The plantar reflex is an involuntary movement of the foot in response to rubbing on the outside of the foot. Babinski’s sign is a pathological response that can indicate damage to the central nervous system. There are many methods to elicit the plantar reflex, each with a different name for the pathological response.
The plantar reflex is an involuntary movement of the foot in response to rubbing on the outside of the foot from heel to toe. The toes curl inward toward the ball of the foot, and the foot flips over or away from the midline of the body. The plantar reflex is the sign of a healthy central nervous system.
When the plantar reflex is elicited, there are three possible responses, the normal flexor reflex described above, indifferent or no response, and the extensor reflex, in which the big toe flexes upward and the other toes fan out. The latter response is called Babinski’s sign or Koch’s sign and is usually indicative of damage to the central nervous system. However, it is normal in children up to the age of one or two, during sleep and after prolonged walking.
The results of a plantar reflex test are usually referred to as “Babinski’s sign present” or “Babinski’s sign absent”. An indifferent response is generally no cause for alarm. Babinski’s sign can be caused by damage to the spinal cord or brain.
While the Babinski test is the current standard for eliciting the plantar reflex, there are many possible methods, each with a different name for the pathological response after the physician who invented the test. Bing’s sign is a response to multiple pin pricks on the top of the foot, while Cornell’s sign is in response to scratching the top of the foot. Chaddock’s sign is induced by stroking the bone on the side of the ankle, and Gonda’s sign is activated by bending and releasing the fourth toe. Gordon’s sign is a response to squeezing the calf and Moniz’s sign is a response to bending the foot at the ankle. Oppenheim’s sign can be induced by pressing on the inner edge of the tibia or calf muscle, and Schaffer’s sign is tested by pressing on the Achilles tendon.
To test for Stransky’s sign, the little finger is pulled to the side and released. Strümpell’s sign is tested by having the patient flex the knee against resistance, and Throckmorton’s reflex can be induced by striking the metatarsophalangeal joint of the big toe. Any of the tests described will cause the plantar reflex in a healthy adult.
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