SCI reflexes and some pediatric conditions

Plantar reflex

S1—S2

• Stroke lateral aspect of sole and medially to base of great toe

• Flexion of toes

Bulbocavernosis reflex

S2—S4

• Squeeze glans or tug catheter

• sphincter contraction → first after SCI, indicates end of spinal shock

Biceps and brachoradialis R

C5—6

Triceps R

C7—8

Patellar R

L2—4

Achilles R

S1—2

Babinski

Toe extension and fanning, normal for infant

Torticollis

SCM tightness

Expected motions affected by torticollis or SCM tightness?

Flexion, I/L SB and C/L rot

• R Torticollis — affects flexion, R SB and L rot

  • R Torticollis Tx — Stretch into extension, L SB and R rot

Myelomeningocele

CSF, SC tissue and nerve fibers — most severe

Meningocele

CSF, SC intact

• can lead to tethered cord syndrome

• least common

Arthrogryposis

Nonprogressive

• 2 or more joint contractures and muscle weakness at birth

DMD

X—linked recessive; ie: males affected, carried by mothers

• missing dystrophin gene → permeable sarcolemma → muscle destruction

Gowers sign

Seen with DMD; due to weak quads + gluteals

Erb palsy

C5—6 roots involvement

• Upper arm paralysis

• “waiter’s tip” — Shd add + IR, elbow extended, forearm pronated and wrist flexed

Klumpke palsy

C8—T1 roots involved

• Lower arm paralysis

• “claw hand” — intrinsic mm affected, wrist extended, fingers flexed