PRIMITIVE REFREXES in neonatal (pediatrics) .pptxPRIMITIVE REFREXES in neonatal (pediatrics) .pptx

PRIMITIVE REFREXES in neonatal (pediatrics)

1. Sangwani Ng’ambi Primitive Reflexes

2. Introduction Primitive reflexes are automatic stereotypic movements directed from the brainstem and require no cortical involvement. They are needed for survival and development in the early months of life. As the higher cortical centers begin to mature → successive disappearance of these reflexes take place allowing proper neurological development.

3. Moro Reflex

4. Clinical value of Moro reflex Normal reflex in the normal time frame →to normal neurodevelopment Abnormal reflex Sluggish in sedated newborn and sepsis Exaggerated in early kernicterus Unilateral (asymmetrical ) in Erb’s palsy, fracture clavicle or humerus . Absent reflex (two sided) Premature < 28 weeks CNS depression by e.g. Anoxia, anesthesia or intra cranial hemorrhage Reflex persisting beyond 6 months is seen in neurodevelopmental disorders e.g. cerebral palsy , autistic disorders.

5. Palmar and Solar grasp reflexes

6. Stepping and Placing Reflexes

7. Rooting and spinal Galant reflexes

8. Suckling reflex Stimulus: Place baby’s hand in the mouth or offer mother’s breast Response: Strong suckling response in the term infant, rather weaker in the preterm. Becomes well coordinated with swallowing It develops from 34 to 35 weeks gestational age. Disappearance Becomes a voluntary response

9. Swallowing Reflex Method: It is elicited by putting the baby to breast. Normal Response : Rhythmical swallowing movements will be felt and seen at neck. It is present at birth and disappears by 6-9 months . Abnormal Response : Decreased or absent in general neurological depression, hypotonia, immaturity and bulbar palsy.

10. Landau and parachute reflexes

11. Pupillary reflex Method : Exposure to bright light leads to pupillary constriction While exposure to dim light → pupillary dilatation Clinical significance: 1 – It appears at birth and persists 2 – It important for evaluation of vision

12. Babinski reflex Method : scratching the outer aspect of the feet Response : dorsiflexion this reflex is normal in infant up to 2 years old (usually disappear by the age of 1 year) Abnormal Response Persistence above 2 years of age → upper motor neuron disease