Definition

Or even also beam. pyramidal Reflex disappearing during the first months of life while the cortex (gray substance of the brain) increasingly magnitude and plays its role in decision-making. In other words, the cortex will come to inhibit further in more these archaic reflexes.

The best known of them is the reflex of grasping, also called “grasping”. It is obtained by stimulating the palms of the hands and the soles of the feet.

The Moro reflex is triggered by a sudden extension of the head. To perform this task, the examiner submits a hand back and the other head of the child, and then it suddenly straightens the head. The child reacts first in away from the arms of his body, then by opening the hands, and then by flexion of the forearm on the arm. It’s called the manœuvre of embrace, it usually ends with a cry. This reflex should be symmetric, it is asymmetric in the presence of a fracture of the clavicle or paralysis of the nerves in the arms (brachial plexus) or inflammation of the arm. This is done in the last because it raises the child crying. Other classic reviews as automatic walking, which involves walking the baby, to step over an object, have no neurological meaning.

At birth, a newborn has not yet fully completed his brain maturation. Movements it takes are largely of automatisms, which will be progressively modulated as archaic reflexes and measure the cortex will develop.
These archaic movements are not the essential element of the review. Brain, being form, does not yet have all the capabilities to properly perform specific actions. Apart from asking a possible neurological diagnosis, this examination must allow to realize if the baby normally in contact with his environment.
The movements of the baby, very clumsy in early life, will gradually to refine with the arrival of the muscle tone, as that the child will acquire more muscular strength but also more than precision.

The conditions of the examination
Neurological examination must not be in any conditions: it is necessary to reassure the child: atmosphere of serenity and gentleness
Meet the schedule of the decision-making of the tété
Make a comment of his behaviour, but also its posture-its spontaneous motor
Conscientiously observe the position of its members and the manner in which it moves
The awakening of the newborn State and how it will react when it stimulates are important, the child to react when it passes the State of sleep to wakefulness
The position of the head, which must be maintained at the outset by the examiner, may influence the overall position of the body
When the tone of the newborn is normal, upper and lower limbs are half bent and body, i.e. the trunk of the baby rests completely on the mattress
If the muscle tone of the baby is too large, the arm will be abnormally bent, legs will be too straight, slightly hooked back trunk. Otherwise, when the muscle tone of the baby is too low, the arms are extended (i.e. strained), lower members excluded too significantly, the feet are turned on inside or outside and are based entirely on the mattress. This is called “the pits” position
During the examination, the child should not present small rapid movements and tremors of the Chin as the thrills, and mouthing movements

The exam itself
To appease a child, the best technique is to talk to. By supporting its neck, on the structures on itself in position fœtale. This is interest to establish contact between the medical examination and the child, normally, not mourning more (if the examiner is experienced). Otherwise, do not hesitate to change an examiner or to resume the review at any other time of the day, when the child slept, or after the feeding, in accordance with the digestion time.
The infant is able to get in communication with his examiner unless it is in a State awake but calm. Generally, the opening of the hands translated this appeasement and somehow the given to the practitioner to begin the neurological examination.

One must begin by assessing the gaze and its spontaneous mobility
And then the use of a (usually targets consisting of black lines concentric) drawing that it passes in front of the face of the baby, to to give an idea of the interest that the child to his surroundings. In medical terms, this is called Visual orientation

By moving the target in the Visual field, a distance of approximately 20 cm of the baby’s face, one can observe the continuation of eyes searching the object in all directions of space

The displacement of the object is in the vertical, horizontal direction and rotating

The opening of the eyes must be combined, the exploration of the environment is most often by saccades

The medical research the existence of a strabismus by using a light source. This is the study of the reflection of light on the cornea. This reflection must normally be centered on the pupil

Auditory orientation is research in making sound a Bell. It must nevertheless take care that the child has not seen it. Indeed, it is the sound of the Bell to gradually draw the head and eyes to the sound source

Palpation of the fontanelles (membranous space between the bones of the skull of the newborn and infant, must believe is progressively) that must not be bulging, or be dug

Active muscle tone of several areas of the body (slight voltage at which a muscle is subjected when it is at rest) should be explored by the examiner to various tests (they give the importance to the neurological examination of the newborn, and are not only running to please parents):

Audit of the so-called axial, i.e. of the spinal column musculature: the relief of the head and lower limbs is tested

The movement of the head, while the child is supine, is accompanied by slight relief of the back and lower limbs. This manœuvre is a normal examination of the axial musculature. The child must appear either too rigid or too flaccid

The examiner then performs a so-called manœuvre of the sign of the scarf: it takes the hand of the infant in the direction of the opposite shoulder. The position of the elbow is noted for the right and the left. This position is called normal if the elbow stops at the level of half of the clavicle in the same side (ipsilateral). This test is suspicious or abnormal if the elbow moves half of the clavicle, is referred to as hypotonia (low muscle tone). If the elbow stops before half of the ipsilateral clavicle, one speaks of hypertonia (muscle tone too). Finally, if there is an asymmetry between the right side and left side, this can translate either a fracture of the clavicle, or a problem with the nerves from arm (brachial plexus).

Another review to assess the State of the axial tone is, once the child lying, to enter it by wrists and get him in a sitting position. In these circumstances, the child must maintain his head for a few seconds in the alignment of the body. If the child adopts an asymmetrical position of the head, this leaves suspecting a congenital torticollis.

In conclusion
The interest of this exam is screening at the birth of abnormal neurological type, it must allow, if it was made in the rules of the art, by a practitioner experienced guide in case of doubt, to more in-depth investigations, biological blood glucose levels or a show type, or radiological (EEG, scanner, or MRI).

Last updated December 2001
The archaic reflex is present when system nervous and any particular grouping of motor nerve (nerve bundles, specifically a pyramidal beam) from the brain to the movements of the members, has not completed its maturation.

The pyramidal beam is a main nerve track belonging to the central nervous system (brain and spinal cord). It consists of a group of nerve fibers with a route to transport the voluntary motor messages (nerve impulses to obtain a movement, unlike messages destined for the perception of sensations) and common. It connects the nerve cells of pyramidal in cerebral bark (gray substance of the brain) to other nerve cells in the spinal cord.

Its archaic reflexes without normally present in the newborn up to three months.

Example of three other archaic reflexes:
The grasping is a reflex of closure of the fingers and hands on an object placed in the hand of the newborn.
The reflex of automatic walk. If it submits a new born in vertical position, his feet building on the examining table, his legs will sketch a walking movement.
Cross extension reflex is observed if it lengthens a leg of the child while scraping the bottom of his foot on the same side, the other leg is extended then and the foot is in contact as to prevent the examiner to continue.