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Snouting, Pouting and Rooting
  1. Martin Rossor
  1. Dementia Research Group, Department of Clinical Neurology, Institute of Neurology, Queen Square, London, WC1N 3BG. Email: M.Rossor{at}dementia.ion.ucl.ac.uk

    Abstract

    Primitive oral reflexes are always accorded space in neurological textbooks and, excuse the pun, paid lip service to in clinicopathological conferences. The terminology is confusing and the reflexes are often misinterpreted. They can however, be occasionally diagnostically useful. There is a profusion of terms in the literature including ‘snout’, ‘pout’ and ‘rooting reflexes’, and often inadequate distinction is made between primitive behavioural responses and brisk facial myotactic reflexes.

    The primitive oral reflexes include sucking and rooting. These are appropriate motor responses in the infant to ensure adequate feeding at the breast. They are subsequently inhibited as the infant matures, but can re-emerge with frontal lobe damage or diffuse cerebral cortical damage. They may be seen in relative isolation in frontal lobe degenerations and frontal lobe tumours. The sucking reflex, evoked by placing an object such as a spatula in the mouth, is usually only seen in severely demented patients or

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