THE PLANTAR REFLEX - RePub

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~ N 00 TABLE XIX LACK OF CORRELATION BETWEEN O<strong>THE</strong>R PYRAMIDAL SIGNS IN 50 PATIENTS WITH A UNILATERAL BABINSKI RESPONSE exaggeration of weaknes.r or spasticity increa.red decrease of flexion reflex lrHJ of skill tendon abdominal or in the foot J'eflexes cremasteric t·eflexex All patients with a Babinski sign (n = 50) 58% 92% tGtft. 74(7r 48% A. Patients without ipsi1aterally m- creased tendon reflexes (n = 1.1) ofl3 (46%1 11/13 (85%1 0/13 (0%) ---- 3/13 (23% I B. Patients without ipsilaterally 10- creased flexion reflex in proxi- ---- mal muscles (n = 21) 20/21 (95%) 2j21 (10%) 11/21 (67%) 8j21 (38%)
Leaving asymmetry aside for a moment, almost all legs with a Babinski sign showed at least some contraction in tensor fasciae latae, hamstrings or iliopsoas. There were only two exceptions among the 50 patients. Exaggeration of the flexion in proximal limb muscles accompanied the Babinski response in 58% of the patients. In other words, the Babinski sign is as often as not accompanied by hyperactivity of the flexion reflex as a whole. It is clear from table XIX, B, that release of the flexion reflex in proximal limb segments occurs independently of other signs, and in particular of an increase in tendon jerks. The lack of correlation between these two forms of hyperreflexia also holds true when 'absolute' values are considered instead of asymmetry: figure 12 shows that every activity level of the flexion reflex can be found together with a wide range in activity of tendon reflexes, and vice versa. Flexion reflex +++ 0 ++ + ...... 0 0 0 ± 0 0 -4 0 co 0 ~~ 0 -3 -2 -1 0 ooA~~IIO +l +2 +3 +4 Tendon reflexes (KJ+ AJf2) FIGURE 12. Lack of correlation between 'c~bwlute' value_r of flexion reflex and tendon reflexes in 50 patients with a unilateral Babinski sign (triangles = side of Bt~binxki sign; circles = control side). 129
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THE PLANTAR REFLEX a historical, cl
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THE PLANTAR REFLEX A HISTORICAL, CL
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Aan mijn ouders Aan Carien, Maarten
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TELEOLOGICAL SPECULATIONS - science
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- EMG result and 'final' neurologic
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LIST OF ILLUSTRATIONS figure page 1
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Electromyographic recording from mu
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The plantar reflex before Babinski
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viz. those of Striimpell (1899), Op
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These early reports did not reach m
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Charcot's concepts about hysteria w
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TABLE I STUDIES CONFIRMING BABINSKI
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False positive findings? Babinski's
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FLEXION AND EXTENSION SYNERGIES The
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confirmed by Walshe (1914). His is
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esult in disappearance of the Babin
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without an ipsilateral upgoing toe
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RIVAL SIGNS Confusion When Babinski
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8. Stroking the anterior surface of
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Contradictory findings THE PLANTAR
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Bersot 1920,'2! ? X ]l 2 Burr 1921
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curious case of one healthy infant
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9. Infants under one year of age ge
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INTRODUCTION Observer error: examin
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following a suggestion that most re
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TABLE IV INFORMATION PRECEDING THE
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TABLE VI RATINGS OF 'INFORMATION' G
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unm i stakab I y upward possibly up
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Clinical experience appeared to be
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CHAPTER III BABINSKI SIGN: STIMULUS
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TABLE VII CLINICAL COMMENTS ON THE
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Normal plantar response: flexor hal
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I. rn. extensor hallucis longus 2.
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TABLE VIII OCCURRENCE OF REFLEX ACT
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ecruited and even interrupted by EH
Page 78 and 79: value (the minimal stimulus intensi
Page 80 and 81: FIGURE 8 Relative dimen.riom and we
Page 82 and 83: the two separate bursts of electrom
Page 84 and 85: 5. In general, reflex effects produ
Page 87 and 88: INTRODUCTION When is an upgoing toe
Page 89 and 90: stimulated side diminishes extensor
Page 91 and 92: 30 patients with equivocal plantar
Page 93 and 94: A FHB EHL E TA EHL c FHB TA _j1mV 5
Page 95 and 96: Inexperienced observer An additiona
Page 97 and 98: patient 2 3 4 5 6 7 8 sex F M M F F
Page 99 and 100: Practical use of the flexion reflex
Page 101 and 102: 1. Contraction of the tibialis ante
Page 103 and 104: FHB I ! ¥ _j 02 FHB ...,. r~~a..,.
Page 105 and 106: Finally the method of stimulation.
Page 107: CHAPTER V THE BABINSKI SIGN AND THE
Page 110 and 111: TABLE XIV THEORIES INVOKING A SUPRA
Page 112 and 113: change of the plantar reflex was of
Page 114 and 115: An upgoing toe response in lower pr
Page 116 and 117: noticed no special features, and of
Page 118 and 119: 'pyramidal syndrome' were not. Thei
Page 120 and 121: movements, but also the capacity to
Page 122 and 123: - rapid foot tapping on the couch,
Page 124 and 125: TABLE XVI FREQUENCY OF V ARlO US SI
Page 126 and 127: ~ N 0\ TABLE XVIII PATIENTS WITH A
Page 130 and 131: ~ '->' 0 TABLE XX PATIENTS SHOWING
Page 132 and 133: 3. BABINSKI SIGNS APPEARING IN OR D
Page 134 and 135: --------------~~- ~ '-" TARLE XXI "
Page 136 and 137: DISCUSSION Two principal features e
Page 138 and 139: patients in the first group in whom
Page 140 and 141: The most striking examples of Babin
Page 142 and 143: eflex arc must have its impact at o
Page 144 and 145: hallucis longus motoneurones to seg
Page 146 and 147: 9. The paradoxical downward toe res
Page 148 and 149: showed very little agreement with t
Page 150 and 151: A second condition to be fulfilled
Page 152 and 153: eide met dubieuze voetzoolreflexen,
Page 154 and 155: waarin de Babinski-reflex verdween,
Page 156 and 157: BABINSKI,]. (1885). Recherches sur
Page 158 and 159: approche d'une interpretation du si
Page 160 and 161: BUCK, D. de, and MOOR, L. de (1900)
Page 162 and 163: DEJERINE, ]., and LEVY V j\LENSI, J
Page 164 and 165: FRIEDMAN, E. D. (1920). On a possib
Page 166 and 167: GROSS, F. (1971). The Emperor"s clo
Page 168 and 169: IIDA, M., and BASMAJIAN,]. V. (1974
Page 170 and 171: LANDAU, W. M., and CLARE, M. H. (19
Page 172 and 173: MANFREDI, M., SACCO, G., and SIDER!
Page 174 and 175: NYBERG-HANSEN, R., and RINVIK, E. (
Page 176 and 177: lombo-sacrCe avec amyotrophie globa
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STRDMPELL, A. VON (1887). Ueber ein
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WALSHE, F. M. R. (1956). The Babins
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ACKNOWLEDGEMENTS I am grateful for
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CURRICULUM VITAE De schrijver van d
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