Clinical Mastermind Group
Functional Neurology Every Doctor Should Know!
For example, achieving upright posture and two-footed gait are two uniquely human traits and the stimulus for these human expressions is gravity. While gravity pushes things toward the earth, the great majority of the human nervous system is designed to resist gravity's attraction resulting in upright, bipedal stance. Further, our bipedal abilities allow movement while using gravity to our favor. It all starts as muscles and joints increase their influence on the brain. With stronger influence comes greater mobility.
Introduction to Brain-Based Solutions™
5 Simple Tests Every Doctor Should Know & Use on Every Patient
Our brains give us access to our outside world; input and response. But sometimes our brains can express sickness. What happens if someone’s brain gets sick? How would you know it was sick? Would it hurt? Learn some brain-based solutions™ that help keep our patient’s brains well.
What makes humans so unique?
Specific traits set mammals apart from other animals. The same is true with humanity, but humans are unlike animals. A few of the traits that distinguish humans from other species are self-awareness and morality, speech and symbolic cognition, nimble thumbs, upright posture, conscience, sociability, and the capacity to imagine. Every edition of Brain-Based Solutions™ will address these uniquely human traits from a functional neurology perspective.
The Human Design
Some consider the human nervous system to be mammalian, but the converse is not true: the mammalian system is not human. The human nervous system works unlike any other; only the human nervous system is human. It is each doctor’s job is to help each human brain be as effective as possible.
Stance and gait are important, but how does a doctor know if they contain functional troubles? If a person looks like they stand straight is there still trouble? Statistics show that the highest incidence of accidental death is from incidental falls. People fall when their center of gravity exceeds limits of stability. Once outside their safety zone, gravity takes over and down they go. Falls happen fast and people hit the ground hard resulting in bruises, fractures, concussions, and even death. The doctor should know if a person has a propensity to fall. The Brain-Based Solutions™ articles discuss just such issues with simple tests to do at each visit. You will also know if your patients are becoming more stable, too.
Simple clinical tests such as Romberg test, standing on one foot or the other with eyes open and/or closed, how about just walking, heel to toe walking or walking backwards, the Fakuda or the pull test can all assess stability, but the eyes will reveal the dysfunction. Any functional error will be obvious if you know what to look for, and the Brain-Based Solutions™ articles will help you recognize these errors quickly.
Balance Has Limits
Did you ever try to stand with both feet on the ground and lean as far as you can in any direction without falling? Can you lean further one way than another? Balance is the unconscious sensation you get that keeps you upright against gravity.
It may seem elementary, but it is nonetheless important to point out, that one of the essentials to upright posture is the ability to stay within your own personal protective limits of balance.
Erroneous reflexes produce abnormal and asymmetrical muscle tone leading to subluxation complexes and dysfunctional motion. Learn for yourself how these reflexes work and find out how to address them quickly to optimize your patient’s human performance.
With an aging population, doctors should be searching for movement disorders at every visit. We should be turning errors into accuracies and encouraging a more efficient expression of the uniquely human aspects of stance and gait. These Brain-Based Solutions™ articles add a new perspective to the doctor while giving poise to the patient.
After this first introductory report, the next five Brain-Based Solutions™ articles describe five functionally useful physiological reflexes that are easy to check on every patient. The deep tendon, tonic neck, flexor withdrawal, crossed cord, and Galant reflexes each have their own distinct display. The integration of these reflexes amongst themselves produces a uniquely individual display that you will learn to test and rebuild. When these reflexes work, they work. When they fail, you will know it. A failed reflex response probably means other problems are on display in the more rostral neuraxis; i.e., the cerebellum, thalamus, and cortex. Learn how to address these fundamental reflex issues and help your patients shape their humanity. You can help your patients reach their highest level of their human expression because you have read and apply Brain-Based Solutions™.
What provokes upright posture and what keeps us from falling down? Upright posture is more than standing up straight and walking is more than putting one foot in front of another to move from place to place. Basic human movement patterns are inborn; posture is an unconscious practice. Elementary movement patterns provide the framework for more mature abilities later in life as the system matures. For example, a baby cannot do much right after birth, but once their head rises from their bed their neurological maturation starts. We clinically observe the expressions of primitive reflexes in practice, but the doctor must know how to elicit them properly, and then understand what they are observing.
