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Gordon Reflex – Pyramidal Tract Sign Explained

The Gordon reflex is a pathological reflex indicating damage to the central nervous system. It is elicited by squeezing the calf muscle and belongs to the Babinski sign group.

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Things worth knowing about "Gordon Reflex"

The Gordon reflex is a pathological reflex indicating damage to the central nervous system. It is elicited by squeezing the calf muscle and belongs to the Babinski sign group.

What Is the Gordon Reflex?

The Gordon reflex is a pathological reflex belonging to the group of so-called pyramidal tract signs. It was named after the British neurologist Alfred Gordon (1874–1953). Pathological reflexes do not occur in healthy individuals; instead, their presence indicates damage to the central nervous system (CNS) -- specifically a lesion of the corticospinal (pyramidal) tract, which is the primary motor pathway running from the brain through the spinal cord.

How Is the Gordon Reflex Elicited?

The Gordon reflex is triggered by applying firm pressure to the calf muscle (musculus triceps surae). The examiner squeezes the calf of the patient. A positive response consists of dorsiflexion of the big toe (upward movement) and often fanning of the remaining toes. This response is functionally equivalent to the Babinski sign but differs in the type of stimulus used to elicit it.

Clinical Significance

A positive Gordon reflex indicates damage to the upper motor neuron (first motoneuron), meaning the central motor pathway is disrupted. It may be present in various neurological conditions, including:

  • Stroke (ischemic or hemorrhagic)
  • Multiple sclerosis
  • Amyotrophic lateral sclerosis (ALS)
  • Brain tumors
  • Spinal cord injuries or diseases
  • Cerebral palsy

The Gordon reflex is one of several pyramidal tract signs routinely assessed during a neurological examination. Other well-known signs in this group include the Babinski sign, the Oppenheim sign, and the Chaddock sign.

Examination and Diagnosis

Testing the Gordon reflex is part of the standard neurological examination. It is quick to perform, requires no special equipment, and causes minimal discomfort. However, a positive result alone is not sufficient for a diagnosis; it must always be interpreted in the context of other clinical findings, the patient's medical history, and, if necessary, imaging studies such as MRI of the brain or spinal cord.

Important Notes for Patients

In newborns and infants, the Gordon reflex may be present as a normal (physiological) finding, since the pyramidal tract is not yet fully myelinated in the first months of life. In adults, however, a positive response is always considered pathological and warrants neurological evaluation.

Distinction from Related Reflexes

The Gordon reflex belongs to the Babinski group of equivalent signs. All share the same positive response -- dorsiflexion of the big toe -- but differ in the stimulus used:

  • Babinski sign: stroking the plantar surface of the foot
  • Oppenheim sign: firm pressure along the tibial crest
  • Chaddock sign: stimulus applied to the lateral aspect of the foot
  • Gordon reflex: squeezing the calf muscle

References

  1. DeMyer, W.E.: Technique of the Neurologic Examination. 5th Edition. McGraw-Hill, New York, 2004.
  2. Fuller, G.: Neurological Examination Made Easy. 5th Edition. Churchill Livingstone, Edinburgh, 2013.
  3. Blumenfeld, H.: Neuroanatomy through Clinical Cases. 2nd Edition. Sinauer Associates, Sunderland, 2010.

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