. These reflexes are suppressed by the development of the frontal lobes as a child transitions normally into child development. These primitive reflexes are also called infantile, infant or newborn reflexes. Older children and adults with atypical neurology (e.g., people with cerebral palsy) may retain these reflexes and primitive reflexes may reappear in adults. Reappearance may be attributed to certain neurological conditions including dementia (especially in a rare set of diseases called frontotemporal degenerations), traumatic lesions, and strokes. An individual with cerebral palsy and typical intelligence can learn to suppress these reflexes, but the reflex might resurface under certain conditions (i.e., during extreme startle reaction). Reflexes may also be limited to those areas affected ...
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Frontal Lobe
The frontal lobe is the largest of the four major lobes of the brain in mammals, and is located at the front of each cerebral hemisphere (in front of the parietal lobe and the temporal lobe). It is parted from the parietal lobe by a groove between tissues called the central sulcus and from the temporal lobe by a deeper groove called the lateral sulcus (Sylvian fissure). The most anterior rounded part of the frontal lobe (though not well-defined) is known as the frontal pole, one of the three poles of the cerebrum. The frontal lobe is covered by the frontal cortex. The frontal cortex includes the premotor cortex, and the primary motor cortex – parts of the motor cortex. The front part of the frontal cortex is covered by the prefrontal cortex. There are four principal gyri in the frontal lobe. The precentral gyrus is directly anterior to the central sulcus, running parallel to it and contains the primary motor cortex, which controls voluntary movements of specific body par ...
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Reflex
In biology, a reflex, or reflex action, is an involuntary, unplanned sequence or action and nearly instantaneous response to a stimulus. Reflexes are found with varying levels of complexity in organisms with a nervous system. A reflex occurs via neural pathways in the nervous system called reflex arcs. A stimulus initiates a neural signal, which is carried to a synapse. The signal is then transferred across the synapse to a motor neuron which evokes a target response. These neural signals do not always travel to the brain, so many reflexes are an automatic response to a stimulus that does not receive or need conscious thought. Many reflexes are fine-tuned to increase organism survival and self-defense. This is observed in reflexes such as the startle reflex, which provides an automatic response to an unexpected stimuli, and the feline righting reflex, which reorients a cat's body when falling to ensure safe landing. The simplest type of reflex, a short-latency reflex, has a ...
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Palmar Grasp
Palmar grasp reflex (or grasp reflex) is a primitive and involuntary reflex found in infants of humans and most primates. When an object, such as an adult finger, is placed in an infant's palm, the infant's fingers reflexively grasp the object. Placement of the object triggers a spinal reflex, resulting from stimulation of tendons in the palm, that gets transmitted through motor neurons in the median and ulnar sensory nerves. The reverse motion can be induced by stroking the back or side of the hand. A fetus exhibits the reflex ''in utero'' by 28 weeks into gestation (sometimes, as early as 16 weeks), and persists until development of rudimentary fine motor skills between two to six months of age. Evolutionary significance Biologists have found that the reflex is significantly more frequent in infants of fur carrying primate species. It is theorized that the grasping reflex evolved as it is essential to survival in species, usually primates, where the young are carried in the fur. ...
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Glabellar Reflex
The glabellar reflex, also known as the "glabellar tap sign", is a primitive reflex elicited by repetitive tapping of the the smooth part of the forehead above the nose and between the eyebrows. Subjects respond to the first several taps by blinking; if tapping were to then be made to persist, in cognitively intact individuals this would lead to habituation and consequent suppression of blinking. If instead the blinking were to persist along with the tapping, this is known as Myerson's sign, and is abnormal and a sign of frontal release; it is often seen in people who have Parkinson's disease. The afferent sensory signals are transmitted by the trigeminal nerve to the brain stem; the efferent signals go to the orbicularis oculi muscle via the facial nerve, causing the muscle to reflexively contract, yielding blinking. This reflex was first identified by Walker Overend. See also * Glabella The glabella, in humans, is the area of skin between the eyebrows and above th ...
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Extrapyramidal Disorder
Movement disorder refers to any clinical syndrome with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity. Movement disorders are synonymous with basal ganglia or extrapyramidal diseases. Movement disorders are conventionally divided into two major categories- ''hyperkinetic'' and ''hypokinetic''. Hyperkinetic movement disorders refer to dyskinesia, or excessive, often repetitive, involuntary movements that intrude upon the normal flow of motor activity. Hypokinetic movement disorders refer to akinesia (lack of movement), hypokinesia (reduced amplitude of movements), bradykinesia (slow movement), and rigidity. In primary movement disorders, the abnormal movement is the primary manifestation of the disorder. In secondary movement disorders, the abnormal movement is a manifestation of another systemic or neurological disorder. Classification Diagnosis Step I : Decide the dominant type of movement disorder S ...
