Babinski's reflex

Definition

Babinski's reflex occurs when the great toe flexes toward the top of the foot and the other toes fan out after the sole of the foot has been firmly stroked. This is normal in younger children, but abnormal after the age of 2.

Alternative Names

Reflex - Babinski's; Extensor plantar reflex

Considerations

Reflexes are specific, predictable, involuntary responses to a particular type of stimulation.

Babinski's reflex is one of the infantile reflexes. It is normal in children up to 2 years old, but it disappears as the child ages and the nervous system becomes more developed. It may disappear as early as 12 months.

In people more than 2 years old, the presence of a Babinski's reflex indicates damage to the nerve paths connecting the spinal cord and the brain (the corticospinal tract). Because this tract is right-sided and left-sided, a Babinski's reflex can occur on one side or on both sides.

An abnormal Babinski's reflex can be temporary or permanent.

Causes

Generalized tonic-clonic seizure (there may be a temporary Babinski's reflex for a short time after a seizure)
Amyotrophic lateral sclerosis
Brain tumor (if it occurs in the corticospinal tract or the cerebellum)
Familial periodic paralysis
Friedreich's ataxia
Head injury
Hepatic encephalopathy
Meningitis
Multiple sclerosis
Pernicious anemia
Poliomyelitis (some forms)
Rabies
Spinal cord injury
Spinal cord tumor
Stroke
Syringomyelia
Tuberculosis (when it affects the spine)

Home Care

Typically, a person (older than an infant) who has a Babinski's reflex will also have incoordination, weakness, and difficulty with muscle control. Safety is important to prevent the risk of injury. The person may need assistance with activity, and the environment should be kept free of hazards.

When to Contact a Medical Professional

This finding is usually discovered by the health care provider, and the affected person usually is not aware of its presence.

The medical history will be obtained and a physical examination performed.

Medical history questions will be asked documenting this reflex in detail.

The physical examination will probably include a complete nervous system (neurologic) examination.

Diagnostic testing may include:

MRI scan of the head or MRI scan of the spine
Angiography of the head
Somatosensory evoked potentials
Lumbar puncture and analysis of the cerebrospinal fluid

Review Date: 3/5/2007
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Previously reviewed by Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network (3/5/2007).

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