Galant’s reflex is a primitive neonatal reflex characterized by movement of the pelvis toward the side of the back that is stroked laterally to the spinal column. It is normally present at birth and typically disappears by 2 months of age. This reflex assesses the integrity of the spinal cord from T1 to S1.

Pathophysiology

• The reflex is mediated through spinal interneurons connecting cutaneous receptors along the lateral trunk to the lower motor neurons of the paraspinal and hip muscles.

• Stroking the back on one side activates sensory input, causing ipsilateral contraction of the paraspinal and gluteal muscles, resulting in pelvic movement toward the stimulated side.

• Absence, asymmetry, or irregularity of the reflex may indicate spinal cord lesions, peripheral nerve injury, or central nervous system dysfunction.

Examination Technique

1. Patient positioning: Place the neonate prone on an examining table or securely on your hand.

2. Stimulation: Using a finger or a blunt instrument, stroke the back laterally to the spinal column from the shoulder to the buttocks.

3. Observation: Watch for pelvic movement toward the stimulated side.

4. Documentation: Record presence, strength, symmetry, or absence of the reflex.

Clinical features

Differential Diagnosis

Pediatric considerations

• Premature infants may have weaker or inconsistent responses.

• Persistent reflex beyond 2 months can indicate neurological abnormalities and warrants further evaluation.

Geriatric considerations

Not applicable; this is a neonatal reflex and normally disappears in infancy.

Limitations

• Reflex may be difficult to elicit in fussy or active neonates.

• Asymmetry can be subtle; careful observation is required.

• Must differentiate from other primitive reflexes such as the asymmetric tonic neck reflex.

Patient counseling

• Explain to parents that the reflex is normal at birth and usually disappears by 2 months.

• Persistent or absent reflexes may require neurological evaluation.

• Emphasize that early detection of asymmetry can help identify spinal cord or neurological issues early.

Conclusion

Galant’s reflex is a key neonatal reflex indicating spinal cord integrity from T1 to S1. Assessment of its presence, symmetry, and timing is essential in neonatal neurological examination, helping to detect early spinal or neurological abnormalities.

References

1. Oommen A, et al. Neonatal Reflexes: Assessment and Clinical Significance. J Clin Neonatol. 2014;3(1):1–7.

2. Kamenetsky L, et al. Neurological Examination of the Newborn. 2nd ed. New York: Springer; 2018.

3. Ropper AH, Samuels MA. Adams and Victor’s Principles of Neurology. 11th ed. New York: McGraw-Hill; 2021.

4. Sarnat HB, et al. Neonatal Neurology. 2nd ed. Philadelphia: Saunders; 2000.