The Babinski Sign or Reflex | Upper Motor Neuron Lesion

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This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The Babinski sign is characterized by great toe extension and toe abduction and is indicative for an upper motor neuron lesion or temporary pyramidal tract disturbance due to epilepsy or intoxication.
Articles:
www.ncbi.nlm.nih.gov/pubmed/2...
pn.bmj.com/content/2/1/42.full...
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[@Physiotutors]

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[@butterfly8272]

WHAT IF YOU ALWAYS PULL YOUR TOES BACK STRONGLY IF YOU DO THIS TO YOURSELF? MAYBE MY FEET ARE SENSITIVE. i CAN'T DETERMENT CERTAINLY IF MY TOES GO AWAY OR TO AN OBJECT....I HAVE SCOLIOSIS...

[@alexismarquez3674]

BABINSKI REFLEX IS THE DORSIFLEXION OF THE BIG TOE AFTER STIMULATION OF THE LATERAL TOE. IT IS A NORMAL REFLEX IN INFANTS UNDER THE AGE OF 6 MONTHS, BUT INDICATES A LESION OF THE PYRAMIDAL (CORTICOSPINAL) TRACT IN OLDER INDIVIDUALS. TIME: 10:48AM

[@niklasdressler5149]

OKAY THANKS BUT WHY ARE WE SCREAMING?

[@akshinbarathi8914]

@@niklasdressler5149 may be we can REMEMBER IT!!!! more easily?

[@zest7063]

NO NEED TO YELL

[@thesilver7238]

Would a toe twitch to either direction (upwards or downwards) be in favor of a positive/negative result or is it still neutral? Is full motion required for a positive/negative result?

[@dylanjohnson4624]

Stop yelling at me

[@juliakaufmann6460]

Thanks for the explanation. Finally I could see how it looks.

[@nadirah6365]

Really clear video, thank you!

[@medicolec3194]

your videos are helpfull for medical student stay blessed..

[@tariqhassan3046]

U r the best available teacher...

[@miranmuslem]

Thank you very much! Now I will never forget it!

[@user-ij3ct2ob1f]

you've a brilliant creative doctor and the video has been useful to me thankyou very much 👏👏😍👍🌹

[@reemsami3526]

Thank you so much 💜

[@molivers2024]

Short & direct thank u 🙏

[@muteebazeenath5145]

Thank you so. much for this. I finally understood this!

[@Physiotutors]

+Muteeba Zeenath you're welcome! Glad we could help

[@chartreux1532]

+Physiotutors I'm german and currently study PTSD and "war neurosis" (as it was called) and read thousands of german doctor reports and cases regarding the type of PTSD that happened between 1914-1918 after artillery shelling and in several reports it mentions the "babinski'sche zeichen" (engl: babinski sign) being observed in these patients who suffered 24h long artillery shelling on the western front. I had no idea what that was, so the video was helpful when i found it. So it seems like these patients suffered upper motor neuron lesion, probably from the blast wave of artillery causing this effect. That's interesting and that video helped me understand that many of these soldiers had not only psychological but also physical damage to their brain causing the babinski sign

[@Physiotutors]

Das klingt wirklich interessant! Es freut uns, dass wir eine Erklärung geben konnten! Nur sind war das Babinski Zeichen hier ein Zeichen von bleibendem Schaden oder temporärer Störung des ZNS?

[@jdokis]

Thanks for posting your articles!

[@Physiotutors]

+Jeremy Dokis you're welcome !

[@scenes82]

Thank you

[@alexandrutirlea4043]

Does a slight flick downward mean its a negative babinski sign?

[@lua8510]

Thank you❤️ Iraq

[@aydon1276]

What's the song?!? I've heard it before but can't remember it for the life of me. I've been trying to think of it for days now.

[@good_miyorning]

0:46 babinski sign

[@Ahmed-zv9uw]

Thank u . this video made my day .

[@Physiotutors]

Ur welcome Ahmed!

[@ahmedyehia1138]

kont ts2lni ycta T_T

[@Ahmed-zv9uw]

Ahmed Yehia هو الكومنت موصل ع MFM ولا ايه 😂😂😂

[@ahmedyehia1138]

Ahmed El-Gendy la 4oftk sodfa 😂😂😂

[@Wasp239]

What to do if I have this reflex? What shall I do?

[@isabelbarra2830]

Thank you! Brazil 😊

[@Physiotutors]

Good to see some Brazilian Students here!

