Which of the following conditions is the brisk Moro reflex seen?
A brisk moro reflex can be seen in neonates with hypoglycemia. In hypoglycemic babies, there is activation of the autonomic system, which results in jitteriness. Newborns often exhibit this as an exaggerated Moro reflex. The Moro Reflex: It is a primitive reflex which is very sensitive to the infant&;s level of aleness. It can be elicited by suppoing the infant in the semierect position and allowing the infant&;s head to fall backwards onto the examiner&;s hand. The Moro reflex: caused by significant generalized disturbance of the CNS. Stage III HIE Kernicterus Asymmetric Moro reflex: feature of root, plexus, or nerve disease Fractured clavicle Brachial plexus injury (Erb&;s palsy) Hemiparesis Brisk Moro reflex Neonatal hypoglycemia Can also be a normal variant in healthy infants Stage I HIE Exaggerated, stereotyped, non-habituating Moro reflex is a feature of severe bilateral intrauterine cerebral disturbance, perhaps because of the release of the brain stem from inhibitory coical influences. It is seen in conditions such as the following: Hydranencephaly Severe microencephaly Other options: In stage III hypoxic-ischemic encephalopathy (HIE), the muscles are flaccid and the infants is in a comatose state. So, Moro reflex is absent. Erb&;s palsy results from an injury to the brachial plexus. So, Moro reflex is absent on the side of injury since the nerve supplying the muscles is affected. Moro reflex in different stages of Hypoxic-ischemic encephalopathy(HIE) Stage I HIE(mild): Brisk Stage II HIE (moderate): Weak/incomplete Stage III HIE(severe): Absent Ref: Nelson textbook of pediatrics 21st edition Pgno: 3059
Kernicterus
Stage III hypoxic ischemic encephalopathy (HIE)
Hypoglycemia
Erb's palsy
New born infants