NeuroTeach 13 - Corneomandibular reflex

Corneomandibular reflex!!!

“there is hardly a more valuable test than this to uncover a supranuclear lesion of the trigeminal nerve”

Russian neurologist Robert Wartenberg (1887–1956)

2) History

1902 by German doctor Von Sölder - first description, normal patients 1918 by German neurologist Ernst Trömner - rediscovered the reflex 1948 by Russian neurologist Robert Wartenberg - complete description - 'jaw wincking phenomenon'

3) Pathophysiology

Mesencephalic trigeminal nucleus - there is an inhibitory interneuron ipsilateral motor nucleus of V CN Lesions in cortico-pontine boundaries lesions - inhibitory influence disappear - massive activation of trigeminal motor neuron

4) Corneomandibular reflex

representation in pediatric and adult individuals

5) Corneomandibular reflex

“stimulation of cornea causes contralateral movement of the mandible” - usually associated movement > reflex - supranuclear interruption of ipsilateral corticotrigeminal tract - ALS

6) Corneomandibular reflex

7) Corneomandibular reflex

8) Corneomandibular reflex

9) Other frontal release signs

Palmar grasp, palmomental, rooting & sucking, snout, glabellar, and head retraction reflex