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.