| The "grasping" reflex is classified as one of the so called "primitive", "regressive" or” frontal release" reflexes. Other reflexes of the same type, pathological like this one, are the sucking and snout reflex, the glabellar reflex, the palmomental and policomental reflexes.
They are patho-physiologically complex reflexes as they are not produced by the alteration of a central monosynaptic arc. Their interpretation is difficult because they can sometimes be seen in healthy individuals or as the only indication of illness. In any case, the grasping reflex is one that is obtained in pathological circumstances with frontal affectation, generally serious, and not in normal individuals or those with mild lesions.
In order to elicit it, the palm of the hand is stimulated gently by the examiner’s hand being placed perpendicular to the hand of the patient’s and then displacing it gently from the wrist to the fingers. The pathological response is seen when the patient grasps the examiner’s hand.
In the video the normal response is shown in the right hand (the patient is unreactive and hypotonia of the hand is appreciated) and the pathological response obtained with stimulation of the left hand.
In the presented case we are treating sequelae of Listeria monocytogenes meningitis that led to a tetraventricular hydrocephalus and serious and extensive lesions in the brain. The extensive bilateral frontal lesions can be obviously seen in the Figs 1 and 2 and can be compared with similar cuts of a normal CT (Fig 3).
For more information and test questions on, please consult listeriosis in the "image of the month" of December 2007.
Autor:
Juan Ignacio
Pérez Calvo
Servicio de Medicina Interna
Hospital Clínico Universitario
Zaragoza
Translation: Kelly
Watt
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