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At least 163 records · Page 9Linked to original sources

Stapedial reflex in amyotrophic lateral sclerosis.

OBJECTIVE: To examine mechanisms controlling the stapedial reflex in patients with amyotrophic sclerosis (ALS). METHODS: The stapedial reflex was examined using impedance audiometry in 38 patients with sporadic ALS and in 25 age matched controls. RESULTS: All patients showed normal reflex decay test results. There were no significant differences between patients with ALS and control subjects in reflex threshold, latency, amplitude, or contraction time (C50). Although each reflex variable in the patients with classic or progressive muscular atrophy types of ALS showed no significant difference from that in control subjects, the patients with bulbar type ALS showed significantly longer latency, C50, and retraction time (D50), and significantly lower amplitude than control subjects. Three types of abnormal reflex waveforms (polyphasic, abnormally delayed retraction, and abnormally early retraction) were noted in six patients. CONCLUSION: The subclinical involvement of the stapedius motor neurons or of the supranuclear stapedius motor system might be responsible for the abnormalities of the stapedial reflex in ALS.

Acoustic Impedance Tests↗

Association of umbilical cord blood lead with neonatal behavior at varying levels of exposure.

BACKGROUND: In the light of the ongoing debate about lowering the cut-off for acceptable blood lead level to <5 microg/dL from the currently recommended level of <10 microg/dL, we considered whether prenatal exposure to varying levels of lead is associated with similar or disparate effects on neonatal behavior. METHODS: Using Brazelton's Neonatal Behavioral Assessment Scale (NBAS), an epidemiological approach and robust statistical techniques like multivariate linear regression, logistic regression, Poisson regression and structural equations modeling analyses we estimated the simultaneous indirect effects of umbilical cord blood lead (CBL) levels and other neonatal covariates on the NBAS clusters. RESULTS: We observed that when analyzed in all study subjects, the CBL levels independently and strongly influenced autonomic stability and abnormal reflexes clusters. However, when the analysis was restricted to neonates with CBL <10 microg/dL, CBL levels strongly influenced the range of state, motor and autonomic stability clusters. Abnormal walking reflex was consistently associated with an increased CBL level irrespective of the cut-off for CBL, however, only at the lower cut-offs were the predominantly behavioral effects of CBL discernible. CONCLUSION: Our results further endorse the need to be cognizant of the detrimental effects of blood lead on neonates even at a low-dose prenatal exposure.

Journal Article↗

Topodiagnostic value of brain stem reflexes.

The masseter and medial pterygoid stretch reflexes, the masseter inhibitory reflexes, and the blink reflexes are useful diagnostic tools for evaluation of brain stem disorders. The structures mediating these reflexes are largely known. Characteristic changes of the normal response patterns due to various lesions have been described. Distinct reflex abnormalities indicate lesions at specific sites. Multireflex testing improves the accuracy with which localization can be made. A number of lesions suspected on clinical data may be confirmed by reflex findings only and not by imaging studies. Reflex testing can be utilized to demonstrate multiple lesions evoked by a single vascular event and evaluate dissemination of central nervous involvement in multiple sclerosis patients.

Blinking↗

[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↗

Tropicamide effects on pupil size and pupillary light reflexes in Alzheimer's and Parkinson's disease.

Diagnostic tests for Alzheimer's disease (AD) involving tropicamide blockade of cholinergic oculomotor functions were examined in AD patients (n=15), Parkinson's disease (PD) patients (n=15), and non-clinical control (NC) participants (n=15). Pupillographic methods were used to measure pupil diameter and pupillary light reflexes after double-blind ocular administration of dilute tropicamide (0.01%) in one eye and saline in the other eye. Changes in pupil size were measured in bright background light and near-darkness. Tropicamide increased pupil diameter to a similar extent in all three groups in light and darkness. Tropicamide also reduced the amplitude and latency of the pupillary light reflex to a similar extent for all three groups. Tropicamide pupillary response tests, therefore, were not sensitive or specific diagnostic tests for AD. Peak constriction amplitude of the pupillary light reflex was significantly reduced in both eyes in AD and PD groups relative to non-clinical controls, but AD and PD groups did not differ significantly. The pupillary light reflex test, therefore, was sensitive to AD, but lacked adequate specificity. Finally, peak constriction amplitude correlated significantly with dementia severity and donepezil treatment may have partially normalized pupillary light reflex abnormalities in AD patients. The pupillary light reflex test, therefore, may index central cholinergic dysfunction associated with disease progression and improvement in cholinergic function associated with pharmacologic treatment response in AD.

Aged↗

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↗

Neurological long-term sequelae after spinal anaesthesia in a tropical setting: a case control study.

Spinal anaesthesia (SA) is an important form of anaesthesia in tropical countries. It is considered to have few long-term complications or sequelae, although this hypothesis has not been proven in a rural tropical setting. In a case control study we found SA to he a significant risk factor for lower back pain, reflex abnormalities and muscular atrophy and mild impairment of muscle power in patients examined between 3 months and 4 years after SA. These long-term sequelae need to be confirmed in a larger prospective study employing all possible neurophysiological and neuroimaging techniques.

Adult↗

Trisomy 16 in a pigtailed macaque (M. nemestrina) with multiple anomalies and developmental delays.

