Clinical significance of the corneomandibular reflex
A. Guberman
Lesion site, etiology, and clinical signs were analyzed in 50 cases of
unilateral or bilateral corneomandibular reflex. The reflex was seen most
commonly in acutely ill patients with a reduced level of consciousness and
elevated intracranial pressure (ICP). Large cerebral hemispheric lesions
with secondary brainstem pressure, intrinsic lesions of the upper
brain-stem or diencephalon, diffuse or metabolic processes (often
accompanied by raised ICP), and involvement of corticobulbar pathways in
amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS) were the
most common settings where the reflex occurred. The sign is useful in
distinguishing structural from metabolic processes in acutely comatose
patients, localizing lesions to the upper brainstem area, determining the
depth of coma and its evolution, providing evidence of uncal or
transtentorial herniation in acute cerebral hemisphere lesions, and
suggesting involvement above the spinal level in cases of ALS and MS.
