Babinski / plantar response

[Danijela]

My partner has both upper and lower motor neuron symptoms, and has correctly been diagnosed with MND/ALS.

Last week we attended a specialist clinic (we go every 4 months) and in the notes that followed I noticed that his Babinski/plantar reflex is still normal (absent), that is downward contraction of the toes. His reflexes are brisk in all limbs.

I am interested in how many PALs diagnosed with both upper and lower motor neuron involvement (ALS) have a normal plantar response, that is, the absence of Babinski's sign. Or perhaps your response was normal early in the disease, and then you develped Babinski sign?

Here is a little write up to claryfy:

"Test the plantar response by scraping an object across the sole of the foot beginning from the heel, moving forward toward the small toe, and then arcing medially toward the big toe. The normal response is downward contraction of the toes. The abnormal response, called Babinski's sign, is characterized by an upgoing big toe and fanning outward of the other toes. In some patients the toes are "silent," moving neither up nor down."

 

[paleshia]

i have not had the babinski thing, not up or down....nothing. now, tap my forearm and my hand jumps off the table...guess we will see if it's a limb thing...my onset was in my hand/arm and i have both upper and lower motor neruon issues of course.

 

[GlenBrittle]

Depends which foot right now.

Left - Babs
Right - curls.

Glen

 

[Zaphoon]

Besides the direction of the toes, the neurologist look to see if the stimulus provokes a triple flexion response. One neuro told me that because my big toe only went up on 1 foot that my Babinksi was only lateral. A second neurologist, after hearing what the first had told me, informed me that I had bilateral Babinksi sign as evidenced by a triple flexion response, bilaterally.

To clarify (as best as my feeble mind will allow), a triple flexion response is indicated by a reaction in the ankle, knee and hip when the foot is stroked while trying to elicit the Babinksi sign. So, in other words, toes may not always go up but that doesn't mean Babinksi sign is not present if there is a triple flexion response.

Hope this helps and someone is certainly clear to spank me if I'm wrong here.

Zaphoon