The grasp reflex may be present bilaterally in patients who are semiconscious or fully alert. Like the extensor plantar response in the same clinical setting, this is not very useful information.
Put your index and middle fingers or the handle of the reflex hammer on the palm of the patient's hand and slowly stroke the palm toward the thumb or little finger.
The patient's fingers flex and grasp the handle of the hammer. If you are quick, you can remove the stimulus before it is caught. Sometimes a simple nonmoving touch to the patient's palm will evoke finger flexion. You may repeat the stimulus indefinitely and provoke finger flexion each time. Tell the patient "Do not squeeze this [handle] when I put it in your hand"—he can overcome the reflex and not do it, usually once only. Once he has grasped it, he usually cannot open his hand on command.
This reflex indicates contralateral frontal lobe disease. The reflex will vanish in the presence of corticospinal tract disease.
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