Snout reflex

Abstract: Neurological signs were assessed in 178 patients satisfying NINCDS/ADRDA criteria for Alzheimer's disease. A snout reflex was present in 41%, extrapyramidal signs in 12%, drug-induced extrapyramidal signs in 3%, myoclonus in 5%, and a history of epileptic fits in 3%. A grasp reflex, extrapyramidal signs and symptoms were associated with severe cognitive impairment. On CT scanning, extrapyramidal signs were associated with increased 3rd ventricular size and basal ganglia calcification, a grasp reflex with frontal lobe atrophy and a history of epilepsy with left temporal lobe atrophy. Lateral ventricular size was greater in patients developing a grasp reflex during a 12 month follow-up. Extrapyramidal signs and primitive reflexes were associated with a higher mortality.

Abstract: Fifteen patients with prolonged coma after craniocerebral injury were observed for a year or more, and their communicative functions were evaluated. Nine of them showed a considerable degree of recovery, while 6 remained in a vegative state. Of the 9 with recovery, 6 showed complete recovery of semantic functions, while 3 remained with aphasic deficits. Eight out of these 9 remained dysarthric. Communicative recovery began as late as 5.7 months after injury, and it roughly paralleled recovery in locomotion and A.D.L. Restlessness and sweating were favorable prognostic factors. Excessive salivation, snout reflex, corneomandibular reflex, retractory nystagmus and stereotypic movements were unfavorable. The 8 patients who remained dysarthric showed marked diminution of their expiratory and inspiratory reserves, and of their forced vital capacity.

Abstract: We report a case displaying upper motor sign, parkinsonism, and behavioral abnormality, with marked degeneration of the precentral cortex, neostriatum and frontotemporal lobes, as well as ubiquitinated neuronal inclusions. The patient was a 66-year-old male at the time of death. At age 57, he noticed progressive difficulties in speaking and swallowing. At age 60, he was severely anarthric and displayed emotional lability and incontinence. Neurologically, very poor movement of tongue was observed, but without atrophy or fasciculation. Deep tendon reflexes were hyperactive. Grasp reflex and snout reflex were also positive. Needle electromyography revealed no abnormalities. A diagnosis of primary lateral sclerosis and character change was made. At age 62, he developed bradykinesia and rigidity of the neck and all extremities. Treatment with carbidopa-levodopa was initiated, but resulted in minimal improvement. At age 65, he was bed-ridden, and had repeated occurrences of aspiration pneumonia; he died of pneumonia. Neuropathological examination revealed marked atrophy of the frontal and temporal lobes with Betz cells completely absent and moderate atrophy of the neostriatum. The spinal cord and nerve roots appeared normal. Immunohistochemically, ubiquitin-positive but tau-negative intraneuronal inclusions were found in the frontal and temporal cortices, including the precentral cortex and the hippocampal dentate gyrus, and the neostriatum. This case could be included with inclusion-associated disorders such as frontotemporal dementia or amyotrophic lateral sclerosis with dementia, and furthermore, predominant upper motor sign and parkinsonism could represent phenotypes of clinical manifestations with such inclusions.

Abstract: Primitive reflexes were studied in patients with presumed Alzheimer disease and in age-matched nondemented controls. A snout reflex occurred with equal frequency (54%) in the two groups. An abnormal glabellar reflex was elicited more often in the demented patients (23%) than the controls (8%). The presence of a snout reflex was directly correlated with increasing age; the glabellar reflex showed a similar but nonsignificant trend. Neither reflex finding correlated with the presence of apparent cerebral atrophy by CT scan or the results of psychometric tests. The finding of primitive reflexes has little clinical value in the evaluation of the elderly.