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Contradictory findings<br />
<strong>THE</strong> <strong>PLANTAR</strong> <strong>REFLEX</strong> IN INFANTS<br />
Babinski (1897, 1898) found his upgoing toe phenomenon present in<br />
new-born infants and used this as an argument for its association with<br />
disturbances of the pyramidal tract, as this fibre system is not yet fully<br />
developed after birth. In subsequent publications, however, the hallux<br />
responses in this age-group were also reported downward or mixed, and<br />
this instigated new series of examinations -again conflicting or inconclusive.<br />
Rather than adding another set of observations to the thousands<br />
already on record, I shall try to analyse the reasons for the diverging<br />
results, displayed in table Ill.<br />
Not included in the table are some observations which went back even<br />
beyond the normal neonatal period. Krabbe (1912) happened to be present<br />
at the birth of a 4-month-old fetus, and found to his surprise a downward<br />
response (of the small toes). Minkowski (1922, 1923) undertook a<br />
systematic study of the plantar reflex in the fetal period, and distinguished<br />
no less than five stages preceding the full-term period.<br />
The grasp reflex of the foot<br />
One important reason for the contradictory findings concerning the<br />
plantar response in babies is the interference of the grasp reflex, which has<br />
no counterpart in adults, except under specific pathological conditions (see<br />
p. 37). The grasp reflex of the toes can be elicited by a slight moving<br />
stimulus or even by pressure alone, and is generally present during the first<br />
year of life (Sittig, 1932; Brain and Curran, 1932).<br />
The few studies which take account of this specific infantile downward<br />
response of the toes invariably mention dorsiflexion of the hallux and<br />
other digits after more vigorous stimulation: Lewy (1909 b), van Woerkom<br />
(1910, 1911), Minkowski (1923), and more recently Dietrich (1957),<br />
Willemse (1961) and Schoch (1967). In other words, it depends upon the<br />
intensity of the stimulus whether the toes go up or down.<br />
The flexion reflex<br />
Many authors comment on the difficulty of interpreting the plantar<br />
reflex in young children, caused by continual spontaneous, 'pseudoathetoid'<br />
movements. As most studies dealt with reflex movements of the<br />
toes in isolation and did not use effects in other limb segments as a<br />
43
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