Pedroso F S, Rotta N T
Division of Neurology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil.
Arq Neuropsiquiatr. 1997 Jun;55(2):186-92. doi: 10.1590/s0004-282x1997000200004.
We studied the mouth opening response to appendicular compression in two groups of children. This study was performed with the intention of testing the semiologic role of the act of mouth opening following stimulation of various regions, based on the hand mouth reflex of Babkin. Group I was formed by 33 normal children who underwent monthly follow up assessments since birth; and group II consisted of 50 children older than 6 months of age, known to have a neurologic deficit and a neuro-psychomotor development equivalent to that of a child in the first trimester of life. We observed that the normal mouth opening response in group I was more pronounced following compression of the hand and forearm when compared to compression of the arm (p < 0.001). This response could persist for as long as the first 6 months of life. We were not able to elicit a mouth opening response following compression of the lower limb in this group. Among children from group II, we observed mouth opening responses to stimulation of all limb segments. Within the upper limb, the response was more pronounced following compression of the hand in comparison to the forearm (p < 0.01), and forearm in comparison to the proximal arm (p < 0.01). Stimulation of the foot was more effective in eliciting a mouth opening response when compared to equivalent stimulation of the lower leg (p < 0.05). However, there was no statistical difference when responses to stimulation of the lower leg and thigh were compared. The presence of the previously unreported foot-mouth response may serve as an indicator of central nervous system compromise and could be associated with a poorer prognosis. We believe that our observations of the specific foot-mouth response patterns may serve as a marker of early neuro-psychomotor development dysfunction during childhood.
我们研究了两组儿童对肢体压迫的张口反应。本研究旨在基于巴布金手口反射，测试刺激不同区域后张口动作的符号学作用。第一组由33名正常儿童组成，他们自出生起每月接受随访评估；第二组由50名6个月以上的儿童组成，这些儿童已知存在神经功能缺陷，其神经心理运动发育水平相当于生命头三个月的儿童。我们观察到，与压迫手臂相比，第一组儿童在手和前臂受压后正常张口反应更明显（p<0.001）。这种反应可持续长达生命的前6个月。在这组儿童中，压迫下肢后我们未能引出张口反应。在第二组儿童中，我们观察到对所有肢体节段刺激的张口反应。在上肢，与前臂相比，手受压后反应更明显（p<0.01），与近端手臂相比，前臂受压后反应更明显（p<0.01）。与小腿同等刺激相比，刺激足部在引发张口反应方面更有效（p<0.05）。然而，比较小腿和大腿刺激的反应时，没有统计学差异。先前未报道的足口反应的存在可能是中枢神经系统受损的指标，并且可能与较差的预后相关。我们认为，我们对特定足口反应模式的观察可能是儿童期早期神经心理运动发育功能障碍的一个标志。
