What is the Babinski reflex. Babinski's reflex

All multicellular organisms that have a nervous system are able to respond to various stimuli with certain stereotyped movements, which are called reflexes. This is the basis of the activity of the central nervous system. Everyone has reflexes, including newborn babies. The presence of reflexes and their strength depends on the state of the nervous system, which is why neuropathologists use them to make certain diagnoses.

What are reflexes

In a normal situation, all reflexes appear and disappear at their own time. They are divided into congenital (unconditional) and acquired (conditional). The first ones are always with us, their loss means illness. As for the second group, some of them are lost with age, others appear. If the presence of a reflex is not characteristic of a given period of a person’s life or there is an increase (weakening) of it, this is a pathology related to the field of activity of a neuropathologist.

It is important to be able to correctly evoke and evaluate reflexes, so this should be done by specialists who can distinguish physiology from pathology. Pathological signs in neurology always mean illness and occur when the pyramidal system (central motor neuron) is damaged.

Both unconditioned and conditioned reflexes can be pathological in nature. Acquired (conditioned) reflexes are considered pathological if they cause an inadequate response to the action of a simple stimulus. The pathological nature of congenital reflexes is said if they do not fit into the neurological status of a given age or are inappropriate from a biological point of view.

In the practice of neurologists, various unconditioned pathological reflexes are studied, which indicate damage to the connections between the brain and spinal cord. Most often, these are signs from the lower extremities. The response to the stimulus is manifested in the extension of the first finger (extensor reflexes) or the flexion of all toes (flexion group). The main pathological extensor reflex is the Babinski reflex.

What does the Babinski reflex mean?

It got its name after the French neuropathologist of Polish origin Joseph Babinski, who described this simple sign and its diagnostic value in determining the state of the human nervous system. No special equipment is required for this, only a hammer is needed, which is passed along the outer side of the sole from the bottom up, causing involuntary slow extension of the thumb, the other fingers fan out or remain motionless.

The Babinski reflex in children up to one and a half or two years old is considered a variant of the norm. Its presence must be checked in the maternity hospital; in healthy babies, it is always positive and symmetrical on both sides. A negative result in infants indicates various neurological disorders. This may be the first sign of cerebral palsy, as well as a symptom of a brain tumor, cerebrovascular disorders, etc. As the child grows older and the cerebral cortex matures, the reflex disappears. If it persists after three or four years of age, this indicates a pathology of the motor neuron.

A positive Babinski reflex in adults is always a pathology. Normally, when the sole is irritated, the toes should bend, some people may have a neutral position of the foot (no reaction), but if the toes diverge, this is a neurological pathology, and it can be both unilateral and bilateral. It is often combined with other disorders of the nervous system (impaired coordination, muscle control, etc.), so these patients have difficulty moving, are likely to be injured, and may need outside help. The appearance of a similar symptom in adults indicates a violation of the relationship between different levels of the spinal cord and brain. The motor neuron stops receiving impulses, which causes this syndrome.

Why does the Babinski reflex appear in an adult

These can be various disorders, for example:

motor neuron disease (named after the author - Charcot or amyotrophic lateral sclerosis) - severe degeneration of the nervous system, in which the motor neurons of the brain and spinal cord are affected, in the future - muscle atrophy and paralysis;
neoplasms of the brain;
hereditary nature of the disease (Friedreich's ataxia);
consequences of traumatic head injuries;
strokes;
liver failure with the development of encephalopathy;
chronic demyelinating diseases (such as multiple sclerosis), these diseases are characterized by transient detection of Babinskiy's sign;
consequences of meningitis;
malignant nature of anemia;
viral infections (eg, rabies);
spinal injuries;
tumor formations in the spinal cord;
tuberculosis of the bones and spine with involvement of the spinal cord;
syringomyelia syndrome.

The reflex can be called from one or two sides. The presence of a unilateral reflex more often indicates the presence of diseases such as stroke, myelopathy, multiple sclerosis affecting one hemisphere, etc. The bilateral Babinski reflex in adults is observed with diffuse pathology of brain structures, for example, with encephalopathy. The revealed reflex is usually quite persistently preserved, with the exception of disseminated encephalopathy (the sign either appears or disappears).

As a rule, the patients themselves are not aware that they have a positive Babinski reflex, it is detected by a neurologist. For this, the following studies are being carried out:

clinical analyzes of peripheral blood;
angiographic examination of the head;
CT or MRI of the head and spine;
spinal puncture with cerebrospinal fluid analysis;
other tests according to indications to find out a more accurate cause of the pathological reflex.

After the examination, the neuropathologist prescribes the appropriate course of treatment. The volume of therapeutic measures depends on the identified cause of the appearance of an age-inappropriate reflex.

Thus, pathological Babinski's reflexes appear when the central motor neuron is damaged, which can later lead to the development of paralysis. Undoubtedly, the diagnostic value of this neurological sign is important, often preceding the identification of more serious symptoms that require long-term treatment.

The Babinski reflex is one of the most well-known neurological symptoms. Today there is no consensus as to whether it is pathological or whether its presence in children under 2 years of age is not dangerous.

Types of reflexes

Being born, a person receives a certain set of behavioral reactions, which has been developed over millennia of evolution. They accompany him throughout his life and are called unconditioned (innate) reflexes. Over time, it develops specific reactions to certain stimuli. These are conditioned (acquired) reflexes. With age, some of them are lost or replaced by new ones. This is a completely natural process, but the loss of innate reflexes almost always leads to illness. But not all reflexes are physiological. If the reflex does not correspond to the level of human development or is too strong or weakly expressed, then it is considered pathological and it falls into the field of activity of a neurologist.

