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The palmomental reflex (PMR) is an example of a primitive reflex. Normally present in infancy, it may reappear because of processes that disrupt the normal cortical inhibitory pathways.1 Whereas a bilateral response may be considered a physiologic phenomenon, a unilateral PMR may provoke suspicion regarding the presence of a localized lesion and has been claimed to reflect a contralateral upper motor neuron lesion above the pons.2 To date, the relevance of the PMR as a localizing sign remains unresolved.3
Methods.
Over 12 months, we evaluated 634 consecutive patients on the neurosurgical ward for inclusion in the study. Patients were excluded before examination for the following reasons: facial nerve palsy and lack of cooperation (most commonly due to stupor or coma) and after examination if brain imaging was considered inadequate.
Patients were examined for a PMR as previously described4 by two neurology residents blinded to the patient’s diagnosis and to the other’s examination. Following PMR examination, the patient’s imaging studies …
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Letters: Rapid online correspondence
- Reply from Authors
- Lack of hemispheric localizing value of the palmomental reflex
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