Inverted & Perverted Reflexes
The first description of the paradoxical (inverted) triceps reflex
French neurologist Alexandre-Achille Souques (1860–1944)
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The first description of the paradoxical (inverted) triceps reflex
French neurologist Alexandre-Achille Souques (1860–1944)
#MedTwitter #neurotwitter #EndNeurophobia #tweetorials
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Definition
“elicitation of the movement opposite to that normally seen when the reflex is elicited”
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“elicitation of the movement opposite to that normally seen when the reflex is elicited”
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Mechanism
“a lesions simultaneously affecting the roots and spinal cord”
Damaged root
- interrupt local reflex
- absence of contraction
Damaged spinal cord
- interrupt corticospinal tract
- hyperactive response of the lower spinal segment
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“a lesions simultaneously affecting the roots and spinal cord”
Damaged root
- interrupt local reflex
- absence of contraction
Damaged spinal cord
- interrupt corticospinal tract
- hyperactive response of the lower spinal segment
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Why is there a hyperactive response?
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Inverted radial (supinator) reflex
Level of pathology: C5/6
Positive response: Flexion of fingers and extension of elbow rather than elbow flexion when eliciting the supinator (brachioradialis) jerk.
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Level of pathology: C5/6
Positive response: Flexion of fingers and extension of elbow rather than elbow flexion when eliciting the supinator (brachioradialis) jerk.
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Paradoxical (inverted) triceps reflex
Level of pathology: C7/8
Positive response: Flexion of elbow rather than extension when eliciting the triceps jerk.
youtu.be via: MedAruth
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Level of pathology: C7/8
Positive response: Flexion of elbow rather than extension when eliciting the triceps jerk.
youtu.be via: MedAruth
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Inverted biceps reflex
Level of pathology: C5/6
Positive response: Extension of elbow rather than flexion when eliciting the biceps jerk.
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Level of pathology: C5/6
Positive response: Extension of elbow rather than flexion when eliciting the biceps jerk.
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Inverted knee jerk
Level of pathology: L2/3/4
Positive response: Flexion of knee (hamstring contraction) rather than knee extension when eliciting the knee or quadriceps jerk.
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Level of pathology: L2/3/4
Positive response: Flexion of knee (hamstring contraction) rather than knee extension when eliciting the knee or quadriceps jerk.
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Special
Absent quadriceps reflex with distant toe flexor response
Level of pathology: L3/4
doi.org via: Clinical Neurology and Neurosurgery
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Absent quadriceps reflex with distant toe flexor response
Level of pathology: L3/4
doi.org via: Clinical Neurology and Neurosurgery
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Clinical clues
C5 lesion – inverted biceps
C6 lesion – inverted radial
C7 lesion – inverted triceps
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C5 lesion – inverted biceps
C6 lesion – inverted radial
C7 lesion – inverted triceps
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