The Importance of Integrating Reflexes by Sonia Story
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Focusing on the Re-Emergence of Primitive Reflexes Following Acquired Brain Injuries
33 Focusing on The Re-Emergence of Primitive Reflexes Following Acquired Brain Injuries Resiliency Through Reconnections - Reflex Integration Following Brain Injury Alex Andrich, OD, FCOVD Scottsdale, Arizona Patti Andrich, MA, OTR/L, COVT, CINPP September 19, 2019 Alex Andrich, OD, FCOVD Patti Andrich, MA, OTR/L, COVT, CINPP © 2019 Sensory Focus No Pictures or Videos of Patients The contents of this presentation are the property of Sensory Focus / The VISION Development Team and may not be reproduced or shared in any format without express written permission. Disclosure: BINOVI The patients shown today have given us permission to use their pictures and videos for educational purposes only. They would not want their images/videos distributed or shared. We are not receiving any financial compensation for mentioning any other device, equipment, or services that are mentioned during this presentation. Objectives – Advanced Course Objectives Detail what primitive reflexes (PR) are Learn how to effectively screen for the presence of PRs Why they re-emerge following a brain injury Learn how to reintegrate these reflexes to improve patient How they affect sensory-motor integration outcomes How integration techniques can be used in the treatment Current research regarding PR integration and brain of brain injuries injuries will be highlighted Cases will be presented Pioneers to Present Day Leaders Getting Back to Life After Brain Injury (BI) Descartes (1596-1650) What is Vision? Neuro-Optometric Testing Vision writes spatial equations -
Improvement and Neuroplasticity After Combined Rehabilitation to Forced Grasping
Hindawi Case Reports in Neurological Medicine Volume 2017, Article ID 1028390, 7 pages https://doi.org/10.1155/2017/1028390 Case Report Improvement and Neuroplasticity after Combined Rehabilitation to Forced Grasping Michiko Arima, Atsuko Ogata, Kazumi Kawahira, and Megumi Shimodozono Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan Correspondence should be addressed to Michiko Arima; [email protected] Received 20 September 2016; Revised 31 December 2016; Accepted 9 January 2017; Published 6 February 2017 Academic Editor: Pablo Mir Copyright © 2017 Michiko Arima et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The grasp reflex is a distressing symptom but the need to treat or suppress it has rarely been discussed in the literature. We report the case of a 17-year-old man who had suffered cerebral infarction of the right putamen and temporal lobe 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after a unique combined treatment. Botulinum toxin typeA (BTX-A) was first injected into the left biceps, wrist flexor muscles, and finger flexor muscles. Forced grasping was reduced along with spasticity of the upper limb. In addition, repetitive facilitative exercise and object-related training were performed under low-amplitude continuous neuromuscular electrical stimulation. Since this 2-week treatment improved upper limb function, we compared brain activities, as measured by near-infrared spectroscopy during finger pinching, before and after the combined treatment. -
The Grasp Reflex and Moro Reflex in Infants: Hierarchy of Primitive
Hindawi Publishing Corporation International Journal of Pediatrics Volume 2012, Article ID 191562, 10 pages doi:10.1155/2012/191562 Review Article The Grasp Reflex and Moro Reflex in Infants: Hierarchy of Primitive Reflex Responses Yasuyuki Futagi, Yasuhisa Toribe, and Yasuhiro Suzuki Department of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan Correspondence should be addressed to Yasuyuki Futagi, [email protected] Received 27 October 2011; Accepted 30 March 2012 Academic Editor: Sheffali Gulati Copyright © 2012 Yasuyuki Futagi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The plantar grasp reflex is of great clinical significance, especially in terms of the detection of spasticity. The palmar grasp reflex also has diagnostic significance. This grasp reflex of the hands and feet is mediated by a spinal reflex mechanism, which appears to be under the regulatory control of nonprimary motor areas through the spinal interneurons. This reflex in human infants can be regarded as a rudiment of phylogenetic function. The absence of the Moro reflex during the neonatal period and early infancy is highly diagnostic, indicating a variety of compromised conditions. The center of the reflex is probably in the lower region of the pons to the medulla. The phylogenetic meaning of the reflex remains unclear. However, the hierarchical interrelation among these primitive reflexes seems to be essential for the arboreal life of monkey newborns, and the possible role of the Moro reflex in these newborns was discussed in relation to the interrelationship. -
The Concept of the Reflex in the Description of Behavior 321
