Marinesco symptom. Recommendations for the treatment of marinescu-radovici syndrome

The palmar-chin reflex of Marinescu Radovici can be provoked by stroking the skin of the inner surface of the forearm with a special tool. Investigated strictly Bottom part current zone. Manipulation is carried out by a qualified specialist to identify a pathological condition.

Most often, the specialist uses a pointed object or a neurological hammer.

Manifestations of oral automatism

The palmar-chin reflex of Marinescu Radovici refers to the manifestations of oral automatism. These abnormal manifestations on the face are observed when a person has spastic paralysis or paresis of the muscles of the face.

The presence of these manifestations indicates the presence of a 2-sided supranuclear lesion in the following departments of the brain:

1. Stem.
2. Subcortical.
3. Cortical.

In the absence of a pathological condition, these manifestations may be present in newborns and very young babies who have not even reached six months of age. In adult patients, these manifestations are extremely rare.

If a similar manifestation is observed in an adult, then it makes sense to undergo comprehensive examination, since this indicates the development of pseudobulbar palsy.

Specialists in the field of medicine distinguish the following oral manifestations:

• nasolabial refl-s (occurs as a result of tapping with a special medical instrument on the back of the nose. As a result, the lips are pulled forward);
• proboscis reflex (lips are pulled forward in case of hammer impact on the lower or upper lip);
• sucking refl-s (specific movements of the lips are provoked as a result of a stroke effect on the actual zone);
• distance-oral reflex (the effect occurs when approaching the actual zone of the neurological malleus - the lips stretch into the proboscis);
• marinescu radovich reflex (as a result of the stroke effect, the chin skin shifts in the upper direction).

general information

For the first time, the palmar chin reflex of Marinescu Radovici was described in the twenties of the twentieth century. The famous Romanian neuropathologists G. Marinescu and A. Radovici saw in this phenomenon an expression of stem automatism. Otherwise, this expression is called a rudimentary manifestation of the ancient asinergic grasping, or chewing.

reflex arc

Marinescu Radovic's reflex comes to light quickly enough. The response is that the chin muscle in the actual area is reduced. This causes a shift skin on the chin to the top.

The closure of the reflex arc occurs in the neostriatum.

This manifestation is also called the exteroceptive skin reflex.

Norm

Like other manifestations of oral automatism, the palmar-chin reflex of Marinescu Radovici normally occurs in twelve to eighteen-month-old children. This manifestation is responsible for the synergism of the main functions. It is also responsible for sucking and grasping.

Pathology

If a positive Marinescu Radovic reflex is detected in adults, this indicates that the GM cortex is in a critical state. Manifestation takes place in case of diagnosis:

1. Encephalopathies.
2. GM injury.
3. Stroke.
4. Multiple sclerosis.

danger sign

Multiple sclerosis in the presence of the Marinescu Radovic reflex in persons who have come out of childhood occurs more often than other pathological conditions.

This disease is chronic and has a neurological character. Usually pathological condition stays with a person until the end of his life and progresses all the time.

The onset of the disease

multiple sclerosis in early stages manifests itself differently each time. In some cases, a person. immediately upon awakening, he cannot keep his balance, sometimes even from slight fatigue he “falls” into a chair.

Multiple sclerosis strikes when a person is least prepared for it. It is a mistake to believe that this pathology affects only the elderly. In fact, a terrible disease can develop in young and young people in their twenties and thirties.

Diagnostics

The danger lies in the fact that, due to the presence a large number symptoms, timely diagnosis of this disease is quite difficult. only an accurate diagnosis can be made qualified specialist in the field of neurology. The most widely used in the diagnosis of MRI-study, with the help of which the doctor determines the pathological foci.

Treatment for multiple sclerosis is lengthy and painful. In some cases, the doctor decides on a spinal tap. In order to protect yourself from a terrible disease, you must strictly adhere to preventive requirements.

The Marinescu-Radovici syndrome is a pathological phenomenon accompanied by the involuntary occurrence of a palmo-mental (palmarofacial) reflex, which is one of the symptoms of oral automatism. Normally, it manifests itself in children 1 year - 1.5 years. The occurrence of this type of reflex activity at an older age is a pathology.

Causes

The appearance of a symptom is characteristic of disorders accompanied by damage to the brain stem. In the vast majority of cases, Marinescu-Radovici syndrome is associated with mild or severe traumatic brain injuries, which include:

• shake;
• brain contusion (bruise);
• intracranial hemorrhage;
• cranial fractures.

In addition, Marinescu-Radovici pathology can manifest itself against the background of some other cerebral diseases, which include:

• encephalopathy;
• meningitis;
• stroke (in ischemic or hemorrhagic form);
• multiple sclerosis;
• tumor neoplasms.

The described syndrome is not considered as an independent disease. Pathology occurs due to concomitant disorders in the functioning of brain structures, which in many cases are irreversible.