Your doctor should know each of these strategies and when they falter. Doctors, your patients depend on your abilities to diagnose and treat their brain properly. The ideas inside each Brain-Based Solutions™ article will give you greater understanding about this framework for movement and discuss ways you can help make it right.
What are Primitive Reflexes?
The “primitive reflexes” are those that appear and disappear in an expected order during prenatal, infant and toddler development. They are important signs of a normally maturing nervous system when present at the expected stages. Likewise, abnormal absence of an expected reflex at a given stage of infancy, or the unexpected return of a reflex implies some abnormal neurological function.
Primitive reflexes are inborn actions originating in the central nervous system. They are exhibited by neurotypical infants and, contrary to other authorities, this author believes the tonic neck reflex to be demonstrably intact in adults also in response to particular stimuli. Most observers believe that these reflexes disappear as a child moves through normal development, but it seems more appropriate that they become modulated by the maturation of the frontal lobes. Similarly, any frontal demise will allow escape of he normal cortical controls (see the article on Cortical Release Signs).
Older children and adults with atypical neurology (primarily thought to be those with cerebral palsy-like displays) may retain these reflexes, and they may re-appear in adults due to certain neurological conditions including, but not limited to, dementia, traumatic lesions, and strokes. However, their atypical display may also be seen in certain functional disorders.
An individual with cerebral palsy and typical intelligence can learn to suppress these reflexes, but the reflex might resurface under certain conditions such as during an extreme startle reaction. Further, a dysfunctional input secondary to movement error can also cause a lack of inhibitory controls of these reflexes.
Reflexes may also be limited to those areas affected by the atypical neurology, such as individuals whose cerebral palsy affects only their lower extremities retaining the Babinski reflex but having normal speech. In individuals with hemiplegia, the reflex might be seen in the foot on the affected side only. Conversely, a cortical deafferentation may also cause a similar but Babinski-like response in the absence of frank neurological pathology. However, these cases make the point that the reflexes remain on display but are more properly modulated by higher order neurological development.
Primitive reflexes are also tested in cases of suspected brain injury to evaluate frontal lobe function. If they are not being modulated properly, they are called frontal release signs. Research potentially indicates that atypical primitive reflexes may be a potential early warning signs of autistic spectrum disorders and other potential learning disabilities.
Five Physiological Reflexes
The interrelationships of the primitive reflex patterns with mature human performance are fundamental to uniquely human behavior. Some authorities say that the primitive reflexes should only last for a few months to a few years and then meet extinction. However, their descriptions are merely observations, unproven in clinical reality.
Every doctor who sees patients with structural problems and movement errors should know what to anticipate each time a patient moves and how to address the problems they find. For example, movements like turning the head one way or the other, flexing and/or extending each leg, rolling over, or standing up from a seated posture, throwing a ball, bending down to pick something up from the floor, or leaning over to brush teeth all require different patterns of movement, but their dysfunction can easily put a person into a spin.
Further, with each movement comes an associated autonomic response that is essential for structural nourishment and endurance, but that autonomic response can be either functional or dysfunctional. The doctor should be able to tell the difference. Every working muscle needs oxygen and fuel, and a way to deliver them to the tissues—i.e., there must be appropriate blood supply. But how does the doctor know if the muscles are getting adequate blood supply? The doctor must know how to evaluate the autonomic concomitants, like blood supply, cord and brain performance, etc. Over time, seemingly benign autonomic problems can lead to the frank signs and symptoms of disease. Shoulder girdle troubles can eventually contribute to brain timing errors that set up heart, digestive, vestibular, and/or many other problems. The key to each person’s uniquely human nervous system lies in the doctor’s ability to better understand the pre-programmed human design. Its functional blueprint links the eyes, ears, and spinal muscles to maintain stability while resisting gravity. Any movement and/or autonomic response other than that which is according to the original human design is clinically pathological and needs fixing. This Brain-Based Solutions™ articles will help you understand what normal movement is and what it is not, if its autonomic concomitants are working, and how to go about fixing what you find.
Reading and applying Brain-Based Solutions™ to your treatment plan will improve the way you relate to your patients and profitably change your practice. You will see faulty muscle display and autonomic concomitants for what they really are and know how to treat them more effectively.