[@moufidamahdjour9049]

Thanks doctor Please I want some advices in order to tell me how I can succeed my neurology exam 😇👌 and how can I revise well thank u ... ^^

[@Physiotutors]

There is no general advice. Watch our videos and practice!;)

[@Sunshine-gc9lb]

Thanks so much.!!!

[@Physiotutors]

No worries, thanks for the compliment and for subscribing!

[@DoctorDj98]

whats a positive sign? is it if the toes flex or ext?

[@abigailcorbett3109]

What does it mean if your feet don't respond? Thanks

[@user-qj5tc4ok3w]

발바닥을 발꿈치뼈 부위에서 가쪽을 따라 발 앞면을 향해 자극-> 엄지 펴지고 나머지 옆으로 벌림 시 양성

[@docwix.]

Thanks ✨

[@sysamanthahope9033]

is this similar with Mute toe?

[@serinesiouan5039]

thanks!

[@saadalhagri9240]

There is slight abduction of the 2nd and 3rd toes .. is that abnormal in adult?

[@top10amazings4]

Is babniski always positive during deep sleep?

[@adamfriend8987]

Question: is it possible to have the B reflex on only one side, or is it always bilateral?

[@MartialXD]

It can be unilateral

[@thesilver7238]

Would a toe twitch to either direction (upwards or downwards) be in favor of a positive/negative result or is it still neutral? Is full motion required for a positive/negative sign?

[@arandomperson589]

If it goes towards your heel it is normal If it goes towards your knee and the others fan out it is abnormal Or positive Full motion doesn't happen generally twitch is enough ig

[@user-mw4mu2uh5z]

Спасибо! Хорошее видео!

[@Physiotutors]

ur welcome!

[@plaque9]

If your feet are ticklish, does it affect the observed response?

[@Physiotutors]

It shouldn't as normal reflexes are basically pre-programmed movement patterns since our infancy

[@ticklishtomato5725]

I guess you would just laugh, and maybe pull away

[@Broxine]

Ticklish Tomato 5 lol @ your username and this topic 😄

[@okay5624]

No response or flexion are both normal responses

[@autismwizard8259]

What does it mean if all the other toes respond, except for the big toe?

[@Physiotutors]

Together with other symptoms that suggest an upper motor neuron lesion we would refer back to a neurologist.

[@nandaakmal6287]

The subtitle said that the fan sign in French is "Signe de Levante" while i was googling i'm unable to find the related result about the Babinski's sign, then i realise that the real spelling is "signe de l'éventail" and the google result refer to the Babinski's sign. Hope this information help!

[@Physiotutors]

Thank you for your comments this is also what I am saying in English and the subtitles have been added by a French viewer. Thank you anyways for the comment

[@sabrine126]

you are the cutest doc i've ever seen *---*

[@Physiotutors]

I am flattered! Only thing is I am not a doc, "just" a physiotherapist

[@samwinter5522]

Heel, medial to lateral lateral part of the foot Across ball of foot -ve: -Flexor +ve Extensor

[@joen9730]

solid thx

[@Physiotutors]

Thank you

[@fatcammal]

lol the intro song... you can tell this guy is an Idubbz fan

[@Physiotutors]

Correction: Ian is a huge Physiotutors fan

[@pareriksson3183]

thanks

[@Physiotutors]

Ur welcome ludvig!

[@sesphosp7139]

Thank you for your informative video I was in semiology class... our professor tested my plantar reflex accidently to show other students this reflex and I was babinski positive ... Should I be worried and go to doctor? Thank you in advance💛

[@Physiotutors]

In isolation hardly any physical test is of value without any other subjective and objective signs of upper motor Neuron lesion

[@sesphosp7139]

@@Physiotutors thank you so much🙏🏻

[@pawepetek7294]

@@sesphosp7139you good? What was the cause?

[@butterfly8272]

@@Physiotutors BUTYOU SAID IT IS 99% SENSITIVITY..? SO OBVIOUSLY HE SHOULD GO AND CHECK IT!

[@UthsukaAnuRathnayakemax]

god job

[@Physiotutors]

Thanks!

[@abdullahqablan8115]

Thanks

[@Physiotutors]

You’re welcome 🤙🏼

[@JL-jy4zo]

Content Cop is here, Bucko

[@juliankingscote1130]

According to Macleod's Clinical Examinations 14th ed, to elicit the Babinski sign you go laterally from heel to little toe, NOT to the great toe as shown in the video.