In their practice, there are quite a lot of pathological unconditioned reflexes, indicating a violation of the connection between the spinal cord and the brain. As a rule, these are signs from the lower extremities. They appear as a response to a stimulus. It is customary to distinguish between flexion and extensor reflexes. The main pathological extensor reflex is considered to be the Babinsky reflex.

How does the reflex manifest?

The name of the reflex is associated with the name of Joseph Babinski, a French neuropathologist who first described it and proved its diagnostic value in determining the state of the nervous system. It's pretty easy to check. In response to irritation of the outer edge of the sole (a solid object is passed along it), the big toe slowly unbends, and the remaining fingers can diverge, remain motionless or slightly pressed. It is believed that only the movement of the thumb is indicative, and the movements of the other fingers are inconsistent and therefore have no clinical significance. However, the Babinski reflex in newborns, in addition to extension of the first finger, is almost always accompanied by a fan-like divergence of the rest. Such a reaction is considered positive. A negative reflex is considered if all fingers are bent.

After birth, all babies are tested for reflexes, among other things. In healthy children, the Babinski reflex is positive and is observed on both legs. A negative reflex may indicate neurological disorders and, in particular, damage to the reflex arc. You can observe the manifestation of the reflex during the first two years of a child's life. However, it may disappear during the first year of life. In children older than two years, the fingers should normally tighten in response to irritation (there may also be no reaction). But most neurologists believe that the presence of the Babinski reflex at this age is not an indicator of the pathology of the pyramidal pathway. Even in three-year-old children, the presence of this sign is perceived as a signal of damage to the nervous system only in the presence of other signs. Only if the child has reached the age of 4-6 years, the Babinski reflex in him is an undoubted sign of the pathology of the pyramidal pathway.

Manifestations of the reflex in adults

If in children up to a certain age the appearance of this sign is attributed to the immature nervous system, then in adults it is always pathological. The reflex can either be unilateral or be observed on both legs. It indicates a violation of the connection between different parts of the spinal cord and brain. This sign can be both temporary (after epileptic seizures) and permanent (in this case, they speak of irreversible damage to the pyramidal tract). Often the pathological Babinski reflex is combined with other disorders of the nervous system. Their list is worth clarifying further.

The Babinski reflex can be observed in the following pathologies:

stroke;
tumors of the spinal cord or brain;
meningitis;
tuberculosis of the spinal cord;
head injury;
pernicious anemia;
rabies;
hereditary diseases (Frideich's ataxia).

Examinations to be carried out with the Babinski reflex

As a rule, in adults, this reflex is detected at a neurologist's appointment. It must be remembered that in itself it is not a disease, but only signals that certain connections have been broken in the body. And in order to find out why this happened, it is necessary to undergo an examination. As a rule, it consists of the following activities:

angiography of the vessels of the head;
MRI or CT of the spine and head;
spinal puncture followed by analysis of cerebrospinal fluid (cerebrospinal fluid).

Depending on the results obtained, other studies are carried out that correspond to the clinical picture, and after that adequate therapy is prescribed.

Often, the pathological Babinski reflex detected in time makes it possible to identify serious pathologies that can lead to paralysis in the future.

Pathological extensor foot reflex, named after the French neurologist Joseph Babinski, who described this phenomenon back in the nineteenth century. The pathological extensor foot reflex, which is part of the structure of various syndromes, was described earlier, but it was Joseph Babinsky who first gave a detailed interpretation of this phenomenon and showed its relationship with the lesion of the cortico-spinal tract.

Symptom (reflex) of Babinsky

It is a pathological plantar reflex from the extensor group. The main reflex of this group. This symptom are of great clinical importance., as well as all reflexes indicating damage to the central motor neuron system. This phenomenon is the earliest and most subtle manifestation of the upper central motor neuron syndrome; and of the symptoms indicating pathology of the motor neuron system, this reflex is the most commonly tested.

Origin mechanism

The positive Babinski reflex is a specific sign of pathological damage to the central motor neuron system, which consists of a motor neuron of the precentral gyrus of the brain and axons that form a cortico-spinal motor tract ("cortical-vertebral", "pyramidal"), following to the motor neurons of the anterior horns of the spinal cord.

The function of the cortico-spinal tract is to conduct motor nerve impulses, "responsible" for voluntary movements, from the cerebral cortex to the skeletal muscles.

Against the background of a deficit of activating influences from the upper motor neuron system, conduction slows down. excitation along motor tracts and the processes of excitation are blocked at the level of the brainstem and segmental formations of the brain; this is the pathophysiological prerequisite for the formation of Babinski's symptom.

reflex arc

receptors that provide tactile sensitivity in the region of the lateral surface of the sole of the feet
afferent fibers of the tibial nerve
afferent part of the sciatic nerve
sensory neurons of the posterior horns of the spinal cord in segments L4, L5, S1
motor neurons in the anterior horns of the spinal cord
efferent part of the sciatic nerve
efferent fibers peroneal nerve
muscles that flex the big toe

Visualization

Babinski's reflex can be caused by a dashed irritation of the skin surface on the outer edge of the plantar side of the foot in the direction from the heel to the toes. In healthy adults with irritation of this type, the so-called normal plantar reflex is caused, which manifests itself in the form of flexion of all the toes at the same time (in this case, a negative Babinsky reflex is recorded).

