EpistemisBabinski sign
Specialty: Neurology.
Why it occurs
- Crebrovascular accident (ischemic or hemorrhagic with involvement of the corticospinal/pyramidal pathway)
- Head trauma or spinal cord trauma with cortical/spinal axonal damage
- Tumors of the central nervous system that compress the motor cortex or the pyramidal tract in the trunk/spinal cord
- Multiple sclerosis (active demyelinating lesion in the corticospinal tract)
- Transverse myelitis of inflammatory, infectious or autoimmune origin
- Todd's palsy after a focal seizure (transient presence)
Initial workup
Firm stimulation of the lateral aspect of the sole of the foot from the heel towards the metatarsals with a blunt object (observing the extension of the big toe and the fanning out of the rest of the toes); Emergency MRI of the suspected level (brain, cervical or dorsal spine); blood analysis and lumbar puncture if there is suspicion of a central inflammatory/infectious process.
red flags
Bilateral and acute appearance of the Babinski Sign associated with rapidly progressive paraparesis, clear sensory level in the trunk, urinary retention and motor functional impotence, which requires ruling out transverse myelitis or urgent neoplastic epidural spinal cord compression.
Standard management
- Methylprednisolone — 1 gram intravenous daily for 3 to 5 days in confirmed acute demyelinating or autoimmune pathologies
- Anticoagulation or antiplatelet aggregation as appropriate if the underlying cause is acute ischemic stroke.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Neurology
- Listed causes
- 6
- Treatment options
- 2