Groping reflex

Introduction The groping reflection belongs to the frontal symptom group. Overview of the frontal lobe symptom group: The frontal lobe is located in the front of the brain and has four major cerebral gyrus, namely the central anterior gyrus, the frontal gyrus, the midline and the inferior gyrus. When the frontal lobe is damaged, it mainly causes obstacles such as voluntary movement, speech, cranial nerve, autonomic nerve function and mental activity. Prefrontal motion lesions, strong grip reflexes, groping reflexes, canine reflexes, and early contralateral tonic reflexes, and opposite upper limb Lei's reflexes.

Cause

Frontal lobe symptoms can occur when the traumatic brain injury affects the anterior cranial fossa, the anterior and middle cerebral arteries to the frontal branch, the sinus infection, the frontal lobe, and the pituitary apoplexy.

an examination

Related inspection

Brain ultrasound examination of brain CT

Clinical manifestation

1. Cranial nerve palsy: precranial fossa tumor or localized arachnoiditis, lesion side olfactory disturbance, primary optic atrophy and contralateral papilledema, bilateral papilledema, visual side vision can rapidly decline, or even completely disappear .

2. dyskinesia: frontal irritative lesions, convulsions on the contralateral upper and lower limbs or face - Jackson's epilepsy; generalized seizures;

3. Abnormal reflex: prefrontal motion lesions, strong grip reflexes, groping reflexes, canine reflexes, and early contralateral tonic reflexes, and opposite upper limbs of Lei's reflex.

4. Frontal lobe ataxia: frontal lobe lesions, half of the patients in the district appear sitting, walking obstacles, unstable rotation, easy to pour to the opposite side of the lesion.

5. Motor aphasia: Complete motor aphasia, the patient completely loses the ability to speak, but the pronunciation and tongue movement muscles are good; some sports aphasia, the patient can make certain words, but the vocabulary is poor, the speech is slow, the grammar is wrong, often wrong words.

6. Autonomic dysfunction: heart rate, blood pressure changes and gastrointestinal dysfunction.

7. Mental disorders: early memory impairment, no memory is still preserved. As the lesion progresses, the far memory is lost, and the expression is indifferent and the concentration is not concentrated. Emotional volatility, sexual desire, excitement, and irritability are characteristics of frontal lobe lesions.

8. Loss of writing, violation of symptoms, stupor state: patients can not dictate and write automatically, that is, writing can not be sick. Appearance is indicated for any action applied to the patient, ie, a violation. There is also a stupor state, the patient does not eat, the facial expression is often fixed, and there is no response to internal and external stimuli. This state can last for hours, weeks, and months.

Differential diagnosis

(a) cerebral arteriosclerosis (cerebral arteriosclerosis) This disease is more than 50 years old, the onset of slow development is progressive, the early manifestations are mainly distracted attention and obvious near forgotten. This memory disorder can have significant fluctuations, often unexpectedly and suddenly recovering. Late memory decline, difficulty in thinking, and slow speech. Affective disorder, the most prominent emotional depression at the beginning of the disease, late emotional stagnation, and strong crying, strong laughter. Personality changes are manifested as sensitive, suspicious and victimized. Some patients have advanced dementia. Nervous system examination, the fundus arteries become thinner, the reflection is enhanced, and the veins are cross-pressed. Head CT limited localized low density area. Blood cholesterol, triglycerides, and lipoproteins should be considered for the possibility of arteriosclerosis.

(B) pituitary apoplexy (pituitary apoplexy) pituitary apoplexy increased volume, increased pressure in the saddle, compression of the frontal lobe, optic nerve, optic palsy, can also appear III, IV, VI cranial nerve palsy. When the lower part of the thalamus is pressed, a disturbance of consciousness occurs.

(C) frontal abscess (frontal sbscess) more secondary to other parts of the infected lesions, more fever history, onset. Peripheral blood and cerebrospinal fluid examination, polymorphonuclear leukocytes increased. In addition to the forehead pain, vomiting, and papilledema, often the pulse is slow. Increased blood pressure, wide pulse pressure, slow breathing, and psychiatric symptoms are often caused by memory loss, especially near-memory loss or loss, while distant memory preservation, lesion aggravation, and near-far memory disappear. Personality changes are often manifested as irritability, euphoria, and childish behavior. The incidence of these mental disorders is about 60%. Seizures are also common symptoms of frontal lobe abscesses. Mostly, it is a systemic episode, and it can also be changed from localized epilepsy to generalized epilepsy. Speech disorder shows only the ability to understand speech, the ability to speak is completely lost, the lighter speech is slow, difficult, and the words stop and eat. Strong grip reflection and groping reflection on one side are important indications for frontal lobe lesions.

(D) frontal tumor (frontal tumor) In addition to headache, vomiting, papilledema and other symptoms of increased intracranial pressure, frontal lobe tumor can cause mental symptoms. This symptom appears earlier and the incidence is high. Mainly manifested as memory impairment and personality changes. Early symptoms are often inattention, memory and comprehension are reduced, and the memory loss is obvious, and the memory is preserved. However, as the disease progresses, the thinking and comprehensive ability are obviously reduced, and the orientation disorder of time and place appears. Personality changes are mainly mental barriers and indifference. Seizures are often the first symptom, and 4/5 are epileptic seizures without aura. The tumor is located at or near the bottom of the forehead, compressing the olfactory nerve, leading to loss of olfaction. In the case of a tumor on the medial frontal lobe, urinary incontinence or urinary urgency appears. In the case of frontal tumors, delicate advanced movement disorders, uncoordinated movements of embroidery and needle insertion, and disjointed speech and behavior. In frontal lobe tumors, the lesions of the contralateral abdominal wall and the cremaster reflex weakened or disappeared, and an ankylosing degenerative reflex occurred.

(5) intracranial parasitosis (intracranial parasitosis) frontal parasitic diseases often have seizures and psychiatric symptoms, but according to epidemiology, parasitic exposure history, other parts of the body have parasites, skin test positive, blood and Cerebrospinal fluid complement fixation test is not difficult to diagnose.

(6) Pituitary tumors are more common in adults, and the main symptoms are pituitary dysfunction. Headache, primary atrophy of the optic nerve, hemianopia on both sides. When the tumor develops into the saddle, mental symptoms and seizures may occur. Hemiplegia can occur when the tumor affects the internal capsule or oppresses the anterior and middle cerebral arteries and affects its blood circulation.

(7) Subdural hematoma The subfrontal hematoma of the frontal lobe is seen at any age, and the psychiatric symptoms are more obvious. A few patients may have seizures. There was a significant history of trauma, and symptoms of increased intracranial pressure occurred shortly or several months after the injury, and the localized signs were not obvious. Carotid angiography, in the anterior-posterior image, the anterior cerebral artery is displaced to the contralateral side, the middle cerebral artery is depressed and displaced to the inside in different degrees, and there is a half-moon-shaped avascular region between the blood vessel and the inner plate of the skull. .

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