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Parkinson's Disease
Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms become more common. The most obvious early symptoms are tremor, rigidity, slowness of movement, and difficulty with walking. Cognitive and behavioral problems may also occur with depression, anxiety, and apathy occurring in many people with PD. Parkinson's disease dementia becomes common in the advanced stages of the disease. Those with Parkinson's can also have problems with their sleep and sensory systems. The motor symptoms of the disease result from the death of cells in the substantia nigra, a region of the midbrain, leading to a dopamine deficit. The cause of this cell death is poorly understood, but involves the build-up of misfolded proteins into Lewy bodies in the neurons. Collectively, the main motor symptoms are also ...
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Palmar Grasp
Palmar grasp reflex (or grasp reflex) is a primitive and involuntary reflex found in infants of humans and most primates. When an object, such as an adult finger, is placed in an infant's palm, the infant's fingers reflexively grasp the object. Placement of the object triggers a spinal reflex, resulting from stimulation of tendons in the palm, that gets transmitted through motor neurons in the median and ulnar sensory nerves. The reverse motion can be induced by stroking the back or side of the hand. A fetus exhibits the reflex ''in utero'' by 28 weeks into gestation (sometimes, as early as 16 weeks), and persists until development of rudimentary fine motor skills between two to six months of age. Evolutionary significance Biologists have found that the reflex is significantly more frequent in infants of fur carrying primate species. It is theorized that the grasping reflex evolved as it is essential to survival in species, usually primates, where the young are carried in the fur. ...
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Palmomental Reflex
The palmomental reflex (PMR) or Marinesco-Radovici Sign or Kinn reflex or Marinesco Reflex is a primitive reflex consisting of a twitch of the chin muscle elicited by stroking a specific part of the palm. It is present in infancy and disappears as the brain matures during childhood but may reappear due to processes that disrupt the normal cortical inhibitory pathways. Therefore, it is an example of a frontal release sign. Eliciting and observing response The thenar eminence is stroked briskly with a thin stick, from proximal (edge of wrist) to distal (base of thumb) using moderate pressure. A positive response is considered if there is a single visible twitch of the ipsilateral mentalis muscle (chin muscle on the same side as the hand tested). Clinical relevance Gheorghe Marinescu and Anghel Radovici in their seminal 1920 paper hypothesized that both the afferent (receptive) and efferent (motor) arms of the reflex are on the same side (ipsilateral) to the hand stimulated; th ...
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Thenar Eminence
The thenar eminence is the mound formed at the base of the thumb on the palm of the hand by the intrinsic group of muscles of the thumb. The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex. The word thenar comes . Structure The following three muscles are considered part of the thenar eminence: * Abductor pollicis brevis abducts the thumb. This muscle is the most superficial of the thenar group. * Flexor pollicis brevis, which lies next to the abductor, will flex the thumb, curling it up in the palm. (The Flexor pollicis longus, which is inserted into the distal phalanx of the thumb, is not considered part of the thenar eminence.) * Opponens pollicis lies deep to abductor pollicis brevis. As its name suggests it opposes the thumb, bringing it against the fingers. This is a very important movement, as most of human hand dexterity comes from this action. Another muscle that controls movement of the thumb is adductor pollicis. It ...
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Rooting Reflex
Primitive reflexes are reflex actions originating in the central nervous system that are exhibited by normal infants, but not neurologically intact adults, in response to particular stimuli. These reflexes are suppressed by the development of the frontal lobes as a child transitions normally into child development. These primitive reflexes are also called infantile, infant or newborn reflexes. Older children and adults with atypical neurology (e.g., people with cerebral palsy) may retain these reflexes and primitive reflexes may reappear in adults. Reappearance may be attributed to certain neurological conditions including dementia (especially in a rare set of diseases called frontotemporal degenerations), traumatic lesions, and strokes. An individual with cerebral palsy and typical intelligence can learn to suppress these reflexes, but the reflex might resurface under certain conditions (i.e., during extreme startle reaction). Reflexes may also be limited to those areas affected ...
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Sucking Reflex
Primitive reflexes are reflex actions originating in the central nervous system that are exhibited by normal infants, but not neurologically intact adults, in response to particular stimuli. These reflexes are suppressed by the development of the frontal lobes as a child transitions normally into child development. These primitive reflexes are also called infantile, infant or newborn reflexes. Older children and adults with atypical neurology (e.g., people with cerebral palsy) may retain these reflexes and primitive reflexes may reappear in adults. Reappearance may be attributed to certain neurological conditions including dementia (especially in a rare set of diseases called frontotemporal degenerations), traumatic lesions, and strokes. An individual with cerebral palsy and typical intelligence can learn to suppress these reflexes, but the reflex might resurface under certain conditions (i.e., during extreme startle reaction). Reflexes may also be limited to those areas affected ...
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