Key Clinical Message
A single session of functional neurology intervention can significantly
improve the integration of primitive reflexes in children with Primitive
Reflex Integration Dysfunction, leading to enhanced motor coordination,
balance, and cognitive function. This case highlights functional
neurology as a promising treatment for neurodevelopmental challenges.
Keywords : Functional Neurology; primitive reflex; Moro reflex;
Tonic labyrinthine reflex anterior; Tonic labyrinthine reflex posterior;
Spinal Galant reflex; Grasp reflex.
1. Introduction
Primitive reflex integration dysfunction (PRID) refers to the condition
where primitive reflexes, which are automatic movements seen in
newborns, are not properly integrated as the child grows. These reflexes
are crucial for survival in infancy and should typically diminish or
transform into more complex motor patterns by the age of one. However,
in some cases, these reflexes persist, leading to various developmental
issues. PRID can contribute to a range of difficulties, including poor
motor coordination, balance problems, and learning disabilities (1).
Primitive reflexes are involuntary motor responses originating in the
brainstem that are present after birth and play a vital role in early
child development (2). These reflexes, such as the Moro reflex, palmar
grasp reflex, and asymmetric tonic neck reflex, are essential for a
newborn’s survival and initial interaction with the environment (3).
However, the persistence of these reflexes beyond infancy can indicate
central nervous system dysfunction and lead to developmental delays and
disorders (4). The incidence of PRID varies, but it is notably higher in
children with neurodevelopmental disorders, such as autism spectrum
disorder and attention deficit hyperactivity disorder (ADHD), affecting
their daily functioning and academic performance (3). Research indicates
that children with persistent primitive reflexes may struggle with motor
control, balance, and coordination, impacting their ability to engage in
typical childhood activities and learning processes (1).
Functional neurology is gaining recognition as an effective approach for
addressing various pathologies, including primitive reflex integration
dysfunction. By integrating principles from traditional neurology with
functional medicine, this field emphasizes the interconnectedness of
neurological and systemic health. Functional neurology focuses on
individualized treatment plans derived from comprehensive neurological
assessments to restore balance and enhance overall health outcomes (5).
Recent advancements demonstrate its potential in treating conditions
inadequately managed by conventional methods, providing new hope for
patients with chronic and complex issues (6). Previous research
indicates that functional neurology interventions can improve quality of
life by alleviating symptoms associated with neurological dysfunctions
(7). This approach is particularly promising in cases where traditional
treatments have failed, offering a comprehensive and holistic method to
patient care. Furthermore, studies have shown that such interventions
can lead to significant improvements in both neurological function and
overall patient well-being, highlighting the importance of continued
research and application in this emerging field (8).
The present study aimed to evaluate the effectiveness of a single
functional neurology intervention in integrating primitive reflexes in a
pediatric patient. Despite growing interest in functional neurology,
there remains a paucity of empirical evidence supporting its application
in treating PRID. This case study seeks to fill this gap by providing
quantitative data on the improvement of specific primitive reflexes
following treatment. The primary objective is to determine whether a
targeted functional neurology intervention can significantly reduce the
presence of primitive reflexes in a child with PRID. We hypothesize that
the intervention will result in measurable improvements, as evidenced by
lower scores on reflex integration assessments, thereby demonstrating
the potential of functional neurology as a viable treatment option for
PRID.
Case History/examination
The patient was a 7-year and 2-month-old female presenting with retained
primitive reflexes, including the Asymmetrical Neck Reflex (ANR),
Symmetrical Neck Reflex (SNR), Tonic Labyrinthine Reflex (TLR, anterior
and posterior), Spinal Galant Reflex, Grasp Reflex, Moro Reflex, and
Paralysis by Fear Reflex. The patient had difficulties in motor
coordination, balance, and cognitive performance, indicating potential
developmental delays linked to these retained reflexes. The reflexes
were assessed based on their degree of integration, with scores ranging
from 0 (integrated) to 4 (not integrated). Initial evaluations revealed
that several reflexes, particularly the ANR (3/4), SNR (3/4), and TLR
(2/4), were not integrated, contributing to the patient’s developmental
challenges. The study adhered to the ethical standards laid out in the
Helsinki Declaration and received ethical approval from the University’s
Bioethics Committee under code 2024-738. Written Informed consent was
obtained from the patient’s guardians prior to participation. The
consent included permission for the patient’s participation in the
research, the publication of the case report, and the use of any
accompanying images or clinical data in accordance with ethical
guidelines. All procedures performed in this study were in accordance
with the ethical standards of the institutional and national research
committee and with the 1964 Helsinki declaration and its later
amendments or comparable ethical standards.