Trömner reflex

Of the Trömner reflex is a muscle reflex (increased finger flexion reflex) that can occur in almost every healthy person. It is considered a sign of vegetative overexcitability and, in strong or one-sided expression, also as a pyramidal orbit sign. The one-sided lack knows e.g. a radicular lesion (sensorimotor pain and failure in the area of ​​a spinal nerve root).

What is the Trömner reflex?

The Trömner reflex is a so-called pathological reflex. A pathological reflex is an involuntary response by the body that does not normally occur. The Trömner reflex is visible when you hit the palmar side of the distal phalanx of the middle finger.

The flexor side of the hand is called the palmar side. Under pathological conditions, the blow causes reflex flexion of the fingers. This movement is also called flexion.

Function & task

The Trömner reflex is a muscle reflex. In the muscle reflexes, the receiving and success organs are in the same muscle. Normally, weaknesses or lack of reflexes are an indication of illness. A different intensity on both sides can also indicate damage. However, the Trömner reflex is a pathological reflex. It does not occur in healthy people. If it can be observed, this suggests an illness.

A reflex hammer is used to perform the Trömner reflex. This can be used to test muscle, tendon and skin reflexes. Most reflex hammers have two different sized rubber inserts on their heads. The smaller rubber insert is used for the reflex test on the hand. This is used to hit the flexor side of the middle finger phalanx. Nothing happens in a healthy person. If the nervous system is disturbed, however, the fingers bend reflexively. One then speaks of a positive Trömner reflex.

The reflexes are always checked in a side-by-side comparison. Only in this way can the reflex response be assessed. This reflex response is usually documented in the categories normal, reduced, weakened, increased or absent. There are also clinical scale systems that allow a more precise classification. The best-known scales are the nine-level Mayo Clinic Scale (MCS) and the National Institute of Neurological Disorders and Stroke (NINDS scale). However, they are rarely used in everyday practice because the assignment to the individual values ​​varies too widely between different examiners. The scales are therefore only reliable to a limited extent.

The Trömner reflex is interconnected via vortex segments C7 and C8. The effector nerves are the middle arm nerve (median nerve) and the ulnar nerve (ulnar nerve). Effector muscles are the finger flexors, the so-called Mm. flexores digitorum.

Illnesses & ailments

A slightly positive Trömner reflex can occur with vegetative overexcitability. This over-excitability is also known as vegetative dystonia. Here there is a disturbed conduction of excitation in the autonomic nervous system. The autonomic nervous system regulates blood pressure, pulse, respiratory rate, digestion and, in some cases, muscle tension as well.

Vegetative dystonias are often the result of stress, emotional stress and hectic life. In addition to increased reflexes or pathological reflexes, nervousness, restlessness, irritability, insomnia, dizziness, cramps, constipation, liver-gallbladder complaints or a loss of libido can occur.

In a strong and one-sided expression, the Trömner reflex is considered to be an uncertain pyramid orbit sign. Pyramidal tract signs are neurological symptoms, reflexes, or involuntary, rhythmic contractions of muscle groups or muscles that are pathological in adults and occur in particular when the so-called pyramidal tract is damaged. The pyramidal tract is a nerve tract in the spinal cord and brain that plays an important role in controlling voluntary motor skills. The Trömner reflex is one of the pyramidal trajectories of the upper extremity. Further signs of the pyramidal trajectory of the upper extremity are the Gordon finger splay sign or the Wartenberg reflex.

The pyramidal tract within the brain can be damaged by a stroke. A stroke leads to an insufficient supply of oxygen to the brain. This severely damages the tissue in the brain. The most common cause of a stroke is vascular occlusion. One also speaks of an ischemic infarction.

Cerebral haemorrhage can also cause a heart attack. This is also called a hemorrhagic infarction. Typical symptoms are unilateral paralysis, speech disorders, visual disorders, impaired consciousness up to unconsciousness, confusion, disorientation, nausea or sudden headaches.

In multiple sclerosis, too, positive pyramidal signs are often found. Multiple sclerosis is a chronic disease that is associated with inflammation of the myelin sheaths in the nervous system. The myelin sheaths are used to electrically isolate the nerve fibers in the central nervous system (CNS). The cause of the disease is unclear. Demyelinating occurs as a result of autoimmune processes. The white matter of the brain and spinal cord is particularly affected. Multiple sclerosis is the chameleon of neurological diseases. Because of the wide distribution of demyelinating foci, it can cause almost any neurological symptom.

Typical symptoms include visual disturbances, numbness, pain, muscle cramps, slurred speech, nystagmus (eye tremors), difficulty swallowing, dizziness, incoordination, and an intention tremor. In the case of disorders of vegetative centers or tracts, bladder and bowel function can also be impaired. Those affected often suffer from increased fatigue and depressive moods.

The Trömner reflex can also turn out to be positive when amyotrophic lateral sclerosis (ALS) is beginning. ALS is an incurable disease of the nervous system. There is progressive damage to the nerve cells that are responsible for moving the muscles (motor neurons). The motor nerve cells of the cerebral cortex and the anterior horn cells of the spinal cord can be affected. The cause of the disease is unclear.

The clinical picture of amyotrophic lateral sclerosis is very variable. There are functional limitations of the muscles, spastic paralysis, a slowed gait pattern, speech and swallowing disorders, jaw clamps, muscle spasms and twitching of the tongue muscles.