[@Physiotutors]

Babinski originally describes simply pricking the sole with a sharp object when he first observed it. Most descriptions run a pointed object along the lateral aspect of the foot from the heel towards the base of the toes / great toe.

[@juliankingscote1130]

@@Physiotutors Do you have any reputable references?

[@Physiotutors]

- Babinski's Report: www.thelancet.com/journals/laneur/article/PIIS1474-4422(16)30416-1/fulltext - The reference in the description. Often acknowledged that there are various ways to elicit the reflex (pdfs.semanticscholar.org/d19c/549f7eb4fbd05a9b78ce5160be6663d839ae.pdf)

[@augustandroyal]

The intro music has the same audio fx as the Content Cop song.

[@barney3053]

That content cop music❤

[@nowcanindonesiapapua695]

awsom

[@Physiotutors]

Thx!

[@Joshuaversa]

What does it mean when the sign is positive on one side but negative on the other?

[@Physiotutors]

As this test is positive in an upper motor neuron lesion, you would expect this test to be positive on both sides. However, clinical practice is different than in the books most of the time. Be aware that this is only 1 test. It should fit into your whole clinical picture of an upper motor neuron lesion to make a good diagnosis.

[@almonds2228]

Just because it's an upper motor neuron lesion does not mean it has to be present bilaterally, that is incorrect. a positive sign on one side suggests the contralateral or even ipsilateral tracts such as the corticospinal tract are not working properly. they do not have to be bilateral signs

[@Joshuaversa]

Thank you, I ask because I suffered a Diffuse Axonal Injury with cervical spine fractures C3 to C7 and only have the signs on one (left) side.

[@almonds2228]

My pleasure! I am sorry to hear about your injury and hope you have a speedy recovery!

[@Physiotutors]

+Almonds22 thanks for the correction almonds22!

[@MultiNerve]

Just know if you only see big toe move without any other movement, the result of the test is inconclusive

[@daniabakir9585]

Так я откинусь если нет рефлекса ?

[@ketameanii]

my feet would get tickled doing this lol

[@Physiotutors]

Yeah, they kind of do

[@ernestopiquera8680]

Fgvgbbvyf

[@ernestopiquera8680]

Vggvyvmjshxn

[@jesuschristcunt8469]

@@ernestopiquera8680 thankyou

[@sespis2r]

My mom is always barefoot in the living room with her feet up so ever since i learned about this technique ive been coming up to her and scratching her foot lol, she gets so annoyed

[@kellyasp52]

I'll watch these just to hear your accent

[@ernestopiquera8680]

Fhgvgcfxffgcg

[@ernestopiquera8680]

Thhbcbfh

[@graysonred2641]

Tha k you

[@Physiotutors]

Ur welcome Justin!

[@user-bp9zg6hb3x]

Do more videos with Greek subs :)

[@Physiotutors]

The subtitles are provided by our community and you can see who provided the subtitles at the bottom of the video description :)

[@azharalam3529]

good very nice

[@Physiotutors]

Thx!

[@edvondorn2910]

Same person has and does not have Babinski?

[@snehavasava6558]

babinski and plantar reflex are different?

[@92conan]

Babinski is a type of pathological cutaneous plantar reflex. Indeed they are different

[@Physiotutors]

Love it when our followers answer questions of other followers! Appreciate it Omar!

[@qorghsksan92]

is it normal to laugh in burst when doing that?

[@_nursepat]

Nice on the eyes and smart :)

[@Physiotutors]

Appreciate it 😊

[@jadumonigogoi403]

Why same subject once show positive after normal babinsky sign?

[@Physiotutors]

Because it’s a demonstration and not an actual pathological reflex

[@jamestucker1068]

what if no response is evoked in both legs?

[@Physiotutors]

Then it's probably a negative result

[@jurgerris2769]

Yahamyo? How do i spell it?

[@Physiotutors]

+Jur Gerris you can find the articles in the description!

[@pabloBeelen]

I think you knowledge of neurology is very old fashion you should tead about modern sciences of motor control? Tell me whats the therapy of babinsky ? We do no more discrimination between upper and lower see the modularity of the brain by fodor?

[@mhdwahoud]

thank you😬

[@Physiotutors]

No worries buddy!

[@Emily-zx3lp]

What if there is no response?

[@Physiotutors]

Compare to the other side. Only positive in case of big toe extension.