In the case when there is a pathology in the system of the central motor neuron, the result of such irritation is flexion of the big toe, while the rest of the toes either remain motionless or unbend "fan" after the big one. That is, the normal plantar reflex gives way to an abnormal extensor reflex. This is the so-called Babinsky symptom.

There are various ways to identify the extensor reflex of the foot.

Pressing on the calcaneal ("Achilles") tendon (Schaffer reflex)
Compression of the distal calf muscles (Gordon's reflex)
Pressing the thumb on the anterior-medial surface of the lower leg with a downward shift along the entire length of the lower leg in the direction of the foot (Oppenheim reflex).

Clinical Significance

It occurs in the clinical picture of a number of neurological diseases.

It should be noted that in newborns, a positive Babinsky symptom is not a sign of any pathology. At this age, its appearance is associated with insufficient maturity. cerebral cortex, - just the same motor neuron, the defeat of which this syndrome indicates when it is registered in adults.

In the maternity hospital, during the examination of the baby, this indicator is also checked; in case of a negative result pathology of the pyramidal system should be suspected(tumor process, cerebrovascular syndrome, other disorders). Most sources indicate that the extension of the toes is a normal response to irritation of the lateral edge of the sole until the age of two.

The volume of mandatory studies upon detection of a positive symptom of Babinski

Clinical blood test
Angiography of the head
Tomography of the head and spine - computer and magnetic resonance

If necessary, spinal puncture.

Ignore what was revealed during inspection positive Babinski reflex by no means is it possible. The consequences will concern primarily the motor sphere. At the very least, a mandatory minimum of research should definitely be carried out.

A prerequisite for the successful survival of any living creature on earth is the complex structure and well-coordinated functioning of the central nervous system. However, under the influence of certain negative factors, a failure occurs in it. To determine it and select the appropriate treatment, a specialist examines a person with an assessment of his reflexes. One of them is Babinski's symptom, a pathological disorder in the pyramidal nerve tract that accompanies many neurological diseases. According to the degree of its severity, the doctor decides on the severity of the patient.

The structure of the central nervous system in humans involves a complex scheme of subordination of some structures - on the periphery, to others - the cerebral cortex and subcortical centers. To accomplish the task - the transmission of an electrical impulse, or command, the so-called nerve tracts are provided. One of the most important is the pyramidal path. On it, impulses move from the brain to the muscle groups of the skeleton.

The mechanism of control over movements in a person provides for the execution of not only voluntary contractions - on command, but also involuntary - unconscious, as well as a ban on motor activity. For example, in a situation where a sharp foreign object gets into the shoe, a pain signal immediately arrives at the cerebral cortex - but in order for the person not to fall, the leg muscles stop bending after the first involuntary contractions. The balance is not broken.

If damage to the pyramidal tract occurs, Babinski's symptom will be positive. This means that the inhibitory function of the motor nerve pathway has been lost. Such disorders are possible both on one side and on both sides at once - bilateral damage.

Main reasons:

neuroinfections - inflammation of the nerve fiber of a bacterial or viral nature;
vascular accidents - strokes;
traumatic brain injury;
autoimmune disorders - multiple sclerosis;
neoplasms - benign / malignant tumors;
intracranial hypertension.

To assess the value of the Babinski reflex is only possible for a specialized doctor - a neuropathologist. Indeed, in people's lives there are periods when a failure in the pyramidal tract is a sign of a nervous system that has not yet fully matured. In a number of situations, the symptom accompanies injury to the tendons of the extremities.

Features of manifestations in adults

If the Babinski reflex is detected in a person after reaching the age of 18, this indicates a pathological process in the central nervous system. Such a symptom cannot be a physiological norm.

Normally, when applying stroke-like movements along the sole of the lower limb, the toes must be bent. In some people, they can maintain a neutral position - the required reaction is absent. However, in a situation with a divergence in adult fingers to the sides, this is only a pathology. It requires clarification and differential diagnosis.

The pathological Babinski reflex is characterized by a combination with other symptoms - impaired cerebellar coordination, or muscle self-control over the limbs. People seek medical advice because of difficulties with movement, frequent injuries, paresis. On examination, they will have not only Babinsky's symptoms, but also others - in direct proportion to the cause of the disorder and the level of damage to the pyramidal tract.

Provoking factors for the Babinsky symptom can be:

amyotrophic lateral sclerosis - motor neuron disease;
a tumor in any area of the spinal cord / brain;
Friedreich's ataxia;
toxic encephalopathy;
hemorrhagic type of stroke;
demyelization of the nerve fiber;
consequences of meningitis;
spinal injuries;
tuberculosis of the meninges.

In the case of a neurological deficit - a symptom of motor neuron damage, the study of the symptom in adults requires an integrated approach. Delaying differential diagnosis means exposing a person to additional danger. As the disease progresses, the prognosis is poor.

Manifestations in children

The situation with the Babinski reflex in children is far from unambiguous - a symptom up to a certain age can be attributed to a variant of the immaturity of nervous structures. It will definitely be tested in babies who have just been born. Normally, it is positive, and on both sides. A negative result of the Babinsky study may indirectly indicate such pathologies of the nervous system as cerebral palsy or a congenital tumor.

As the connections between nerve cells and fibers strengthen, reflexes in newborns change - some of them weaken, while others strengthen. Up to two or three years, the system is constantly rebuilding and adapting to changes inside and outside the body.

Later, the manifestations of the Babinski reflex after 3-4 years should cause a natural alarm - by this age, the symptom gradually fades away. However, its presence may indicate either an underdevelopment of the nervous system, or a hidden pathology. It is often caused by trauma to the brain in children.

