頭後屈反射（head retraction reflex）の手技と意義 期待のルーキー，司馬康先生が回診で，頭後屈反射を認めた患者さんを提示しました．私はルーチンで行わない反射なので「なかなか，やるな」と思いました．研修した亀田総合病院仕込みのようです．早速，この反射についての議論が始まりました．まず方法ですが，できるだけ首の力を抜いてもらい，頭を少し前に曲げさせて，打腱器で上唇の少し上をやや下方に向けて叩きます．正常では，頭はさらにうつむきになります（反射陰性）．しかし反射陽性ならば，頭は迅速に後屈します．この反射は，私の神経診察のバイブルのひとつ，Robert Wartenberg先生の「The examination of reflex（1945）」によると，上位頸髄の両側錐体路病変で生じるとの記載があり，具体的な例として，ALS進行期，両側性痙性対麻痺，dorsolateral paralysis（現在のどの疾患か検索しても分かりませんでした）やびまん性脳症で認めると書かれています．「ベッドサイドの神経の診かた」にも記載があり，反射中枢はC1-4とのことです．じつはこの反射，最
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頭後屈反射（head retraction reflex）の手技と意義 期待のルー …
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