Characteristic symptoms

Clinical manifestations, accompanied by the development of the palmo-mental reflex, differ significantly. The nature of the symptoms depends solely on what disease they are provoked. In particular, the affected side plays a significant role. If the appearance of the Marinescu-Radovici syndrome on the right is noted, this in most cases indicates a lesion of the cerebral cortex, which indicates multiple sclerosis.

The palmomental reflex is characterized by a contraction of muscle tissue in the chin area when creating a focus of irritation in the palm of your hand. The contraction is noted on the side of the hand involved in the procedure. At the same time, there is a shift of the skin in the corresponding direction.

in number accompanying symptoms, arising simultaneously with the palmar-chin reflex, also includes other reflexes of oral automatism, normally found only in children. These include:

1. Sucking (appearance of sucking movements of the lips when touching them).
2. Proboscis (change in the shape of the lips with a light tap on the nose).
3. Nasolabial (change in the shape of the lips with light tapping on the lower or upper lip).
4. Karchikyan's syndrome (reaction of the lips to an instrument that is slowly approaching, but not in contact with the skin).

The occurrence of these reflexes in children is associated with the need to receive mother's milk. In adults, these types of activity die off, so their occurrence indicates damage to certain brain structures.

Diagnostics

The occurrence of the Marinescu-Radovici symptom is considered valuable in itself. diagnostic criterion. With its help, the presence of brain diseases that affect the trunk or cortex of the hemispheres is revealed. The presence of several reflexes of oral automatism at the same time in an adult indicates a pathological process in the central motor neuron.

If these symptoms occur, immediate health care. Diagnosis is aimed at identifying the disease that caused reflex deviations.

For diagnostic purposes, the following procedures are used:

• Magnetic resonance imaging;
• lumbar puncture;
• encephalography;
• angiography of cerebral vessels;
• evoked potential analysis.

The diagnosis is made on the basis of the results of the procedures, taking into account the individual clinical picture of the patient.

Therapy

There is no specific treatment for Marinescu-Radovici syndrome. The main therapy is aimed at eliminating the manifestations of the provoking disease.

In some cases, a complete cure is impossible, for example, with severe traumatic brain injuries, multiple sclerosis, which is why treatment is reduced to symptomatic therapy.

For minor injuries and medium degree severity, especially with concussions, the greatest intensity of the palmar-facial reflex is noted on days 4–5. During this period, the patient should observe bed rest, take medications prescribed by the doctor.

Inpatient treatment is required when potentially life-threatening conditions occur, including hemorrhagic or ischemic stroke, cerebral hemorrhage, encephalopathy.

The Marinescu-Radovici reflex (palmar-chin) is typical. It occurs normally in children up to 12-18 months, providing a friendly implementation of two various functions: grasping the breast with the hands and sucking milk at the same time.

Determining this reflex during a neurological examination allows you to understand the cause of the disease and find out the location of the pathological process in the brain. The reflex was first described in 1920 by two neurologists Marinescu and Radovici.

Phenomena of oral automatism

The Marinescu-Radovic reflex refers to reflexes. These are pathological reflexes on the face that occur with central (spastic) paralysis or facial muscles innervated by cranial nerves.

The appearance of these reflexes indicates a bilateral supranuclear lesion of the brain stem, subcortical structures, or cerebral cortex.

These reflexes, including those of Marinescu-Radovic, normally appear in children up to 18 months of age. This is due to the immaturity of the brain structures and the ongoing differentiation of the parts of the central nervous system.

Oral automatism reflexes include:

All these reflexes are observed in newborns and children of the first year and a half of life, but then fade away, and can occur in adults against the background of damage to brain structures.

Information about the Marineschi-Radovici reflex

The reflex was first described in the 1920s by two Romanian neurologists, Marinescu and Radovici. Observing this phenomenon in their patients, they found that the appearance of the reflex is associated with damage to the brain stem and is a reflection of the rudimentary synergism of grasping and sucking, or chewing.

The reflex consists in contraction of the chin muscle on the face with a gentle stroke of the palm in the base area. thumb. As it was revealed later, the nuclei of the seventh pair of cranial nerves participate in this reflex.

In this case, the response time of the reflex is several milliseconds. The main response is the contraction of the mental muscle on the side of irritation of the palm. At the same time, there is a noticeable shift of the skin on the chin in the corresponding direction on the face.

A characteristic feature of this reflex is the one-sidedness of the reaction: when the skin is irritated on the right, the response is observed on the right half of the face, despite the bilateral brain damage.

Use in diagnostics

As mentioned above, the palmar-chin reflex occurs in adults and children older than one and a half years with damage to the structures brain: brainstem, subcortical formations and cerebral cortex.

Its appearance is associated with damage to the central motor neuron or its axon, and the occurrence of spastic or central paralysis in a certain muscle group in a patient. At the same time, the inhibitory effect of the neuron of the cerebral cortex on the muscles disappears, as a result of which the reflex readiness of the muscles increases and pathological reflexes appear, which are normally absent.