THE CONCEPT OF THE REFLEX IN THE DESCRIPTION OF BEHAVIOR 321 The present paper was published in the Journal of General Psychology, I I 2 * s here the editor. ( 93 > 5' 4 7~45$) an^ reprinted by permission of INTRODUCTORY NOTE THE EXTENSION of the concept of the reflex to the description of the behavior of intact organisms is a common practice in modern theorizing. Nevertheless, we owe most of our knowledge of the reflex to investigators who have dealt only with "preparations," and who have never held themselves to be con- cerned with anything but a subsidiary function of the central nervous system. Doubtless, there is ample justification for the use of relatively simple systems in an early investigation. But it is true, nevertheless, that the concept of the reflex has not emerged unmarked by such a circumstance of its development. In its extension to the behavior of intact organisms, that is to say, the his- torical definition finds itself encumbered with what now appear to be super- fluous interpretations. The present paper examines the concept of the reflex and attempts to evaluate the historical definition. It undertakes eventually to frame an alterna- tive definition, which is not wholly in despite of the historical usage. The reader will recognize a method of criticism first formulated with respect to scientific Ernst Mach in The Science and concepts by [ of Mechanics} per- haps better stated by Henri Poincare. To the works of these men and to Bridgman's excellent application of the method [in The Logic of Modern Physics] the reader is referred for any discussion of the method qua method. -
Retained Neonatal Reflexes | the Chiropractic Office of Dr
Retained Neonatal Reflexes | The Chiropractic Office of Dr. Bob Apol 12/24/16, 1:56 PM Temper tantrums Hypersensitive to touch, sound, change in visual field Moro Reflex The Moro Reflex is present at 9-12 weeks after conception and is normally fully developed at birth. It is the baby’s “danger signal”. The baby is ill-equipped to determine whether a signal is threatening or not, and will undergo instantaneous arousal. This may be due to sudden unexpected occurrences such as change in head position, noise, sudden movement or change of light or even pain or temperature change. This activates the stress response system of “fight or flight”. If the Moro Reflex is present after 6 months of age, the following signs may be present: Reaction to foods Poor regulation of blood sugar Fatigues easily, if adrenalin stores have been depleted Anxiety Mood swings, tense muscles and tone, inability to accept criticism Hyperactivity Low self-esteem and insecurity Juvenile Suck Reflex This is active together with the “Rooting Reflex” which allows the baby to feed and suck. If this reflex is not sufficiently integrated, the baby will continue to thrust their tongue forward, pushing on the upper jaw and causing an overbite. This by nature affects the jaw and bite position. This may affect: Chewing Difficulties with solid foods Dribbling Rooting Reflex Light touch around the mouth and cheek causes the baby’s head to turn to the stimulation, the mouth to open and tongue extended in preparation for feeding. It is present from birth usually to 4 months. -
Classic Signs Revisited Postgrad Med J: First Published As 10.1136/Pgmj.71.841.645 on 1 November 1995
Postgrad MedJ3 1995; 71: 645-648 C The Fellowship of Postgraduate Medicine, 1995 Classic signs revisited Postgrad Med J: first published as 10.1136/pgmj.71.841.645 on 1 November 1995. Downloaded from The Babinski reflex J van Gijn Summary The information that may be deduced from scratching a patient's sole, is as The plantar response is a reflex important as a diagnostic sign as it is simple to elicit. When the great toe moves that involves not only the toes, but upward (sign of Babinski), this signifies, as everybody knows, a disturbance of all muscles that shorten the leg. In the pyramidal tract. This explains why few patients with neurological symptoms the newborn the synergy is brisk, can avoid having their plantar reflexes examined - often to their great surprise, or involving all flexor muscles of the even alarm if the trouble is in the head. Unfortunately the reality is less simple leg; these include the toe 'exten- than the theory. Often it is difficult to decide whether the great toe actually does sors', which also shorten the leg go up: the toe movements may be slight, vacillate between up and down, seem on contraction and therefore are down one day but up the next, or be interrupted by voluntary withdrawal flexors in a physiological sense. As movements. It is therefore no great surprise that such difficult plantar responses the nervous system matures and give rise to wide variations between doctors, or even between different occasions the pyramidal tract gains more with the same observer. Under these circumstances the interpretation may be control over spinal motoneurones influenced by the physician's previous expectations.' Since it is obviously the flexion synergy becomes less important for the diagnosis in individual patients whether or not a lesion of the brisk, and the toe 'extensors' are pyramidal system exists, there is a need for criteria that are both reliable and no longer part of it. -
