palmar-chin reflex
Introduction
Introduction The palmar reflex is a pathological reflex that occurs after the cortical medullary bundle is damaged. Palmar reflex: lightly stroke the palm of the big fish muscle area caused by ipsilateral diaphragm contraction, such as the cerebral cortex - subcortical central damage. Normal people can also have this reflex, but the bilateral contraction is symmetrical, the reflex muscle contraction is very small, and the sacral muscle contraction is not sustained, but the normal person appears different from the pathological manifestation, and the pathological palm engraving reflection range is wider. Not limited to big fish.
Cause
Cause
The afferent nerve is the median nerve, the central column is in the posterior horn of the cervical spinal cord 5-8 and the thoracic spinal cord 1, and the spinal thalamus bundle is the pons nucleus. The nerve facial nerve is transmitted. This reflex occurs in cortical brain stem lesions, especially in bilateral cortical brain stems. This reflex can occur when the fibers on the nucleus of the facial nerve are involved. Can be seen in cerebral arteriosclerosis, amyotrophic lateral sclerosis, peripheral facial paralysis, bulbar paralysis, polyneuritis, due to the influence of transmission or efferent nerve, this reflex occurs, cortical bridge extension (especially bilateral) damage When the disease is in the frontal lobe, the lateral palmar palpebral reflex is hyperthyroidism.
Examine
an examination
Related inspection
Brain CT examination, cranial nerve examination, brainstem reflex examination
Use a blunt needle to gently stroke or use acupuncture on the palm of the big fish to cause contraction of the ipsilateral mandibular diaphragm. Normal people can also have this reflex, but the bilateral contraction is symmetrical, the reflex muscle contraction is very small, and the sacral muscle contraction is not sustained, but the normal person appears different from the pathological manifestation, and the pathological palm engraving reflection range is wider. Not limited to large fish, but also in the back of the hand, upper limbs, trunk, and even stimulate the lower limbs. The pathological palmar reflex muscle has a large contraction and a long duration.
Diagnosis
Differential diagnosis
a) Peripneral paciacial paraysis has a history of cold and infection. All facial muscles are paralyzed on the same side of the lesion, and the mouth is drooping and the sail is positive. The eyebrows are restricted, the frontal lines become shallow or disappear, the eyelids cannot be fully closed, and the scleral band is exposed at the lower edge of the cornea, and the eyeball moves up from the healthy side. The contralateral platysma contraction, the paralysis side does not contract. Due to the styloid and genioglossus, the tongue is biased to the healthy side. Occasionally, hypersensitivity, paralysis of the occipital rim of the eyelid, reflex of the orbicularis oculi muscle, blinking of the eye, reflection of the eye, and low reflex of the palmar palpebral. 2/3 wow sensation in front of the lateral tongue, tears sometimes overflow, the sucking of the facial nerve is limited when the baby is paralyzed, and the salivation of the paralyzed side is reduced.
b) bulbar paralysis There are many bilateral medullary nerve motor function loss and autonomic dysfunction, increased salivary secretion, due to poor swallowing and lip paralysis. Peripheral paralysis of the soft palate, pharyngeal muscles, laryngeal muscles, and lingual muscles. Early speech disorder, tongue muscle fibrillation, accompanied by atrophy of the tongue muscle, the tongue gradually becomes smaller, the tongue tendon is severe, and the facial and orbicularis muscles are involved. Due to the spasm of the muscle, the pronunciation is ambiguous due to the tongue muscle. The contraction of the lips is thin, the lips are weak, the lips are wrinkled, and the whistle cannot. The paralysis of the soft palate and the pharyngeal muscles, and the occurrence of throat sounds and vocal disorders. Then there is a nasal sound. Due to the loss of motor function of the vagus nerve, the pronunciation is difficult, the difficulty of swallowing occurs when the condition is aggravated, the drinking water convulsions, the pharyngeal reflex disappears and the chewing is weak. Invading the facial nucleus, there are bilateral facial expressions around the muscles, and the face is dull and expressionless, and the palmar reflex is reduced. Respiratory rhythm disorders occur as the condition worsens. There are even phenomena such as Chao's breathing and apnea. Late circulatory failure and death.
c) polyneuritis (polyneuritis) affected limbs have pain or sensorimotor dysfunction, the lesion area has tenderness or tenderness, sputum reflexes disappear, deep and shallow sensation diminished or disappeared. Symmetrical lower motor neuron spasm, decreased muscle tone, decreased tendon reflexes earlier than knee reflexes, and muscle atrophy distal to be more proximal. Lower extremity muscle atrophy with the tibialis anterior and tibialis anterior muscles, the upper limbs with interosseous muscles, sacral muscles, and large and small fishes are obvious, and the hands and feet can sag. The skin of the distal part of the limb is symmetrical, smooth, thin or dry, without sweat or sweating, and affects the afferent or efferent nerves, and the palmar reflex is reduced.
4) Cerebral infarction This disease is more common in patients over 50 to 60 years old. Patients with hypertension, arteriosclerosis or diabetes. More men than women, mostly in a quiet state or at rest. In the frontal and internal sac lesions, mental symptoms and hemiplegia, partial sensory disturbance and hemianopia, dominant hemispheric lesions accompanied by aphasia, non-dominant side involvement of contralateral sensory dysfunction and somatosensory disturbance. The frontal lobe lesions are sometimes positive for the contralateral palmar palsy.
5) Cerebral arteriosclerosis (cere bral arteriosclerosis) Age more than 45 years old, early can be similar to neurasthenia, headache, head sinking, dizziness, tinnitus, numbness, tremors, insomnia, forgetting, slow thinking, attention Concentration, poor computational power, poor work efficiency, memory loss, brain-like mental symptoms and dementia as the disease progresses, with personality changes, apathy, carelessness, childishness, no hygiene, more words, repeated language, Luo Wei Or reduced speech. The superficial temporal artery is fusiform, with asymmetry of tendon reflex, positive palmar and sucking reflex.
Use a blunt needle to gently stroke or use acupuncture on the palm of the big fish to cause contraction of the ipsilateral mandibular diaphragm. Normal people can also have this reflex, but the bilateral contraction is symmetrical, the reflex muscle contraction is very small, and the sacral muscle contraction is not sustained, but the normal person appears different from the pathological manifestation, and the pathological palm engraving reflection range is wider. Not limited to large fish, but also in the back of the hand, upper limbs, trunk, and even stimulate the lower limbs. The pathological palmar reflex muscle has a large contraction and a long duration.