• Stewart - Holmes symptom (JP Stewart, 1869-1949, English neuropathologist; G.M. Holmes, 1876-1965, English neuropathologist; syn. recoil symptom) - the patient's inability to keep the flexion of his own arm in the elbow joint, when the examiner suddenly stopped prep. ..
• Foix - Thevenard symptom (Ch Foix, 1882-1927, French neuropathologist; A. Thevenard, 1898-1959, French neuropathologist; syn: pushing symptom, push phenomenon) - loss of patient balance in vertical position with a slight push to the side; sign of brain injury...

News about Marinescu - Hirschberg symptom

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Discussion of Marinescu - Hirschberg symptom

• My daughter is 1.9 months old. She has an increased gag reflex. From birth, all specialists, including a neuropathologist, looked, there was no pathology. Now she began to spit up from fright (the plane will fly by, the dog will whine or other noise). I do not know what to do. Our pediatrician prescribed to drink Phenibut. Is it worth it

The syndrome is known today under the name "Marinescu-Sjogren's syndrome", but in fact it is a variant of "Sjogren's syndrome" (it was described in 1935 and is characterized by a combination of congenital cataract with mental retardation). The Romanian neurological school also collaborated in the development of this syndrome.

Etiopathogenesis of the Marinescu-Sjogren syndrome.

Marinescu-Sjögren syndrome is a hereditary cerebellar spinal degeneration due to an unknown cause.

The syndrome appears in early age(up to a year) and affects both sexes approximately to the same extent. It is transmitted hereditarily (there are some exceptions) in an autosomal recessive manner, very rarely by an autosomal gene (a small number of cases described before 1969 - only 50 - favor this assumption). Parental consanguinity appears to play an important role in the occurrence of hereditary transmission of the syndrome.

In some cases, the familial nature of the syndrome has also been proven. Genetic studies (karyogram) remained negative in all examined cases.

Back in 1930, three Romanian researchers, two neurologists and one ophthalmologist, drew attention to the severe neurological manifestations of patients with congenital cataract and oligophrenia, and Sjogren's merit lies in the fact that recently, in 1950, he systematized and described completely characteristic anomalies of this syndrome. . From the beginning of the description, until now, this syndrome appears in the medical literature under various names:

• Marinescu-Sjogren-Garland syndrome;
• Marinescu-Garland syndrome;
• Marinescu-Draganescu-Vasiliu syndrome;
• cataract syndrome - oligophrenia - cerebellar ataxia.

Symptomatology of the Marinescu-Sjogren syndrome.

• congenital bilateral cataract. Initially zonal, rapidly becoming full, even within early childhood; begins at birth and usually manifests itself by the age of 4;
• oligophrenia, manifested clinically - late, from ordinary dementia to idiocy;
• spinal-cerebellar ataxia combines all the neurological signs that are constantly present in the clinical picture of the syndrome, appearing even from the first year of life;
• cerebellar ataxia, with uncoordinated movements and intentional trembling; lack of balance when walking and standing; nystagmus;
• muscle hypotension with reduced reflexes;
• amyotrophy (appearing late);
• various paresis and paralysis of muscles.

Spinal ataxia appears early and always before cataract development. Sometimes, neurological manifestations resemble clinical picture spastic diplegia or neuronal amyotrophy (Chareot-Marie and Tooth).

Other anomalies that are combined inconsistently:

• eye: internally moving strabismus; bilateral epicanthus; pendulum nystagmus; secondary bilateral cataract;
• skeletal anomalies: kyphoscoliosis; lordosis; crooked leg;
• anomalies of the joints and fingers;
• anomalies of the skin appendages (dystrophic nails; brittle hair);
• anomalies of the genital organs (hypospadias; epispadias);
• nanism.

Diagnosis of the Marinescu-Sjogren syndrome.

Biological examinations do not reveal characteristic and permanent changes. Only in some cases, during electrophoresis of blood serum, an increase in the content of beta, alpha 2 and gamma globulins was revealed, but it is also insignificant.

An electroencephalogram and a pneumoencephalogram sometimes reveal anomalies showing complete atrophy of the cerebellar cortex or only some of its lobes.

Pathological anatomical examination at autopsy showed the anatomical and histological integrity of the brain, while there are many lesions in the cerebellum and spinal cord. In the cerebellum, atrophy of the cortex is found, not affecting the nodule and ventral tuft, as well as the perilocular zone of the cerebellum, opercular nuclei and tonsils.

Nerve cell atrophy and rarefaction of myelin fibers, which occur constantly, explain mental retardation presented by these patients. In the spinal cord, a thickening of the pyramidal bundles is determined.

The course of the Marinescu-Sjogren syndrome.

Cerebellar disorders progressively increase and, at the same time, mental deficit.

Treatment of the Marinescu-Sjögren syndrome.

Does not exist effective treatment in most cases, as a result of which some preventive measures are prescribed:

• avoidance of consanguinity among parents;
• genealogical research of patients.

Genetic advice is especially helpful in the lives of those with this syndrome; the doctor's duty to inform the family about the hereditary nature of the anomaly and draw attention to the possibility of its occurrence in the heirs. Parents who are aware of the situation can decide whether or not to have children.