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Pathophysiology
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
TRUE – The Moro reflex is the rapid abduction followed by adduction of limbs when startled. It normally disappears within the first year of life and may re-emerge following frontal lobe lesions, along with other primitive reflexes.12 The primitive reflexes can be remembered using ‘MRS BP’: MoroRooting (movement of head towards side of cheek/mouth that is stroked)Sucking (sucking response when the roof of the mouth is touched)Babinski’s signPalmar and Plantar (curling of digits when the palmar surfaces of hands or feet are stroked).
Growth and development
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
A normal full-term 6-month-old infant is able to sit with support and lift his head when prone, and support the upper trunk on extended arms. He shows no hand preference. The Moro reflex disappears by the age of 5 months. Most children will be able to fix and follow a moving face by the age of 6 weeks.
Primitive or baby reflexes
Published in Jill Christmas, Rosaline Van de Weyer, Hands on Dyspraxia: Developmental Coordination Disorder, 2019
Jill Christmas, Rosaline Van de Weyer
The Moro reflex is present as early as the first nine or ten weeks in the womb and is normally inhibited within two to four months in the young baby. It is elicited in response to an incoming, usually unexpected or unpleasant stimulus. It is there in part as a protective mechanism, and when stimulated can cause a whole-body movement and stress reaction in the body. In response, the baby may startle, fling their arms out to the side, bend both legs up into a flexed position, and take a large intake of breath prior to crying in a distressed manner.
Opsoclonus myoclonus and ataxia syndrome with supraventricular tachycardia
Published in Baylor University Medical Center Proceedings, 2023
Sydney Garner, Alec Giakas, Katherine Holder, Bernardo Galvan, Hollie Edwards
A 9-month-old male was born via cesarean delivery at 34 weeks’ gestation due to maternal preeclampsia and fetal heart rate decelerations. His past medical history was significant for macrocephaly and hypotonia. A month before presentation, he developed abnormal eye and body movements. He was noted to be more tired and to be eating less than usual. Upon examination, he was alert and had intermittent, rapid, low-amplitude, chaotic eye movements, abnormal jerking of the head and arms, and low truncal tone. Muscle bulk and reflexes were normal except for an exaggerated Moro reflex. An extensive initial workup included magnetic resonance imaging of his brain consistent with benign enlargement of subarachnoid spaces of infancy. Computed tomography of the neck, chest, abdomen, and pelvis and urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels were within normal limits and did not reveal a neuroblastoma.
İpsilateral clavicle and humerus diaphysis fractures in newborn after vaginal delivery; a very rare case report
Published in Journal of Obstetrics and Gynaecology, 2022
Metin Celik, Emre Arikan, Sevil Eraslan, Songul Celik Tastan
Failure to take the moro reflex in the postnatal examination of the newborn may first suggest a brachialplexus injury. However, accompanying clavicle fracture and/or humerus fracture is another cause of the moro reflex that cannot be removed. In these patients, the moro reflex is taken at an earlier stage. Neonatal fractures can be encountered in all delivery methods and manoeuvres. Therefore, early detection of such traumas is very important; acomprehensive examination and evaluation is essential in the early period after birth. Differential diagnoses should be considered, and high suspicion should be raised.
General movements and motor outcomes in two infants exposed to Zika virus: brief report
Published in Developmental Neurorehabilitation, 2019
Daniele de Almeida Soares-Marangoni, Natália Matos Tedesco, Andressa Lagoa Nascimento, Priscila Rimoli De Almeida, Caroline Neder dos Santos Pereira
His 18-year-old mother presented rash and itching in the 10th week of gestation. PCR (polymerase chain reaction) on her blood confirmed ZIKV. Investigation of dengue, chikungunya, human immunodeficiency virus (HIV) and TORCHS (toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis) gave negative results. The infant was born at 39 weeks and 6 days of gestation and had a head circumference of 29.5 cm (InterGrowth z-score of −3.01, indicating microcephaly14). Serology for TORCHS and PCR for ZIKV on urine, cerebrospinal fluid and umbilical cord samples in the post-natal screening were negative. Non-contrast brain computed tomography (CT) revealed loss of cortical sulci determining enlarged gyri predominant in frontal and temporal lobes (pachygyria), bilateral punctiform calcifications in subcortical white matter and basal ganglia, supratentorial ventriculomegaly, and normal posterior fossa. Ophthalmoscopy identified bilateral pallor, atrophic macula scar involving the fovea in the right eye, and pigment changes in the macular area in the left eye. No auditory damage or musculoskeletal deformities were found. In the 13th week after term, the infant presented with crying and fussing, and attempts in performing neurodevelopmental assessments were not successful. At 16 weeks after term, the infant was assessed with GMA. Fidgety movements were absent and concurrent cramped-synchronized GMs were identified. No intentional movements, such as reaches or rolling were present. General neurologic examination identified increased Moro reflex; nonobligatory asymmetric tonic neck response; absent visual orientation; poor auditory orientation (stopped moving when a toy was squeezed near ears); and hypertonia and reduced active range of motion in upper and lower limbs, mainly in the upper limbs. Motor performance was very limited as the infant was not able to bring hands to midline in supine or lift and maintain head during prone and supported sitting and standing. At 12 months of age, the neuromotor findings remained. Because the infant presented severe motor impairment, he was tested in the four positions but the positions could not be scored on the AIMS.13 Specifically, the infant was able to move the head to midline and maintain it for several seconds in supine position, but moving his hands to midline or reaching hands to knees or feet were not observed; in prone, he was able to lift the head to 45°, but maintaining it in midline was not observed. In supported sitting and standing, he was able to turn the head and lift it to 90° in midline, but maintaining it for a long period or reach for objects were not observed.