Shevell Michael
Department of Neurology/Neurosurgery & Pediatrics, McGill University, Division of Pediatric Neurology, Montreal Children's Hospital-McGill University Health Center, Montreal, Quebec, Canada.
Neurology. 2009 Mar 3;72(9):850-3. doi: 10.1212/01.wnl.0000343961.35429.09.
The standard neurologic examination of the newborn and infant includes the elicitation of the tonic neck reflex. Normally present, its persistence is suggestive of neurologic dysfunction and a prognostic marker highly suggestive of an adverse outcome. Working in different fields, with different approaches and largely independently, three leaders of early 20th century neurosciences (Rudolf Magnus, Josef Gerstmann, and Arnold Gesell) elaborated different aspects of this primitive reflex. Magnus provided the first description in an animal model utilizing a meticulously prepared decerebrate cat correctly identifying the reflex's reliance on proprioceptors in the neck and processing in the upper cervical segment. Gerstmann first described its occurrence in the setting of neurologic disease, providing a meticulous written description in an early description of the index case of what would later be eponymously designated Gerstmann-Straussler-Scheinker syndrome. Gesell initially described the reflex's fundamental occurrence in normal young infants, highlighting its adaptive role in early development and its persistence as a hallmark of neurologic pathology.
对新生儿和婴儿的标准神经学检查包括引出紧张性颈反射。该反射通常存在，其持续存在提示神经功能障碍，是高度提示不良预后的一个预后指标。20世纪早期神经科学的三位领军人物（鲁道夫·马格努斯、约瑟夫·格斯特曼和阿诺德·格塞尔）在不同领域工作，采用不同方法且很大程度上相互独立地阐述了这种原始反射的不同方面。马格努斯在一个动物模型中首次进行了描述，他使用精心制备的去大脑猫，正确地确定了该反射对颈部本体感受器的依赖以及在上颈段的处理过程。格斯特曼首次描述了其在神经系统疾病中的出现情况，并在对后来被命名为格斯特曼-施特劳斯勒-申克综合征的首例病例的早期描述中给出了详细的书面描述。格塞尔最初描述了该反射在正常幼儿中的基本出现情况，强调了其在早期发育中的适应性作用以及作为神经病理学标志的持续存在。
