A 5 year old female has a history of road traffic accident. On stroking the plantar surface of the foot from the heel to the toe, extension of great toe and fanning of remaining toes is seen. The clinical findings of this patient are indicative of :
Correct Answer: Spinal cord injury
Description: The Babinski sign, indicating an upper motor neuron lesion, is characterized by extension of the great toe and fanning of the remaining toes. Too vigorous stimulation may produce withdrawal, which may be misinterpreted as a Babinski sign. Plantar responses have limited diagnostic utility in neonates, because they are mediated by several competing reflexes and can be either flexor or extensor, depending on how the foot is positioned. Asymmetry of the reflexes or plantar response is a useful lateralizing sign in infants and children.
Note:
The Babinski sign can be elicited by stroking the sole of the foot with a firm stimulus. The normal adult response is plantar-flexion. The sign is positive when the application of the stimulus elicits extension of the large toe and fanning of the other toes. The Babinski sign is known to be a normal response in infants before full maturation of the corticospinal tract. However, in adults, a positive sign is indicative of underlying UMN damage. Other reflexes exist which represent lesions of the corticospinal tract. The Brissaud reflex is linked with the extensor response of the Babinski sign and is positive when stroking the sole of the foot elicits contraction of the tensor fascia latae of the ipsilateral leg. The Hoffman sign is an analog of the Babinski reflex for the upper limbs. The test is performed by loosely holding the patient’s middle finger and quickly flicking the fingernail downward. A positive sign is the flexion and adduction of the thumb.
Damage anywhere along the Corticospinal Tract can result in the presence of a Babinski sign.
Category:
Dental
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