The prognosis will depend on the timing of the diagnosis - the detection of Babinsky's symptom, as well as the implementation of therapeutic measures with subsequent rehabilitation. The child's body is flexible and has great potential for recovery. Therefore, with appropriate therapy, the child will develop according to age.

Diagnostics

As a rule, a positive Babinsky test is the result of a special examination performed by a neurologist. After all, people themselves without a medical education may not be aware of the presence in their body of a failure of an impulse to skeletal muscles.

In order to clarify what was the root cause of the pathological symptom, it will be necessary to carry out a number of clarifying diagnostic procedures:

various blood tests - general, biochemical, for autoimmune processes;
angiography of cerebral vessels - previous headaches may indicate vascular lesions, for example, atherosclerosis with ischemic foci;
magnetic resonance imaging - a change in the nerve impulse due to compression of the fiber by a tumor, traumatic tissue edema, intracranial hematoma;
spinal puncture to take cerebrospinal fluid for examination - exclusion of an infectious lesion of the system;
according to individual indications - a tissue biopsy, more precisely the motor roots of the spinal cord, for the purpose of differential diagnosis with cancer.

Only after a careful comparison of information and analysis of the results of the study, the neuropathologist will make an accurate diagnosis and select an effective therapy.

Bilateral Babinski's symptom

Evidence of severe damage to the nervous system, both in adults and in children, will be the appearance of Babinski's symptom on both sides. Most often, it is based on the course of the infectious process. For example, this may be a sign of meningitis - a severe pathology of the meninges as a result of bacterial damage.

While the pathological focus in the spinal cord often occurs due to tuberculosis of the bones with the transition to the meninges. As a result of a functional failure in the pyramidal tract, the motility of nerve endings will be impaired on both sides, and not only on the right, as, for example, with a direct blow to the back.

Spinal paralysis is another common cause of the Babinski reflex. If at first it appears on the left, the sign at the same time coincides with a feverish state. However, over time, the muscles will become paralyzed on both sides. They involuntarily contract and provoke a pronounced pain syndrome.

Less often, a severe course of anemia - a decrease in the concentration of hemoglobin in the bloodstream, also contributes to the development of a bilateral Babinsky symptom. Especially with the B12 deficient form of the disease. The symptom will not appear on only one side in such a situation. The final diagnosis will be established after laboratory and instrumental diagnostics.

Types of reflexes

Healthy people will have physiological and pathological reflexes from the moment they are born. They should only be assessed by a doctor.

In the field of neurology, reflexes and symptoms, including Babinsky's, are usually divided into congenital - they are also unconditional, and acquired - developed over a number of years. Their loss or re-development can tell a specialist a lot about the state of the central nervous system.

So, in the absence of congenital reflexes, it is necessary to immediately conduct an in-depth diagnosis of the brain - often its anatomical underdevelopment is detected. If children's reflexes were suddenly detected in adults, it is necessary to exclude infectious, post-traumatic, oncological foci in the brain structures.

Whereas the loss of acquired reflexes is a frequent result of demyelization of nerve fibers, for example, in multiple sclerosis, Alzheimer's disease. With the definition of Babinsky's symptom, the doctor will begin a neurological examination of the patient. Subsequent diagnostic studies will allow you to put everything in its place and choose a treatment regimen.

The achievements of modern medicine make it possible to fight even severe neurological diseases, the sign of which is the Babinski reflex, and to achieve positive results.

Movements of this origin are called reflexes.

Even a newborn child already has some reflexes, which must be manifested in certain situations without fail.

The presence of reflexes, their strength and intensity primarily indicate the state of the nervous system. In the absence of certain reactions, specialists have the right to assume the presence of a disease of neurological origin.

Babinsky's symptom is also included among the pathological reflexes. It can be diagnosed in infancy, which in turn allows us to assert the course of the upper motor neuron syndrome.

With timely diagnosis and proper treatment, the chances of getting rid of the manifestation of unpleasant signs of the disease increase significantly, which allows the patient to continue to lead a healthy lifestyle.

The concept of pathological reflexes in neurology

In neurology, a reflex is understood as the reaction of the body to any irritation localized in the reflex zone, which comes from outside. The presence of reflexes makes it possible to judge the state of health of certain parts of the human central nervous system.

The ongoing studies of reflexes are reduced to establishing their uniformity, character, symmetry, frequency and intensity.

With the normal development of the human body, reflexes at different life stages arise and disappear on their own. They are divided into conditional (which are acquired during life) and unconditional (which are present from birth).

In the absence of congenital reflexes, the presence and development of a certain disease is understood, which in most cases is attributed to the neurological sphere.

Pathological are those reflexes that appear as a result of damage to the main neuron, which is localized in the structure of the brain, neural pathways and nuclei of cranial nerves. It is these structures that are responsible for the correctness and sequence of motor acts.

Any damage to these structures leads to the fact that the body gives out not quite familiar reactions, in the form of various movements. Typically, such reactions are considered abnormal, since they are quite different from the reflex reactions of a healthy person.

Diagnostics in neurology

To establish a competent diagnosis, the specialist should pay special attention to the following issues:

Careful history taking of the patient and his family members (great importance is given to genetic predisposition to neurological pathologies).
Clinical laboratory blood tests.
Carrying out all necessary medical examinations.
Diagnosis of abnormalities in the work of the central and peripheral nervous systems.