The Brain That Changes Itself
The Brain That Changes Itself Stories of Personal Triumph from the Frontiers of Brain Science NORMAN DOIDGE, M.D. For Eugene L. Goldberg, M.D., because you said you might like to read it Contents 1 A Woman Perpetually Falling . Rescued by the Man Who Discovered the Plasticity of Our Senses 2 Building Herself a Better Brain A Woman Labeled "Retarded" Discovers How to Heal Herself 3 Redesigning the Brain A Scientist Changes Brains to Sharpen Perception and Memory, Increase Speed of Thought, and Heal Learning Problems 4 Acquiring Tastes and Loves What Neuroplasticity Teaches Us About Sexual Attraction and Love 5 Midnight Resurrections Stroke Victims Learn to Move and Speak Again 6 Brain Lock Unlocked Using Plasticity to Stop Worries, OPsessions, Compulsions, and Bad Habits 7 Pain The Dark Side of Plasticity 8 Imagination How Thinking Makes It So 9 Turning Our Ghosts into Ancestors Psychoanalysis as a Neuroplastic Therapy 10 Rejuvenation The Discovery of the Neuronal Stem Cell and Lessons for Preserving Our Brains 11 More than the Sum of Her Parts A Woman Shows Us How Radically Plastic the Brain Can Be Appendix 1 The Culturally Modified Brain Appendix 2 Plasticity and the Idea of Progress Note to the Reader All the names of people who have undergone neuroplastic transformations are real, except in the few places indicated, and in the cases of children and their families. The Notes and References section at the end of the book includes comments on both the chapters and the appendices. Preface This book is about the revolutionary discovery that the human brain can change itself, as told through the stories of the scientists, doctors, and patients who have together brought about these astonishing transformations. -
Intro to Pediatric HCC Module
A Message from Mark Baiada BAYADA Home Health Care has a special purpose—to help people have a safe home life with comfort, independence, and dignity. BAYADA will only succeed with your involvement and commitment as a member of our home health care team. I recognize your importance to the organization and appreciate your compassion, excellence, and reliability. I value the skills, expertise, and experience that you bring with you. And, as an organization, BAYADA is committed to providing you with opportunities to help broaden your expertise and experience. Acquiring new skills will allow you to participate in the care of a wider variety of clients. That makes you an increasingly valuable member of our home health care team. Most importantly, our clients benefit when you successfully master new skills that contribute to their safety and well-being. BAYADA University and the School of Nursing courses are designed to help you perfect your knowledge and skill to achieve clinical excellence in the care of clients. I applaud your willingness to continue the journey of life-long learning and wish you continued success in your professional development as an important member of the BAYADA team. Sincerely, Mark Baiada President Table of Contents Welcome ...........................................................................................................................iv Introduction to home care ................................................................................................. 1 Psychosocial .................................................................................................................. -
Newborn Reflexes
O C T O B E R 2 0 1 9 NEWBORN REFLEXES MORO Reflex: also known as the embracing or startle reflex. Moro reflex is mediated by the brain stem and becomes apparent at approximately 25 to 26 weeks' gestational age. It is an involuntary motor response meant to protect the infant from sudden changes in body displacements.In normal infants, the response is symmetrical and disappears by 3 to 4 months. The Moro reflex consists predominantly of abduction and extension of the arms with hands open, and the thumb and index finger semiflexed to form a “C”. Leg movements may occur, but they are not as uniform as the arm movements. With return of the arms toward the body, the infant either relaxes or cries. Absence of the reflex may indicate: intracranial lesions asymmetrical response may indicate birth injury involving the brachial plexus, clavicle, or humerus abnormal persistence of embrace gesture may indicate hypertonicity persistence of entire Moro reflex after 4 months may indicate delay in neurologic maturation. ROOTING Reflex: Indicates normal maturity and intact trigeminal nerve. When cheek is stroked, infant turns toward stroking and opens the lips to suck (if not fed recently). This reflex helps the newborn baby find food; when the mother hold the child and allows her breast to brush the newborns cheek, the reflex makes the baby turn toward the breast. The rooting reflex disappears around the sixth week of life. SUCKING Reflex: Indicates normal maturity and intact hypoglossal nerve. Offer non-latex gloved finger or nipple to test; Newborns suck even when sleeping (non-nutritive sucking) and it can have a quieting effect on the baby; This reflex doesn't start until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. -
