The "Bedsheet" Babinski
The "Bedsheet" Babinski
Background: Babinski's reflex (dorsiflexion of the hellus and fanning of the toes in response to planter stimulation) is a classic sign in neurology. Although typically elicited by stroking the plantar surface of the foot with a firm object, other means of obtaining the response have been described.
Methods: We assessed the frequency of the Babinski response after planter stimulation by exposing the feet by removal of the bedsheet or socks in 10 patients with neurologic disease and 10 control subjects. These results were compared with those obtained by traditional means of stimulation.
Results: We found a high correlation between the two responses (sensitivity of 80% and specifity of 90%).
Conclusion: Although this study is small and requires a larger study to verify its accuracy, it appears that simple observation of the toe response at the time that the feet are exposed frequently provides evidence of pyramidal tract dysfunction.
Babinski's reflex has been regarded as the most important sign in clinical neurology and is perhaps the best known eponym in this discipline. Although the toe response to plantar stimulation had been recognized earlier, the difference between normal and pathologic responses and their clinical implications were first described by Joseph Babinski in two papers published in 1896 and 1898, respectively. Subsequently, many variants of the reflex have been reported. Among the names attached to these variants are those of Chaddock, Oppenheim, Bing, Gordon, Schaefer, Moniz, Strümpell, Cornell, Cleclkey, Gonda, and Allen.
We were impressed with the frequency with which the characteristic features of Babinski's reflex, namely, dorsiflexion of the hallux and fanning of the toes, is elicited simply by removing the bedsheets covering a patient's feet or by removing a patient's socks. Although this "spontaneous Babinski" has been noted on similar manipulation of the feet of infants and children, we believe it has not been reported in adults.
Background: Babinski's reflex (dorsiflexion of the hellus and fanning of the toes in response to planter stimulation) is a classic sign in neurology. Although typically elicited by stroking the plantar surface of the foot with a firm object, other means of obtaining the response have been described.
Methods: We assessed the frequency of the Babinski response after planter stimulation by exposing the feet by removal of the bedsheet or socks in 10 patients with neurologic disease and 10 control subjects. These results were compared with those obtained by traditional means of stimulation.
Results: We found a high correlation between the two responses (sensitivity of 80% and specifity of 90%).
Conclusion: Although this study is small and requires a larger study to verify its accuracy, it appears that simple observation of the toe response at the time that the feet are exposed frequently provides evidence of pyramidal tract dysfunction.
Babinski's reflex has been regarded as the most important sign in clinical neurology and is perhaps the best known eponym in this discipline. Although the toe response to plantar stimulation had been recognized earlier, the difference between normal and pathologic responses and their clinical implications were first described by Joseph Babinski in two papers published in 1896 and 1898, respectively. Subsequently, many variants of the reflex have been reported. Among the names attached to these variants are those of Chaddock, Oppenheim, Bing, Gordon, Schaefer, Moniz, Strümpell, Cornell, Cleclkey, Gonda, and Allen.
We were impressed with the frequency with which the characteristic features of Babinski's reflex, namely, dorsiflexion of the hallux and fanning of the toes, is elicited simply by removing the bedsheets covering a patient's feet or by removing a patient's socks. Although this "spontaneous Babinski" has been noted on similar manipulation of the feet of infants and children, we believe it has not been reported in adults.