Diagnosis of deviations in the work of the nervous system can also be carried out using the following methods:

Electromyography. During the procedure, the neuromuscular synapse is studied, as well as primary and secondary myopathies. Both the facial nerves and the endings of the upper and lower extremities are examined.
Procedure for studying nerve conduction. Allows you to evaluate the speed of impulse conduction between motor fibers and stimulating points. In the event that the results show low numbers, then the doctor may assume the development of demyelination.
Electroencephalography method. Most often recommended for the study of epileptic seizures. In some cases, it is used to confirm the presence of damage to the human cerebral cortex, and various somatic pathologies.
Lumbar puncture.
Magnetic resonance imaging and computed tomography.

To diagnose the Babinski reflex in newborn babies, no medical equipment is needed. To confirm the diagnosis, the neuropathologist will have enough hammer, which he will carry out from the outside of the sole. In this case, a slow extension of the thumb should occur (the rest should remain motionless at this moment).

Babinski's reflex

Babinsky's symptom is the manifestation of a pathological reflex, which consists in extending the big toe at any contact with the sole.

This reflex was named after the famous French scientist neuropathologist J. Babinsky. It was he who was engaged in a thorough study of this pathology and in the course of his studies concluded that this symptom proves a decrease in the sensitivity of the cerebral cortex to the reactions of the anterior neurons of the spinal cord.

The Babinski reflex can manifest itself in the period from birth and pre-months. It is also diagnosed in children under 2 years of age and in older people.

It is possible to cause a reaction with an ordinary toothpick, needle or other sharp object. To do this, you need to hold the edge of the object from the beginning of the foot to the very toes.

The reflex can be observed in the following cases:

minimal cuts of the lower extremities;
in the presence of a high degree of tendon reflexes.

What does this pathology mean?

Confirmation of Babinski's symptom indicates the presence of disturbances in the work of the central motor neuron. At the same time, there is a parallel change in supraspinal control and a disorder in the control of inhibitory neurons.

Such changes in the body cause a person to manifest motor reactions that are not quite characteristic of him in response to stimuli.

Study of the reflex in children and newborns

Each newborn child is required to check not only all the vital functions of the body, but also reflexes. In healthy children, the Babinski reflex will appear on both limbs. In the event that the reflex is negative, then this may indicate the presence of neurological pathologies, namely, a violation of the reflex arc.

A similar reflex can also appear in the first couple of years of a child's life, but there are cases when the symptom disappeared after a year.

For children whose age has reached the mark of more than 2 years, when exposed to an irritant, the big toes should be drawn in (it is possible that the reaction may be weak or completely absent).

The presence of Babinski's symptom in newborns and older children does not indicate the development of any disorders. Most neurologists claim that such a reaction of the body is absolutely normal and passes on its own over time.

In the same case, if the reflex is diagnosed in a child whose age ranges from 4 to 6 years, then in this case it is appropriate to talk about a violation of the pyramidal pathway.

The reason for the presence of such a reflex at an early age of a child can only be genetic diseases that are associated with impaired functioning of the central nervous system and the main neurons of the spinal cord, or else indicate the immaturity of the nervous system.

Investigation of the symptom in adults

In the event that a child has Babinsky's symptom until a certain age, it does not indicate the presence of health problems, but such a manifestation of signs in an adult fully confirms the presence of neurological pathologies.

In an adult, the pathological Babinski reflex can manifest itself only on one side and be bilateral. Its presence proves that the connection between the areas of the spinal cord and the brain is changed or broken.

Such a symptom may exist for a certain period of time (for example, after suffering epilepsy attacks) or be permanent (then they talk about severe lesions in the pyramidal tracts).

In addition, the Babinski reflex can be caused as a result of various neurological diseases and chronic ailments. Their list is long, but the following pathologies are of particular danger:

Charcot's disease (a disease associated with damage to neurons and the loss of their functions), the consequence of such a disease is the development of paralysis and atrophy of all muscle groups;
diagnosis of neoplasms in the brain;
genetic predisposition (in particular, Friedreich's ataxia);
previous head trauma;
stroke;
diagnosis of liver failure and encephalopathy;
diseases of a chronic nature, the greatest danger is multiple sclerosis, it is during its course that the symptom of Babinsky becomes the first sign of the disease;
negative complications of meningitis;
anemia of malignant origin;
viral infections (rabies);
received back injuries;
diagnosis of tumors in the spinal cord;
tuberculosis localized in the bones, spinal cord and spine;
syringomyelia syndrome.

Features of diagnosis

Very often, the patient does not suspect that he is ill with any disease.

In most cases, the presence of a negative or positive Babinski reflex is reported by a neurologist during examination.

To diagnose deviations, the following procedures will most often be carried out:

laboratory tests of peripheral blood;
angiography (study of the structures and vessels of the brain);
computed tomography or magnetic resonance imaging (for a thorough examination of the spinal column);
lumbar puncture with the study of cerebrospinal fluid.

Only on the basis of the diagnostic results obtained, the specialist is able to make a diagnosis and prescribe further therapy. In each case, the treatment is strictly individual.

Of particular importance during the treatment period is the cause that provoked the disease and the age of the patient himself.

The presence of the Babinski reflex is manifested in violation of the integrity of the central motor neuron. With timely diagnosis and effective treatment, in most cases, the disease does not pose any danger. However, if the disease is left to chance or detected too late, the chances of developing paralysis increase.

Babinski's reflex: norm and pathology

What are reflexes

It is important to be able to correctly evoke and evaluate reflexes, so this should be done by specialists who can distinguish physiology from pathology. Pathological signs in neurology always mean illness and occur when the pyramidal system (central motor neuron) is damaged.

What does the Babinski reflex mean?

