The Babinski sign

Morrow, Jasper M.; Reilly, Mary M.

doi:10.12968/hmed.2011.72.sup10.m157

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…The sign correlates well with all the pyramidal tract lesions. 12 The mechanism of the plantar extensor response is the same as the other signs like Babinski and involves activation of the tibial nerve and contraction of the gastrocnemius.…”

Section: Discussionmentioning

confidence: 98%

A New Method of Eliciting Pyramidal Tract Impairment in Adults

Osuagwu¹,

Bradley²,

Pasupuleti³

et al. 2020

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Background: To suggest a new way of eliciting pyramidal tract dysfunction in adults since the most widely utilized plantar reflex, which is the Babinski reflex, has limitations with different reliability and consistency among different examiners.    Materials and methods: 168 adult subjects were examined for the new sign in addition. It consists of just an observation of the patient’s feet and toes in a conscious patient looking for the extension of the great toe along with fanning, spreading and plantar flexion of the small toes either at rest or when patient elevates one leg up at a time.   Results: We were able to observe the extension of the great toe along with fanning, spreading and plantar flexion of the small toes in patients with impairment of pyramidal tract. The specificity was 94% while the sensitivity was 96%.   Conclusion: Pyramidal tract lesion in adults can be elicited by this new test that observes the extension of the great toe along with fanning, spreading and plantar flexion of the small toes in patients. We suggest this sign as a complement to established signs like Babinski reflex.

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Section: Discussionmentioning

confidence: 98%

A New Method of Eliciting Pyramidal Tract Impairment in Adults

Osuagwu¹,

Bradley²,

Pasupuleti³

et al. 2020

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“…[ 2 ] This response is now referred eponymously as the “Babinski sign” or descriptively as the extensor plantar response (EPR). [ 3 ] Babinski has established a clinical significance of the reflex as a positive Babinski's sign which indicates pathology in the upper motor neuron. The introduction of Babinski's concept on plantar responses has been widely practised as an essential component of a complete neurological examination.…”

Section: Introductionmentioning

confidence: 99%

Differentiating extensor plantar response in pathological and normal population

Loo

Justin

Lee

et al. 2018

Ann Indian Acad Neurol

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Introduction:Approximately 5%–11% of neurologically normal population has extensor plantar response (EPR).Method:This study is aimed to identify differentiating features of EPR between physiological and pathological population.Results:A total of 43 patients with pyramidal lesions and 113 normal controls were recruited for this study. The pathological EPRs were more reproducible, with 89.4% having at least two positive Babinski responses and 91.5% having two positive Chaddock responses (vs. 14.3% and 4.8% in controls, P < 0.001). The pathological EPR was more sensitive to stimulation, in which 89.1% were elicited when the stimulation reached mid-lateral sole (vs. 11.9% in controls, P < 0.001). Most (93.6%) pathological cases had sustained big toe extension throughout stimulation (vs. 73.8% in controls, P < 0.001). As compared to those with brain lesion, the plantar responses in those with spinal lesion are less likely to have ankle dorsiflexion (5.3% vs. 25%, P < 0.05) more likely to have sustained extensor response with Babinski (94.7% vs. 71.4%, P < 0.05), Chaddock (89.5% vs. 64.3%, P < 0.05), and Schaefer (26.3% vs. 3.6%, P < 0.05) methods. A scoring system was computed using four variables, i.e., two consecutive positive Babinski or Chaddock responses, extensor response at mid-lateral sole, and sustained extension throughout stimulation. A score ≥3 is predictive of pathological origin, with sensitivity and specificity of 78.7% and 95.2%, respectively.Conclusion:The pathological EPR is more reproducible, sensitive to stimulation, and sustainable compared to physiological extensor response.

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