Epileptic Disorders
MENUThe Moro reflex: insights into the pathophysiology of generalized tonic-clonic seizures and infantile spasms Volume 24, numéro 5, October 2022
Adult with primary generalized (clonic)-tonic-clonic seizure. At the onset of the seizure, the arms are suddenly elevated and abducted with flexion at the elbows and palms facing forward. The abduction and elevation of the arms are reminiscent of the proximal movements seen in the first component of the MR (and in epileptic spasms). However, unlike the MR (in which arm flexion at the elbows can occur after arm extension), at the onset of generalized tonic-clonic seizures, the elbows are semi-flexed. The flexion of the legs is a further feature that is not typical of the MR. The seizure is shown twice, first at normal speed and then in slow motion.
> DownloadAdult with epileptic spasms. Arms are suddenly elevated and abducted with abrupt flexion at the elbows and of the neck. The abduction and elevation of the arms are similar to the proximal movements seen in the first component of the MR, whereas the semi-flexed elbows from the very onset of the seizure are a different feature. In the patient shown in this video, unlike the MR elicited in a healthy infant where the head remains fixed and the limbs move symmetrically, the head and eyes turn to one side (left) with the left leg being markedly extended and abducted. A movement of extension and abduction of the legs, similar to that exhibited by this patient, can also occur inconsistently during the MR. The epileptic spasm is shown twice, first at normal speed and then in slow motion.
The Moro reflex evoked in a seven-week-old healthy infant. The sudden loss of head support leads to a massive movement of abduction and slight elevation of the arms, which is the primary component of the reflex. The subsequent component of adduction of the arms can be lacking, as in the present case. The MR is shown twice, first at normal speed and then in slow motion.