During assessment of motor response to painful stimuli, which response is within normal limits?

• A. Localize to pain
• B. Abnormal flexion to pain
• C. Push painful stimuli away
• D. Extension to pain

Answer: (C)

When you test motor response to a painful input, a normal reaction is a protective withdrawal of the limb from the stimulus. Pushing or pulling the limb away from the painful stimulus shows this withdrawal reflex, indicating intact sensory input and motor pathways and a proper protective response. This is in contrast to extension to pain (a decerebrate posture) or abnormal flexion (a decorticate posture), which signal significant CNS dysfunction, and to purposeful localization to pain, which is a more deliberate, higher-level response. So, withdrawing the limb away from the pain is the typical normal motor response.