STUDY - Technical - New Dacian's Medicine
babinski's
reflex (Classical / Allopathic Medicine)
Babinski's reflex
(extensor plantar reflex) involves dorsiflexion of the great
toe with extension and fanning of the other toes. It's an
abnormal reflex elicited by firmly stroking the lateral aspect
of the sole of the foot with a blunt object. In some patients,
this reflex can be triggered by noxious stimuli, such as pain,
noise, or even bumping of the bed. An indicator of
corticospinal damage, Babinski's reflex may occur unilaterally
or bilaterally. It may also be temporary or permanent. A
temporary Babinski's reflex commonly occurs during the
postictal phase of a seizure, whereas a permanent Babinski's
reflex occurs with corticospinal damage. A positive Babinski's
reflex is normal in neonates and in infants up to age 24
months. (See Positive Babinski's reflex.)
HISTORY:
Review the patient's medical history for seizures, incoordination, muscle spasms, difficulty speaking, and headache.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient if he has experienced nausea, vomiting, fever, or neck pain.
Ask the patient if he has suffered recent head trauma.
Review the patient's medical history for seizures, incoordination, muscle spasms, difficulty speaking, and headache.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient if he has experienced nausea, vomiting, fever, or neck pain.
Ask the patient if he has suffered recent head trauma.
PHYSICAL
ASSESSMENT:
Evaluate muscle strength in each extremity by asking the patient to push or pull against your resistance.
Check for evidence of incoordination by asking the patient to perform a repetitive activity.
Test deep tendon reflexes in the patient's elbow, antecubital area, wrist, knee, and ankle by striking the tendon with a reflex hammer.
Evaluate pain sensation and proprioception in the feet. As you move the patient's toes up and down, ask him to identify (without looking at his feet) the direction in which the toes have been moved.
Evaluate muscle strength in each extremity by asking the patient to push or pull against your resistance.
Check for evidence of incoordination by asking the patient to perform a repetitive activity.
Test deep tendon reflexes in the patient's elbow, antecubital area, wrist, knee, and ankle by striking the tendon with a reflex hammer.
Evaluate pain sensation and proprioception in the feet. As you move the patient's toes up and down, ask him to identify (without looking at his feet) the direction in which the toes have been moved.
Positive
Babinski's reflex
With a positive Babinski's reflex, the great toe dorsiflexes and the other toes fan out.
With a positive Babinski's reflex, the great toe dorsiflexes and the other toes fan out.
SPECIAL
CONSIDERATIONS:
Babinski's reflex usually occurs with incoordination, weakness, and spasticity, all of which increase the patient's risk of injury. To prevent injury, assist the patient with activity and keep his environment free from obstructions.
Babinski's reflex usually occurs with incoordination, weakness, and spasticity, all of which increase the patient's risk of injury. To prevent injury, assist the patient with activity and keep his environment free from obstructions.
PEDIATRIC
POINTERS:
Babinski's reflex occurs normally in infants up to age 24 months, reflecting the immaturity of the corticospinal tract. After age 2, Babinski's reflex is pathologic and may result from hydrocephalus or one of the causes more commonly seen in adults.
Babinski's reflex occurs normally in infants up to age 24 months, reflecting the immaturity of the corticospinal tract. After age 2, Babinski's reflex is pathologic and may result from hydrocephalus or one of the causes more commonly seen in adults.
PATIENT
COUNSELING:
Instruct the patient on what to expect from diagnostic testing. Provide support to the patient and his family.
Instruct the patient on what to expect from diagnostic testing. Provide support to the patient and his family.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)