The neonatologist has the wrong clinical picture. He is unlikely to have used this assessment in practice, no one syringes cold fluid into newborn babies’ ears.
The spinal cord is still part of the central nervous system. Archie had peripheral motor nerve testing done before the motor withdrawal test. Peripheral nerves communicate with muscles via chemical transmitters, this is unaffected by the central nervous system. This is the preliminary test that was failed.
It’s relevant in the ICU settling because some of the paralysing drugs prevent the communication from peripheral motor nerve to muscle.
Of course, these were well out of his system by the time testing was done