Plantar reflex
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2008-05-25T06:12:29Z
SieBot
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robot Adding: [[it:Segno di Babinski]]
In [[medicine]] and [[neurology]], the Babinski response to the Plantar Reflex is a [[reflex]], named after [[Joseph Babinski]] ([[1857]]-[[1932]]) (a French [[neurologist]] of [[Poland|Polish]] descent), that can identify [[disease]] of the [[spinal cord]] and [[brain]] and also exists as a [[Primitive reflexes|primitive reflex]] in [[infant]]s. When non-pathological it is called the '''plantar reflex''' while the term '''Babinski's sign''' refers to its pathological form.
==Methods==
[[Image:BabinskiSign.jpg|thumb|240px|''Babinski's Sign'']]
The lateral side of the [[sole (foot)|sole of the foot]] is rubbed with a blunt implement so as not to cause pain, discomfort or injury to the skin; the instrument is run from the heel along a curve to the [[metatarsal]] pads. There are three responses possible:
* Flexor: the toes curve inward and the foot [[Eversion (kinesiology)|everts]]; this is the response seen in healthy adults.
* Indifferent: there is no response.
* Extensor: the [[hallux]] [[dorsiflexes]], and the other toes fan out - the ''Babinski's sign'' indicating damage to the [[central nervous system]].
As the [[lesion]] responsible for the sign expands so does the area from which the [[Afferent nerve|afferent]] Babinski response may be elicited. The Babinski response is also normal while asleep and after a long period of walking.
== Interpretation ==
The Babinski’s sign can indicate upper motorneuron damage to the [[spinal cord]] in the thoracic or lumbar region, or brain disease constituting damage to the [[corticospinal tract]]. Occasionally, a pathological plantar reflex is the first (and only) indication of a serious disease process, and a clearly abnormal plantar reflex often prompts detailed [[neurology|neurological]] investigations, including [[Computed axial tomography|CT scanning]] of the brain or [[Magnetic resonance imaging|MRI]] of the spine, as well as [[lumbar puncture]] for the study of [[cerebrospinal fluid]].
===In infants===
{{main|Primitive reflexes}}
[[Infant]]s will also show an extensor response. A baby's smaller toes will fan out, and their big toe will [[dorsiflex]] slowly. This happens because the [[corticospinal tract|corticospinal pathways]] that run from the [[brain]] down the [[spinal cord]] are not fully [[myelin]]ated at this age, so the reflex is not inhibited by the [[cerebral cortex]]. The extensor response disappears and gives way to the flexor response around 12-18 months of age.
==Relationship to Hoffmann sign==
{{main|Hoffmann's sign}}
The [[Hoffmann's sign]] is sometimes described as the [[upper limb]] equivalent of the Babinski's sign<ref>{{cite journal |author=Harrop JS, Hanna A, Silva MT, Sharan A |title=Neurological manifestations of cervical spondylosis: an overview of signs, symptoms, and pathophysiology |journal=Neurosurgery |volume=60 |issue=1 Supp1 1 |pages=S14–20 |year=2007 |pmid=17204875 |doi=10.1227/01.NEU.0000215380.71097.EC}}</ref> because both indicate [[upper motor neuron]] dysfunction. Mechanistically, they differ significantly; the finger flexor reflex is a simple [[monosynaptic reflex|monosynaptic spinal reflex]] involving the [[flexor digitorum profundus muscle|flexor digitorum profundus]] that is normally fully inhibited by upper motor neurons. The pathway producing the plantar response is more complicated, and is not monosynaptic. This difference has led some{{Who|date=October 2007}} neurologists to reject strongly any analogies between the finger flexor reflex and the plantar response.{{Fact|date=October 2007}}
==References==
<references/>
==External links==
* {{WhoNamedIt|doctor|370}}
* {{cite web | url = http://video.google.com/videoplay?docid=-1862844561537172698 | title = Video of reflex on google video}}
[[Category:Neurology]]
[[Category:Reflexes]]
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[[fr:Réflexe cutané plantaire]]
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[[it:Segno di Babinski]]
[[nl:Voetzoolreflex]]
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[[zh:巴宾斯基反射]]