Overview of Gordon Reflex
The Gordon Reflex, a term coined by Dr. Alfred Gordon in 1904, is also known as the “paradoxical flexor reflex”. It is an easy-to-observe sign in a medical check-up that doesn’t require the use of any special equipment. This reflex is triggered when pressure is applied to the calf muscle, causing a flexing motion in the foot.
This simple test can be quite useful for doctors to identify the location of a lesion, or abnormal tissue, in the body. Specifically, it can help check for issues in the pyramidal tract, an area in the brain that helps control voluntary movements.
The Gordon Reflex shares similarities with the Babinski, Chaddock, and Oppenheim reflexes, all of which are different methods used by doctors to assess nerve function. The Gordon Reflex can be particularly handy when a patient has very sensitive soles or is uncooperative during examination.
Anatomy and Physiology of Gordon Reflex
The Gordon reflex is a physical reaction that happens when the calf muscle, located at the back of the leg, is squeezed. The calf muscle is made up of two parts: the gastrocnemius and the soleus. These two muscles join to form the Achilles tendon, which helps in moving the foot down at the ankle.
Normally, when your foot is flexed down or ‘plantar flexed’, several muscles in your leg including the gastrocnemius and soleus play roles. This is a common physical reflex involving all the muscles that shorten the leg: these muscles are collectively making your toes point downward.
However, when there’s a problem or lesion in the ‘pyramidal system’ – a part of your brain that controls voluntary movement – the usual downward response disappears. This can cause an overexcited reaction where other muscles like the ‘extensor hallucis longus’ (a muscle located in the calf) are suddenly involved in this shortened leg/toe pointing movement. This can lead to the big toe pointing upwards rather than downwards during certain reflexes, like the Gordon, Babinski, Chaddock, and Oppenheim reflexes.
Why do People Need Gordon Reflex
The Gordon reflex is a medical procedure that can be helpful during a complete neurological examination. It can aid in diagnosing disorders related to the pyramidal tract, the part of our nervous system that links the brain and the spinal cord.[2]
This reflex test can be performed alongside another test known as the Babinski reflex. However, the Gordon reflex might be more practical in cases where the patient cannot cooperate adequately, or the results from the Babinski reflex are uncertain.[1]
The Babinski reflex involves stimulation on the soles of the feet. This may cause discomfort or mild pain to patients with sensitive feet, causing them to pull back during the test. On the other hand, the Gordon reflex involves manipulating the muscles in the calf area which is typically less sensitive to discomfort or pain, making it a valuable alternative test to conduct.
When a Person Should Avoid Gordon Reflex
The Gordon reflex is a medical test, but it can’t be done in some situations. For example, if there’s an open cut on the lower leg or nearby, if there’s been a recent deep vein thrombosis (a blood clot in a large vein), or if the lower legs are very swollen and painful. These things can be signs of lots of different health problems, like a worsening of congestive heart failure, which is when the heart can’t pump blood as well as it should.
Doctors also need to be extra careful if the patient’s platelet count is very low. Platelets are part of your blood that help to stop bleeding. The Gordon reflex test involves squeezing the calf muscles quite tightly. If the platelets are very low, the squeezing can actually hurt the muscle and cause bleeding that won’t easily stop.
Equipment used for Gordon Reflex
To perform the Gordon reflex test, no special equipment is necessary. Instead, a space should be provided where a patient can lie down comfortable on their back, with both legs straight out. This position makes it easier to conduct the test.
Who is needed to perform Gordon Reflex?
Any suitably trained person can carry out the Gordon reflex test – a simple medical procedure to check your body’s responses. This could be your doctor, a medical student, nurse, or even a physician assistant. If someone hasn’t done the test before, they’ll usually watch a more experienced person do it first, or they might watch a video online to learn the right way to do it. Like anything, the more they practice, the better they’ll get at doing the test correctly and understanding what the results mean.
Preparing for Gordon Reflex
Getting ready for the Gordon reflex test is simple and straightforward. Here’s what you’ll need to do: first, relax and lie down flat on a doctor’s examination table with your legs stretched out. You should be dressed in a hospital gown, with no other clothes or shoes on. This is because your legs, from your knees all the way down to your feet, need to be completely visible.
Before the test starts, the doctor or nurse will make sure their hands are clean by washing or applying sanitizer. The person doing the test can either sit or stand next to you, whatever makes them most comfortable, so long as they can easily reach your calf and keep an eye on how your toes respond.
How is Gordon Reflex performed
The Gordon reflex test is a simple neurological test to possibly identify any nerve problems. The person is usually lying flat on their back with legs out straight, as mentioned previously. You need to be relaxed and your leg muscles need to be loose.
In this checkup, the doctor will rest his or her hand on your calf muscle underneath your leg, then lift and support your leg with the other hand at the ankle area. Next, the doctor will squeeze your calf muscle quite firmly, while watching what happens to the toes on the same side.
The Gordon reflex is considered positive (or unusual) if there’s a reaction where your big toe points upward, and your other toes spread out, this is also known as extensor plantar reflex. A negative (or normal) Gordon reflex is when there’s no movement in your toes when your doctor squeezes the calf muscle.
The doctor can perform this reflex test as often as needed to examine your toe’s response. Along with this, there are few other similar tests, such as the Babinski, Chaddock, and Oppenheim reflex tests, that can be done to further confirm the extensor plantar response.
Possible Complications of Gordon Reflex
It’s not very common, but sometimes doing the Gordon reflex test can have some side effects. This test involves squeezing your calf muscle. After the test, there might be some bruising, pain, or tenderness in the area.
What Else Should I Know About Gordon Reflex?
The Gordon reflex is a physical response that doctors observe while assessing various medical conditions mainly involving the nervous system. If this reflex shows an abnormal response, it points at issues inside a stretch of nerve fibers in our brain known as the pyramidal tract. This symptom can be an indicator of several diseases and help in diagnosis.
The illnesses that could lead to damage in this pyramidal tract or a part of the brain called the corticospinal tract include strokes, multiple sclerosis, Lou Gehrig’s disease, inflammation of the brain, and brain or spinal cord tumors, among others.
Dr. Gordon, who first reported this reflex, identified it in a patient with a severe infection of the chemical interface between two nerve cells and later in a patient with epilepsy following strong convulsions. He speculated that this reflex was a sign of irritation in the brain or the start of damage in the portion of the brain that controls body movements. On the other hand, another reflex called the Babinski reflex indicated a well-established damage in the same region.
In a particular study that maintained the observers’ blindness to the experiment, the Gordon reflex showed decent consistency in being observed by multiple experts with a kappa score of 0.3515 (95% Confidence Interval = 0.255-0.448). It also received the highest score for consistency observed by the same expert with a kappa score of 0.6731. Therefore, this reflex can be a useful backup tool to the Babinski reflex, especially if the latter can’t be triggered or gives an unclear result.