Practice Resource: CARE of the NEWBORN EXPOSED to SUBSTANCES DURING PREGNANCY
Care of the Newborn Exposed to Substances During Pregnancy Practice Resource for Health Care Providers November 2020 Practice Resource: CARE OF THE NEWBORN EXPOSED TO SUBSTANCES DURING PREGNANCY © 2020 Perinatal Services BC Suggested Citation: Perinatal Services BC. (November 2020). Care of the Newborn Exposed to Substances During Pregnancy: Instructional Manual. Vancouver, BC. All rights reserved. No part of this publication may be reproduced for commercial purposes without prior written permission from Perinatal Services BC. Requests for permission should be directed to: Perinatal Services BC Suite 260 1770 West 7th Avenue Vancouver, BC V6J 4Y6 T: 604-877-2121 F: 604-872-1987 [email protected] www.perinatalservicesbc.ca This manual was designed in partnership by UBC Faculty of Medicine’s Division of Continuing Professional Development (UBC CPD), Perinatal Services BC (PSBC), BC Women’s Hospital & Health Centre (BCW) and Fraser Health. Content in this manual was derived from module 3: Care of the newborn exposed to substances during pregnancy in the online module series, Perinatal Substance Use, available from https://ubccpd.ca/course/perinatal-substance-use Perinatal Services BC Care of the Newborn Exposed to Substances During Pregnancy ii Limitations of Scope Iatrogenic opioid withdrawal: Infants recovering from serious illness who received opioids and sedatives in the hospital may experience symptoms of withdrawal once the drug is discontinued or tapered too quickly. While these infants may benefit from the management strategies discussed in this module, the ESC Care Tool is intended for newborns with prenatal substance exposure. Language A note about gender and sexual orientation terminology: In this module, the terms pregnant women and pregnant individual are used. -
Brainstem Dysfunction in Critically Ill Patients
Benghanem et al. Critical Care (2020) 24:5 https://doi.org/10.1186/s13054-019-2718-9 REVIEW Open Access Brainstem dysfunction in critically ill patients Sarah Benghanem1,2 , Aurélien Mazeraud3,4, Eric Azabou5, Vibol Chhor6, Cassia Righy Shinotsuka7,8, Jan Claassen9, Benjamin Rohaut1,9,10† and Tarek Sharshar3,4*† Abstract The brainstem conveys sensory and motor inputs between the spinal cord and the brain, and contains nuclei of the cranial nerves. It controls the sleep-wake cycle and vital functions via the ascending reticular activating system and the autonomic nuclei, respectively. Brainstem dysfunction may lead to sensory and motor deficits, cranial nerve palsies, impairment of consciousness, dysautonomia, and respiratory failure. The brainstem is prone to various primary and secondary insults, resulting in acute or chronic dysfunction. Of particular importance for characterizing brainstem dysfunction and identifying the underlying etiology are a detailed clinical examination, MRI, neurophysiologic tests such as brainstem auditory evoked potentials, and an analysis of the cerebrospinal fluid. Detection of brainstem dysfunction is challenging but of utmost importance in comatose and deeply sedated patients both to guide therapy and to support outcome prediction. In the present review, we summarize the neuroanatomy, clinical syndromes, and diagnostic techniques of critical illness-associated brainstem dysfunction for the critical care setting. Keywords: Brainstem dysfunction, Brain injured patients, Intensive care unit, Sedation, Brainstem -
Neurologic AESI Glossary of Terms
Neurologic AESI Glossary of Terms Includes terms for the following Brighton Collaboration Case Definitions: • Encephalitis, myelitis, acute disseminated encephalomyelitis • Guillain Barré and Miller Fisher Syndromes • Peripheral Facial Nerve Palsy (Bell’s palsy) • Aseptic meningitis • Generalized convulsion Acalculia: inability to perform simple mathematical tasks (addition, subtraction, multiplication) Agnosia: inability to recognize objects or persons Agraphesthesia: difficulty recognizing a written number or letter traced on the palm of the hand Agraphia: impairment in the ability to write AIDP: acute inflammatory demyelinating polyneuropathy (most common form of GBS) Alexia: impairment of ability to read AMAN: acute motor axonal neuropathy (a less common form of GBS) AMSAN: acute motor and sensory axonal neuropathy (a less common form of GBS) Aphasia / Dysphasia: impairment of spoken language abilities that affect production and/or comprehension of speech. Apraxia: inability to execute purposeful movements Aprosodia: decreased ability to generate or comprehend emotion as conveyed in spoken language Asterognosia: inability to identify an object by active touch of the hands without other sensory input (e.g. visual) Ataxia: loss of coordination in voluntary movements; can present in many ways including: lack of coordination, slurred speech, gait abnormalities, inability to balance, trouble eating and swallowing, loss of fine motor skills, tremors; Atonic motor manifestations: sudden loss in tone of postural muscles; may be preceded by