The Babinski reflex in children up to one and a half or two years old is considered a variant of the norm. Its presence must be checked in the maternity hospital; in healthy babies, it is always positive and symmetrical on both sides. A negative result in infants indicates various neurological disorders. This may be the first sign of cerebral palsy, as well as a symptom of a brain tumor, cerebrovascular disorders, etc. As the child grows older and the cerebral cortex matures, the reflex disappears. If it persists after three or four years of age, this indicates a pathology of the motor neuron.

A positive Babinski reflex in adults is always a pathology. Normally, when the sole is irritated, the toes should bend, some people may have a neutral position of the foot (no reaction), but if the toes diverge, this is a neurological pathology, and it can be both unilateral and bilateral. It is often combined with other disorders of the nervous system (impaired coordination, muscle control, etc.), so these patients have difficulty moving, are likely to be injured, and may need outside help. The appearance of a similar symptom in adults indicates a violation of the relationship between different levels of the spinal cord and brain. The motor neuron stops receiving impulses, which causes this syndrome.

Why does the Babinski reflex appear in an adult

These can be various disorders, for example:

motor neuron disease (named after the author - Charcot or amyotrophic lateral sclerosis) - severe degeneration of the nervous system, in which the motor neurons of the brain and spinal cord are affected, in the future - muscle atrophy and paralysis;
neoplasms of the brain;
hereditary nature of the disease (Friedreich's ataxia);
consequences of traumatic head injuries;
strokes;
liver failure with the development of encephalopathy;
chronic demyelinating diseases (such as multiple sclerosis), these diseases are characterized by transient detection of Babinskiy's sign;
consequences of meningitis;
malignant nature of anemia;
viral infections (eg, rabies);
spinal injuries;
tumor formations in the spinal cord;
tuberculosis of the bones and spine with involvement of the spinal cord;
syringomyelia syndrome.

As a rule, the patients themselves are not aware that they have a positive Babinski reflex, it is detected by a neurologist. For this, the following studies are being carried out:

clinical analyzes of peripheral blood;
angiographic examination of the head;
CT or MRI of the head and spine;
spinal puncture with cerebrospinal fluid analysis;
other tests according to indications to find out a more accurate cause of the pathological reflex.

Symptom (reflex) of Babinsky - what is it?

When the central nervous system (brain and spinal cord) is damaged, pathological symptoms are observed, which for the doctor are often a “red flag” of damage and the need for further diagnosis and treatment.

Today we will talk about one of these symptoms, this is the Babinski symptom or the Babinski reflex, a common finding after a stroke and traumatic brain injury.

Your questions, which we will answer today.

Babinski's sign and Babinski's reflex: what's the difference?
Positive / negative symptom of Babinski on both sides what does it mean?
Positive symptom (reflex) Babinski in newborns.
Positive symptom (reflex) Babinski in children.
Positive symptom (reflex) Babinski in adults.
Examination and diagnostics.
The significance of this symptom in neurological and neurosurgical practice.

Babinsky's symptom: what is it and what is the nature of its appearance?

Babinski's sign is an abnormal finding on neurological examination indicating damage to the pyramidal nerve tract. It consists in the extension of the big toe, with mechanical stroke stimulation of the edge of the foot from the heel to the toe. It looks like this:

So, now let's take a closer look.

The pyramidal nerve tract is a nerve pathway responsible for conducting motor nerve impulses to skeletal muscles. It is the largest nerve tract in our body. It originates from large cells of the cortex - Betz's pyramidal cells, then along the cortico-spinal tract enters the anterior horns of the spinal cord. And already from the motor roots it passes to the skeletal muscles, sending a nerve impulse to them, bringing the latter into a state of contraction. Due to this path, our muscles contract and we can move independently.

The cells of the cerebral cortex not only send motor impulses to the skeletal muscles, but also inhibit the constant motor impulses of the motor neurons of the anterior horns of the spinal cord. Due to this, pathological muscle movements do not occur in response to pain effects on skin receptors.

If this pathway is damaged at the level of the brain or spinal cord, this inhibitory effect is lost. And such a mechanical effect on soft tissues causes pathological movements in the extensor muscles, which, in fact, is the manifestation of Babinsky's symptom.

Often, during examination, a find for a doctor is a symptom of Babinsky on both sides (right and left). In this case, there is bilateral damage to the pyramidal tract. This indicates the presence of a pathological focus in two hemispheres or along the entire diameter of the spinal cord. Examples of such diseases:

Diffuse vascular diseases of the brain (atherosclerosis and cerebrovascular insufficiency).
Demyelinating diseases of the brain and spinal cord (multiple sclerosis, encephalomyelitis, etc.)
Infectious and inflammatory diseases of the brain and spinal cord (meningitis, encephalitis, myelitis)
Increased intracranial pressure (intracranial hypertension) with signs of edema and dislocation of the brain.
Subarachnoid intracerebral hemorrhage (traumatic and non-traumatic).
Brain injury with 2 or more contusion foci in both hemispheres.

If the symptom appears on one side, then it is often accompanied by a decrease in muscle strength on the same side; in this case, we are talking about spastic hemiparesis or hemiplegia. In what cases is the Babinski reflex observed on one side:

The appearance of the Babinski reflex and its connection with the pathological process in the pyramidal tract is closely related to the age of the subject. There are periods in the development of the human body when such pathological reflexes are a manifestation of the immaturity of the nervous system.

Positive Babinski sign in newborns.

This is just the case when the positive symptom of Babinski is a consequence of the underdevelopment of the nervous system. The neonatal period is the first 28 days of a baby's life from the date of birth. A newborn has a long way to go in the development of organs and organ systems.

