From the Guidelines
A positive Babinski reflex is associated with brain damage or disease, particularly those affecting the pyramidal tracts.
Potential Underlying Conditions
- Cerebral infarction: A Babinski sign can occur contralateral to the hemiparesis as a result of brainstem notching against the tentorium in cases of cerebral infarction with swelling 1.
- Hepatic encephalopathy: Motor system abnormalities, such as hypertonia, hyper-reflexia, and a positive Babinski sign, can be observed in noncomatose patients with hepatic encephalopathy 1.
- Brainstem compression: Deterioration in cerebellar infarcts with swelling can lead to brainstem compression, which may cause a positive Babinski reflex 1.
- Pyramidal tract lesions: Any condition that damages the pyramidal tracts, such as stroke, traumatic brain injury, or infections, can result in a positive Babinski reflex.
Key Points
- A positive Babinski reflex is a sign of upper motor neuron damage.
- It can be observed in various conditions, including cerebral infarction, hepatic encephalopathy, and brainstem compression.
- The presence of a Babinski sign should prompt further evaluation to determine the underlying cause.
From the Research
Potential Underlying Conditions
The Babinski reflex, also known as the Babinski sign, is a neurological sign that indicates upper motor neuron dysfunction. The potential underlying conditions associated with a positive Babinski reflex include:
- Central nervous system diseases, as the reflex is an indicator of dysfunction in the pyramidal tract 2, 3
- Pyramidal tract lesions, which can cause the extensor plantar response characteristic of the Babinski sign 3
- Upper motor neuron weakness, which can be identified by the presence of the Babinski sign, although its reliability and validity have been questioned 4
- Neurological diseases such as epilepsy, strychnine poisoning, and amyotrophic lateral sclerosis (ALS), which can cause transient or persistent appearance of the Babinski sign 3, 5
Clinical Significance
The Babinski sign is a valuable tool in clinical diagnosis, as it can help distinguish between central and peripheral nervous system diseases 2. However, its reliability and accuracy can be limited, and other signs such as decreased speed of foot tapping may be more useful in identifying upper motor neuron weakness 4. The sign can be elicited through various means, including traditional plantar stimulation and simple observation of the toe response when the feet are exposed 5.