A female pigtailed macaque (Macaca nemestrina) with unusual physical characteristics, deficits in learning and cognitive tasks, abnormal social behavior, and abnormal reflexes and motor control was followed from birth until 3 years of age and found to have trisomy 16, which is homologous to trisomy 13 in humans. The animal described here showed similar features to cases of trisomy 16 and 18 (human trisomy 13 and 18, respectively) reported previously in nonhuman primates. However, both significant differences and similarities were found when compared with the homologous human trisomy. Evaluation of the genetic components of these disorders as well as systematic developmental evaluation can lead to new insights into the genetic basis of speciation, development, and the underlying differences between humans and their closest living relatives.

Abnormalities, Multiple↗

Cutaneomuscular reflex responses recorded from the lower limb in children and adolescents with cerebral palsy.

Cutaneomuscular reflex (CMR) responses were recorded from lower-limb and trunk muscles in 27 subjects with cerebral palsy (CP) (spastic, 21; athetoid, six) and in neurologically healthy (control) subjects, aged 3 to 15 years, while standing. In the 21 subjects with spastic CP, but not in the six subjects with athetoid CP, CMR responses were more widely distributed between ipsilateral lower-limb and trunk muscles compared with age-matched control children. CMR responses in older subjects with CP were similar to younger control subjects, lacking supraspinally mediated, long-latency components. Short-latency, spinally-mediated, excitatory CMR components were seen simultaneously in pairs of distal, antagonistic lower-limb muscles in half of the subjects with spastic CP, but in none of the control children. In subjects with spastic-type CP, the abnormal reflex responses indicate disordered spinal and supraspinal inputs to motor neurones, although there was no convincing correlation between these responses and the severity of spasticity.

Adolescent↗

Prognostic significance of the delayed plantar reflex following spinal cord injury.

The delayed plantar reflex (DPR) is a pathologic flexor variant which requires unusually strong stimulation of the sole of the foot and is characterized by a prolonged interval between the stimulus and the response, slow and protracted plantarflexion of the great toe and/or other toes and slow return to the neutral position. The purpose of this study was to evaluate prospectively the functional outcome of spinal cord injury (SCI) patients based on the presence or absence of a DPR immediately following injury. Thirty-six subjects were evaluated within one week of injury. A complete neurological evaluation following American Spinal Injury Association (ASIA) standards was performed and the presence or absence of a DPR was noted on admission. Ambulation status and ASIA Impairment Scales were recorded at discharge from the rehabilitation unit and the data were analyzed by the Chi-square method with Yates' correction for continuity. The data demonstrated a high correlation of the DPR with motor complete injuries (p < 0.01) and a poor prognosis for recovery of ambulation (p < 0.01). Clinicians should recognize this abnormal reflex, which may be used in conjunction with a complete neurological examination, to help prognosticate future function in the acute SCI patient.

Adolescent↗

Early prediction of outcome following head injury in children: an assessment of the value of Glasgow Coma Scale score trend and abnormal plantar and pupillary light reflexes.

A retrospective study of 95 children less than 15 years of age with significant head injury was made to assess the value of Glasgow Coma Scale (GCS) score trend and plantar and pupillary light reflexes during the first 24 hours after injury, in predicting eventual outcome. GCS score trend or reflexes used alone were significantly correlated to outcome. There was also a statistically significant correlation when these parameters in combination were related to outcome. However, the clinical value of the combined use of GCS score trend and reflexes was only slightly greater than the use of GCS score trend alone.

Adolescent↗

Abnormalities of the blink reflex in Gilles de la Tourette syndrome.

The blink reflex and it's recovery cycle were studied in 26 patients with Gilles de la Tourette syndrome and 10 controls. There was a significant increase in the mean duration of the R2 response. The amplitude of the R2 response following paired shocks (mean R2[T]/R2[C]%) was 11%, 40% and 52% of the conditioning stimulus with intervals of 200 ms, 500 ms and 1 second in the patients, compared with 10%, 17% and 32% respectively in the controls. Half the patients, however, had normal recovery cycles and voluntary suppression of tics and blinks reduced the amplitude of R2 in all patients. These results suggest increased excitability of brainstem interneurons in Gilles de la Tourette syndrome.

Adult↗

Abnormal air-righting reflex in striatal rats.

To understand dynamic postural control of the higher brain, we compared air-righting reflexes in various decerebrate rats. Post-operative 3-5 d thalamic and mesencephalic rats displayed almost similar righting movements as intact. However, in striatal animals, coordination of righting movements was disrupted. The higher brain without cortical control could interfere with the brainstem center of the air-righting reflex.

Animals↗

The abnormal upper gastrointestinal vagovagal reflexes that affect the heart.

The clinically important upper gastrointestinal-cardiac vagovagal reflexes are mainly those initiated by swallowing and rapid gastric distention. Pre-existing-heart disease has little to do with determining susceptibility to upper gastrointestinal stimuli. The dangerous cardiac repercussions concern diminished coronary artery flow and the arrhythmias. The latter can be subcategorized as swallow tachycardia, pharyngeal disease with arrhythmia, glossopharyngeal neuralgia with swallow syncope, spontaneous swallow syncope and swallow bradycardia. Iatrogenic arrhythmias are particularly tragic potential hazards of all pharyngoesophagogastric manipulations.

Adolescent↗