The baby will still have a long way to establish connections between the cerebral cortex and peripheral organs and body systems. The nervous system also requires serious restructuring and development in order to adapt a small person to the surrounding life. In newborns, the Babinsky symptom is the norm. It is not necessary to be afraid of the appearance of this symptom during the examination, this is not a disease.

Positive Babinski's symptom in children.

Here, everything is not as clear-cut as in the previous age group. The period of childhood in a person lasts from birth to 15 years, then comes the youthful period, which is extended to 18 years. Babinsky's symptom in children is the norm until the age of 2 years, if it persists after, then this is already a sign of pathology or underdevelopment. Further examination and identification of the cause of the appearance of this pathological sign is required.

Positive Babinski's sign in adults.

If, during examination, a neurologist finds a positive Babinsky symptom in adults, then this is a pathology. People over 18 should not have it. It is necessary to look for a pathological focus in the spinal cord or brain. To do this, it is worth comparing the data of a general neurological examination, and not just the identification of this reflex. An additional examination is required if this pathological sign is detected.

Examination and diagnostics.

The Babinski reflex is, first of all, a sign for the doctor about the need to examine this patient. What studies can help establish the location of this focus:

MRI or CT scan of the brain and/or spinal cord.
PET positron emission tomography.
Duplex scanning and angiography of cerebral vessels.
ENMG - electroneuromyography (stimulation and needle).
Lumbar puncture.
clinical blood test.

Babinski's reflex and its significance in neurological and neurosurgical practice.

It is difficult to overestimate the importance of this reflex. The Babinski reflex is a universal, simple and reliable marker of damage to the pyramidal tract of the spinal cord and brain. Additional equipment is not required to detect this pathological sign. It is enough to have a hammer or other object that has a ribbed non-sharp edge - safe for the skin.

This is one of the most frequently detected symptoms during a neurological examination. A frequent finding during examination is Babinsky's symptom: every neurologist or neurosurgeon knows what it is and what to do next. Pediatricians are also oriented in what the Babinski reflex is. This pathological sign allows you to navigate the further tactics of examination and treatment of such patients.

Causes, symptoms and treatment of the Babinski reflex

Negative changes in the central nervous system are characterized by the presence of pathological symptoms. These symptoms include the Babinski reflex. This reflex is a symptom of a neurological nature, which is expressed in the fact that with a hard touch or impact on the foot, the thumb unbends, and all other fingers move apart in different directions. The reflex can be found on one leg, and on two. Babinsky's symptom is always diagnosed in children under two years of age, after an attack of epilepsy, stroke, with irreversible changes in the pyramidal pathway.

Diagnostic methods

No special instruments are required to detect the Babinski reflex. For its diagnosis, only a neurological hammer is needed. The patient takes off his shoes and socks and, straightening up, lies down on the couch. The doctor runs the hammer along the sole from the heel to the toes. During the movement of the hammer, involuntary extension of the thumb occurs. At this time, the remaining fingers, like a fan, diverge in different directions. The procedure is necessarily carried out on two feet.

Etiology of occurrence

First you need to understand what the pyramidal nerve tract is. The term "pyramidal nerve tract" refers to the nerve pathway, the main function of which is the transmission of a nerve impulse responsible for the motor function of the body from the brain to the muscles of the skeleton. It is the longest nerve tract in the human body. The impulse begins to move from the cells of the cerebral cortex to the cortico-spinal region, falling into the anterior part (the so-called horns) of the spinal cord. Further, the impulse passes through the spinal cord through the motor nerve endings to the muscles of the skeleton, causing them to contract. This process leads to a contraction of the muscles of the lower extremities and back, allowing the person to move independently.

Pyramidal Betz cells not only send impulses that set the skeletal muscles in motion, but also stop these impulses in a timely manner, which does not allow the muscles to contract spontaneously, that is, they contract only when necessary. Also, this mechanism allows the muscles not to contract when exposed to various factors that cause pain on the skin. For example, if a person steps on a nail, then the brain blocks the contraction of the leg muscles at the first pain. This is necessary so that a person does not lose balance and does not fall, because the brain models the situation that there may be several such nails, and accordingly there will be more damage. If there is any damage to the pyramidal tract, then the inhibitory function is lost. With any mechanical impact on the soft tissues of the lower limb, uncontrolled pathological movements in the skeletal muscles are caused. This is the Babinski reflex.

Very often, during the examination, the doctor reveals a bilateral symptom (appears on both legs). This indicates damage to the pyramidal tract on both sides, that is, there are pathological changes in both hemispheres or along the entire length of the spinal cord. Pathological changes can be caused by such diseases of the central nervous system:

diseases of the large cerebral vessels of the diffuse type;
destruction of the myelin sheath of neurons in the brain or spinal cord;
infections in the brain or spinal cord;
a significant increase in pressure inside the skull with the presence of swelling of the cerebral cortex;
bleeding in the brain as a result of rupture of a blood vessel;
a severe head injury that led to a violation of the integrity of the brain.

In the case of the manifestation of the Babinski reflex, only on one side, a decrease in muscle tone of this part of the body is observed. The unilateral manifestation of the Babinski reflex occurs against the background of such diseases that are localized in one of the hemispheres of the brain:

stroke;
complex traumatic brain injury;
infections;
tumors (both benign and malignant);
intracranial hematoma;
cyst in the spine or brain.

The manifestation of the Babinski reflex depends on the age of the patient. It is not always the result of diseases of the brain or spinal cord, because during the period of development of the human body there are periods when the pyramidal tract reflex is an indicator of an unformed nervous system.