[@Adam-el7pf]

Same no response in any of the sides

[@Adam-el7pf]

Physiotutors what this mean Doc? I’m a little bit worried

[@rawansbaih2503]

Thanks a lot 💜 palestine

[@lakithamaratunga7423]

🙏❤️

[@SamreenPhysiocom]

Can you please tell me anatomy in your video's?

[@Physiotutors]

+samreem wasim do you mean what is happening in the Babinski sign anatomically? Think we mention that in case of an upper motor neuron lesion, we don't have reflex inhibiton.

[@Meraki_98]

Is babinski sign positive in stroke patients too? Or is it lost?

[@MidhunKrishnaR]

I think it depends upon , if the lesion is to Charcots artery it can disrupt internal capsule. This can lead to spastic paralysis, leading to Babinski + ( I'm a first year medical student and don't know much)

[@gabrielsansar6187]

I tried this on my donkey and got kicked in the face - you owe me six teeth

[@LA_ILAH_ILA_YAHU]

Ya ya

[@percapprincess4187]

this explanation was sort of difficult to understand... as SOME other commenters stated-- they were still wondering what was a positive or negative result of this reflex.

[@dcass120]

Patients who exhibit this reflex have upper motor neuron lesions. According to NIH, "UMN lesions are designated as any damage to the motor neurons that reside above nuclei of cranial nerves or the anterior horn cells of the spinal cord. Damage to UMN's leads to a characteristic set of clinical symptoms known as the upper motor neuron syndrome."

[@Fossilized-cryptid]

the umn lesion irrespective if its at the soma, axon or teledendron level will not inhibit the alfa and gamma motor neurons in the anterior grey horn rexed laminae IX X of the grey matter of the spinal medulla, which will cause a disinhibition pathway and lead to lots of action potentials epsp's to the dorsi flexor muscles like tibialis anterior, extensor hallucis longus etc, and will cause the toes to extend, thats a pathological sign which is a positive babinski sign, in infants since the axons aren't fully myelinated the reflex can cause dorsiflexion as well but it isnt pathological

[@h0ted503]

I tried this on my mother and someone tried it on me too. We feel it but we don't do any reflex to it. So what is it? Positive or negative?

[@artemiskardoula6380]

same

[@shishirshandilya8598]

Negative refex

[@matheussalomao8823]

look at the thumbnail. Exactly on that spot, downside the hallux, there's some nerves that if u pass the object there with more pressure, the toes flexionate

[@danialarif4654]

0:37

[@oldnikonian343]

What if your toes don't display either of the two behaviours when the test is performed, i.e. there is no response? Thank you.

[@stutisharma4257]

It is a neutral babinski's sign. May indicate lower motor neuron lesion.

[@oldnikonian343]

@@stutisharma4257 Thank you for your response. I've just looked that up and it's a distinct possibility because I am having nerve problems in my legs/feet and arms/hands after contracting a quite serious staphylococcus aureus infection, i.e. pain and acute sensitivity to hot and cold stimuli. It could also be related to hyperglycaemia/raised blood glucose even though I've managed to lower it naturally now through eating a ketogenic diet, i.e. the nerve damage may have already been done.

[@stutisharma4257]

@@oldnikonian343 oh dear, take care u'll be all fine 💙

[@doinggreat974]

What does babinski sign Absent mean. Peace explain

[@Physiotutors]

Babinski sign absent = normal reaction, which is toe flexion = negative test

[@sysamanthahope9033]

i think those were the same foot demonstrating both positive and negative sign :D so it means patients can fake the test result?

[@Physiotutors]

No because the patients don’t know what’s going on and there is no incentive to fake a babinski sign. It will also be more abrupt on a real patient (as it’s a reflex)

[@nikatokatul935]

Sang PT pko sa doctors gna lantaw tagd ka mung perme.. ahahahha

[@michelelocicero1090]

Bei piedi

[@sonpariallepi7477]

Not understood your language please translate in hindi

[@sonpariallepi7477]

I am mbbs student but not me understand English language

[@sonpariallepi7477]

But write comes

[@GrimWillyNelson]

what happens if your patient poos their pants when you try this reflex? Does this show a LMN lesion?

[@Physiotutors]

Never heard about someone pooing their pants during the test

[@humayrah5523]

Positive babinski sign--- Extension of big toe Abduction of other digits In severe cases- flexion of hip and knee jt!

[@julzescalada185]

the guy is so hot

[@Physiotutors]

Thanks 😏

[@somebody5126]

Thank you

[@danialarif4654]

0:28

[@ayaankeyden7107]

Thank you