In medicine and neurology, the Babinski response to the plantar reflex is a reflex, named after Joseph Babinski (1857-1932), a French neurologist of Polish descent, that can identify disease of the spinal cord and brain and also exists as a primitive reflex in infants. When non-pathological, it is called the plantar reflex, while the term Babinski's sign refers to its pathological form.
Babinski's SignThe lateral side of the 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 toes (metatarsal pads).
There are three responses possible:
Flexor: the toes curve inward and the foot 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 Babinski response may be elicited. The Babinski response is also normal, while asleep and after a long period of walking.
Babinski's Sign in a healthy newborn. 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 neurological investigations, including CT scanning of the brain or MRI of the spine, as well as lumbar puncture for the study of cerebrospinal fluid.
Infants 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 pathways that run from the brain down the spinal cord are not fully myelinated 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
Stroking the lateral part of the sole of the foot with a fairly sharp object produces plantar flexion of the big toe; often there is also flexion and adduction of the other toes. This normal response is termed the flexor plantar reflex.
In some patients, stroking the sole produces extension (dorsiflexion) of the big toe, often with extension and abduction ("fanning") of the other toes. This abnormal response is termed the extensor plantar reflex, or Babinski reflex.
oops, I just re-read my response.. The babinski response is normal in infancy up to a certain age; about 3 months??? If an adult has a babinksi response it is very abnormal. The normal plantar reflex is big toe down often with other toes down. Yet I'm still not sure about no response to the stimulation. The neuro who did the exam is one of the top MS specialists in the country.
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