It is worth noting that before conducting a diagnosis to identify the Babinski reflex, the doctor should examine the lower limbs, because the pathology can manifest itself if there are even small cuts on them that send constant signals to the brain. This leads to a failure in the pyramidal tract. Babinski's symptom may be present in the presence of a high degree of tendon reflexes. This happens during tendon sprains or recent ruptures where they have not fully regained their functionality. Therefore, a complete diagnosis of the brain and spinal cord is very important for making the correct diagnosis.

Manifestations in infants

In infants, the positive Babinski reflex is the result of an incompletely formed nervous system. All the systems of a small person will be fully formed only after three years of life.

Every day, the nervous tissue will be strengthened, forming strong connections between the cerebral cortex and all body systems. The nervous system of a small child during the first two years of life is constantly rebuilt and adapts, so this pathology in newborns is the norm. Many parents, unknowingly and incorrectly informed by a doctor, are frightened and panicked. The reflex will gradually disappear.

Syndrome in children

In children older than three years, the detection of this symptom is not so unambiguous and should be alarming. The presence of a reflex indicates a pathology or underdevelopment of the spinal cord or brain. The earlier the pathology and its focus are detected, the more likely it is to be corrected by special treatment.

The phenomenon in adults

If Babinski's symptom is detected in adults during the examination, then this is considered a pathology, because this symptom should not appear in people over 16 years of age. In this case, it is necessary to undergo a complete examination of the spinal cord and brain in order to identify the focus of the disease, which leads to changes in the pyramidal tract, and to determine the cause of the pathological changes.

Reaction from both sides

A symptom on both sides is most often observed in the presence of infectious and inflammatory processes in the brain (meningitis). The symptom begins to appear only after a series of ailments that are very similar to the flu.

Tuberculosis of the spinal cord also causes a bilateral Babinski reflex, which provokes a violation of the functionality of nerve endings, the body's motility. This leads to loss of sensation in the lower extremities, pain and temperature.

Diseases of the central nervous system of a chronic nature, which tend to progress, lead to the formation of voids in the spinal cord. This causes a bilateral reflex, which is complemented by muscle atrophy. Over time, the muscles become paralyzed. They spontaneously shrink. There is a lack of coordination of movements and severe pain.

Spinal paralysis causes Babinski's symptom. At first it appears only on one side, and then it becomes bilateral. The symptom begins to appear on the fifth day after the onset of fever, which is complemented by severe weakness, bouts of numbness of the lower extremities, muscle atrophy and their spontaneous contraction.

With head injuries, intracranial pressure increases, which leads to a violation of the passage of an impulse along the pyramidal tract. Babinsky's symptom manifests itself during the examination simultaneously with the loss of elasticity of the tendons and unauthorized muscle contractions. The patient complains of severe weakness and loss of coordination.

When a severe spinal cord injury is received at the primary stage, almost all reflexes of the body disappear. This is the result of a strong shock. After the shock has passed, the Babinski reflex can be diagnosed, which can be either a result of damage to the pyramidal tract or a violation of neurological function. A detailed diagnosis will determine the cause of the symptom.

A significant decrease in hemoglobin in the blood in the last stages of the disease leads to the appearance of a bilateral Babinsky symptom. It manifests itself as a result of vitamin B12 deficiency, which leads to gradual damage to the central nervous system.

Pathology also occurs with such an infectious disease as rabies. It causes inflammation of the brain and damage to the pyramidal tract. The reflex occurs against the background of malaise, a significant increase in body temperature. After a while, muscle atrophy begins, and then paralysis follows.

The Babinski reflex is the most tested symptom in neurology, which allows you to identify pathological changes in the pyramidal tract.

Identification and treatment of the disease

The Babinski reflex is the first and very important sign all over the world that signals the doctor about the need for a complete examination of the patient. In most cases, before visiting a neurologist, a person may not suspect that he has a disease of the brain or spinal cord. The present malaise is attributed to stress, flu, overwork. To establish the lesion of the pyramidal tract, the following diagnostic methods are used:

magnetic resonance imaging of the spinal cord and brain;
spiral computed tomography of the spinal cord and brain;
positron emission tomography;
angiography of cerebral vessels;
duplex brain scan;
needle and stimulation electroneuromyography;
taking cerebrospinal fluid for analysis;
detailed clinical blood test.

Based on the results of the tests, the doctor makes a diagnosis, indicating the disease and the area of \u200b\u200bdamage to the pyramidal tract. Further treatment is prescribed. In each individual case, the treatment regimen is developed according to an individual method. During the development of a treatment regimen, the main role is played not only by the disease that caused pathological changes, but also by the age of the patient. In some diseases (meningitis, rabies, severe injuries of the spine and brain), it is impossible to restore the pyramidal tract. A person loses the ability to move independently (muscle paralysis), there is a violation of the sensitivity of the skin, etc. In this case, the patient is assigned psychological and physical rehabilitation. At this time, the support of loved ones is very important.

In most cases, when a focus of damage to the brain or spinal cord is detected, modern medicines make it possible to restore the pyramidal tract, removing the reflex. However, the process of recovery and recovery can take a long time.

Preventive measures

It is impossible to protect your body from all diseases (and especially from injuries of the brain and spinal cord). Preventive measures include proper nutrition, a healthy lifestyle and an annual visit to a neurologist. It is very important to check a child under three years of age several times a year to identify violations in the formation of the nervous system. Children under 16 are required to visit a neurologist annually.