Friday, February 6, 2015

Study group discussion: Babinski sign

What is pyramidal tract sign?

Did you mean Babinski sign ?
There are a specific set of clinical signs for pyramidal tract disease..I haventy heard of just one particular one.. But yes, out of the many..Babinski is the most specific for pyramidal tract disease.

A few days after UMN syndrome, motor signs appear
These include spasticity,  hyperactive reflexes, extensor plantar responses.

That's because the CSF will press on the cortical neurons.. And cause a upper motor neuron type of lesion.

UMN lesion is due to lesion in corticospinal tract between cerebral cortex and SC.

Well, not all pyramidal signs are called Babinski. Babinski is the extensor response to plantar reflex when the lateral surface of the feet is striken/scratched.

Achcha what are the components of the positive babinski reflex? - review question.

Extension of great toe, fanning of other toes, contraction of tensor fascia lata.

Plus, dorsiflexion of ankle and knee joint.

Yeah, that.

Other ways to elicit a babinski ?
Plus the equivalent of babinski in the upper limbs?

It's plantar reflex. It can be elicited different ways, one's babinski, others are Oppenheim and Chaddock.

Schaeffer too.


And do you elicit Babinski with sharp end or blunt end of the hammer? (Viva question)

In Babinski, you have to produce pain and pressure both at same time so I guess blunt end if the hammer is used.

To support my answer - I have also seen many doctors using their keys (blunt end) for eliciting Babinski.

The tip of a pen can also be used to elicit Babinski.

Yeah, they taught us that we could use keys if we didn't have a hammer handy.

Always red, it looks better on a patient's foot.

In paediatrics.. We used our own nails to elicit Babinski!

I was doubtful that it would work.. But it did.. Especially, children aged below 3-5 years.

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