Babinski’s reflex

Alternative names 
Reflex - Babinski’s; Extensor plantar 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.

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 under 2 years old, but it disappears as the child ages and the nervous system becomes more developed.

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.

Common 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.

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

What to expect at your health care provider’s office

The medical history will be obtained and a physical examination performed.
Medical history questions (i.e., Have any other unusual symptoms been noted before this reflex developed?) 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

After seeing your health care provider, you may want to add a diagnosis related to a Babinski’s reflex to your personal medical record.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.