Primitive reflexes

Alternative names
Infantile reflexes; Reflexes in infants

Definition

A reflex is an involuntary muscular response to a sensory stimulus. Certain sensations or movements are known to produce specific muscular responses.

The presence and strength of a reflex is an important indication of neurological development and function. Many of the infantile reflexes disappear as the infant matures, though some remain throughout adulthood.

Considerations

Infantile reflexes are tested and observed by the medical team to evaluate neurological function and development. Absent or abnormal reflexes in an infant, persistence of a reflex past the age where the reflex is normally lost, or redevelopment of an infantile reflex in an older child or adult may suggest significant neurological problems.

Examples of reflexes that persist into adulthood are:

     
  • blinking (corneal) reflex (blinks before eyes are touched or when sudden bright light appears)  
  • sneeze reflex (sneezes when nasal passages irritated)  
  • gag reflex (gags when throat or back of mouth stimulated)  
  • yawn reflex (yawns when needs additional oxygen)  
  • cough reflex (coughs when airway stimulated)

Infantile reflexes (normal in infants, abnormal in all others):

     
  • sucking reflex (sucks when area around mouth stimulated)  
  • startle reflex (pulling arms and legs inward after loud noise)  
  • step reflex (stepping motions when sole of foot touches hard surface)

Other infantile reflexes include:

The MORO RESPONSE is elicited by placing an infant on his back. Support the upper body weight of the supine infant by the arms (not lifting the infant off the surface) then release the arms suddenly. The infant responds by throwing the arms outward, clenching the fist, appearing startled, then relaxing back to a normal rest position.

The TONIC NECK REFLEX is elicited when the head of a relaxed child, lying on his back, is rotated to the side. The arm toward which the infant is facing extends straight away from the body with the hand partially open, while the arm on the side away from the face is flexed and the fist is clenched tightly. Reversing the direction in which the face is turned reverses the position. The tonic neck position is often described as the fencer’s position because it resembles the stance of a fencer.

The GRASP REFLEX is elicited by placing a finger on the infant’s open palm. The hand will close around the finger. Attempting to remove the finger causes the grip to tighten. Newborn infants have strong grasps and can almost be lifted from the examination table if both hands are used.

The ROOTING REFLEX is elicited by stroking the cheek. The infant will turn toward the side that was stroked and begin to make sucking motions with its mouth.

The PARACHUTE REFLEX occurs in the slightly older infant, and is elicited by holding the child upright then rotating the body quickly face forward (as if falling). The arms are reflexively extended as if to break a fall even though this reflex appears long before walking.

The presence of an infantile reflex after the age at which the reflex normally disappears can be a sign of brain damage or damage to the nervous system.

Common Causes

Abnormal presence of infantile reflexes can occur in adults with:

     
  • stroke  
  • brain damage from trauma

Call your health care provider if

Abnormal infantile reflexes are usually discovered by the health care provider during exams performed for other reasons, and the affected individual (or the parents in the case of an infant) may not have been aware of the condition.

What to expect at your health care provider’s office

The medical history will be obtained and a physical examination performed.

Documenting infantile reflexes in detail may include:
In an infant:

     
  • What reflexes were present?  
  • At what age did each infantile reflex disappear?

In an older child or adult:

     
  • What reflexes were present?  
  • What other symptoms are also present?  
  • Is there decreased consciousness or seizures?

PHYSICAL EXAMINATION
An evaluation of the infantile reflexes is performed during well-baby examinations. The (abnormal) presence of infantile reflexes in an older child or adult is discovered during neurological examination.

AFTER SEEING YOUR HEALTH CARE PROVIDER
You may want to add a diagnosis related to abnormal infantile reflexes to your personal medical record.

Johns Hopkins patient information

Last revised: December 3, 2012
by Gevorg A. Poghosian, Ph.D.

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