Isolated Absence of the Moro Reflex in a Baby With CHARGE Syndrome Could Reflect Vestibular Abnormalities

Abstract

We describe a term baby girl with (CHARGE syndrome coloboma, heart anomaly, choanal atresia, retardation, and genital and ear anomalies association) who had persistent complete absence of the Moro reflex but preservation of other primary neonatal reflexes. A computed tomography scan revealed bilateral absence of the semicircular canals and hypoplastic vestibules. We suggest that isolated absence of the Moro reflex may reflect underlying abnormalities of the vestibular system and may, therefore, not necessarily be associated with a generalized disturbance of the central nervous system as is usually the case. This suggestion has implications for the diagnostic and prognostic relevance of an isolated absent Moro reflex.

Keywords

neurodevelopment primitive reflexes congenital abnormality CHARGE syndrome

Get full access to this article

View all access options for this article.

References

Volpe JJ Neurology of the Newborn. 4ed. Philadelphia: WB Saunders; 2001.

Zafeiriou DI Primitive reflexes and postural reactions in the neurodevelopmental examination. Pediatr Neurol. 2004;31:1-8.

Verloes A. Updated diagnostic criteria for CHARGE syndrome: a proposal. Am J Med Genet A. 2005;133:306-308.

Ronnqvist L. A critical examination of the Moro response in newborn infants-symmetry, state relation, underlying mechanisms. Neuropsychologia. 1995;33:713-726.

Morimoto AK , Wiggins RH III , Hudgins PA , et al. Absent semicircular canals in CHARGE syndrome: radiologic spectrum of findings. AJNR Am J Neuroradiol . 2006;27:1663-1671.

Abadie V. , Wiener-Vacher S. , Morisseau-Durand MP , et al. Vestibular anomalies in CHARGE syndrome: investigations on and consequences for postural development. Eur J Pediatr. 2000;159:569-574.

Wiener-Vacher SR , Amanou L. , Denise P. , Narcy P. , Manach Y. Vestibular function in children with the CHARGE association. Arch Otolaryngol Head Neck Surg. 1999;125:342-347.