Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

Pathological reflexes and signsTerminology Manoeuvre SignificanceGlabellar tap, orbicularis oculi or blink reflexRepeated tapping of glabellaIncreased, or fails to fade, with extrapyramidal orsupranuclear disorderSnout or pout reflex (orbicularis oris reflex)Percussing lips leads topoutingElicited with diffuse brain damageSucking reflexStroking mouth produces suckingElicited with severe diffuse brain damageGrasp reflexStroking palm with a finger or an object causes graspingElicited with diffuse brain damage'Magnet' reaction Hands or head follow objects which are brought closeElicited with severe diffuse brain damage'Gegenhalten'Patient tenses muscles which the examiner tries to stretchMay occur with frontal lobe and basal ganglia lesionsPalmomental reflex Forceful stroking of palm leads to homolateral chin musclecontractionDiffuse brain damagePersistent clonus (jaw, finger, patella, ankle)Sudden stretching of muscleleads to involuntary repetitive jerkingPyramidal tract lesionMental state assessment1. Conscious level: retardation, somnolence, delirium, twilight state.2. Orientation: time, place, person.3. Powers of perception and concentration: concrete and abstract notions,interpretation.4. Ability to record, short- and long-term memory: memory gaps (possiblyconfabulation), perseveration, recollection of numbers and personal data.5. Progression of ideas - formal thinking: inhibited, circumstantial, retarded,perseverating, incoherent, twisted, accelerated (flight of ideas), halting of ideas, constriction,autism, judgmental ability, decisiveness, exaggerated ideas.6. Basic mood and affective reactivity: lability of affect, emotional incontinence, inndisquiet, tension, irritability, querulousness, euphoria, anxiety, sadness (depressionhopelessness, lack of affect, antagonism, loss of self-regard, notions of guilt and poverty,