THE PALMOMENTAL REFLEX - CHANGES IN PATIE NTS WITH SYLVIAN CEREBRAL INFARCTION AND EFFECT OF THE LOCATION OF THE INFARCT - RADIOCLINICAL CORRELATIONS

Changes over time in the palmomental reflex were studied in patients w ith acute hemiplegia due to an infarction in the territory of the midd le cerebral artery. There were 30 cases each of deep and superficial s ylvian infarction. The diagnosis was established by computed tomograph y. In some patients, increased briskness of the palmomental reflex on the side of the hemiplegia occurred only after an 18-day period during which the reflex was absent or decreased. Absence or blunting of the reflex on the side of the hemiplegia was related to the severity of th e motor deficit, and occurred in 72% of patients with deep sylvian inf arction versus only 33% of those with superficial sylvian infarction. The literature was reviewed for data on the pathophysiologic mechanism s underlying transient absence or blunting of the palmomental reflex i n deep sylvian infarction. Whether this phenomenon correlates reliably with a subcortical location of the infarct in patients with acute hem iplegia deserves to be evaluated.