Babinski reflex


A plantar extensor response to noxious stimulus on the plantar surface of the foot.

The lateral side of the sole of the foot is rubbed with a blunt instrument from the heel along a curve to the toes.

There are three responses possible: Flexor: the toes curve inward and the foot everts; this is the response seen in healthy adults and is ref2242ed to as a negative Babinski, Indifferent without response, and Indifferent: there is no response, and Extensor: the hallux dorsiflexes, and the other toes fan out.

The latter is ref2242ed to as a positive Babinski’s sign.

A pathological plantar reflex may be an indication of a serious disease process and should prompt detailed neurological investigation.

Infants show an extensor response because the corticospinal pathways are not fully myelinated at this age, so the reflex is not inhibited by the cerebral cortex

Bilateral Babinski sign indicates localization of the lesion in the motor pathways of the cerebral cortex, basal ganglia, central white matter, or brainstem and indicate bilateral corticospinal dysfunction.

92-93% of healthy neonates have flexor plantar responses, and extensive plantar responses in infancy should be interpreted in the context of other findings such as asymmetry, hyp2242eflexia, and clonus.

Occurs when the big toe moves toward the top of the foot and the other toes fan out after the sole of the foot has been firmly stroked.

Can identify disease of the spinal cord and brain in adults, and also exists as a primitive reflex in infants

This reflex is normal in younger children, but abnormal after the age of 2.

It may disappear as early as 12 months in some children.

The presence of a Babinski’s reflex after age 2 is a sign of damage to the corticospinal tract connecting the spinal cord and the brain.

The corticospinal tract runs down both sides of the spinal cord, therefore a Babinski’s reflex can occur on one side or on both sides.

An abnormal Babinski’s reflex can be temporary or permanent.

May be associated with a generalized tonic-clonic seizures, brain tumor, spinal cord injury, spinal cord tumor, stroke, hepatic encephalopathy, head injury, pernicious anemia, meningeal disease, multiple sclerosi, CNS infection, syringomyelia and multiple scerosis.

Typically, associated with incoordination, weakness, and difficulty with muscle control.

Reflects upper motor neuron disease in adults.

May be present in postictal phase of a seizure.

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