Symptom (reflex) Babinsky. What is it in children from two sides, right, left, positive, negative, how to check

Many pathologies are characterized by severe symptoms. However, in their absence, the presence of a disease may be evidenced by human reflexes. This is especially important when the patient is too young to describe the symptoms in words.

Babinsky's symptom is one of the most important, albeit pathological reflexes. It is described as an abnormal response of the central nervous system to irritating mechanical stimuli. That is not only an indicator of the disruption of her work, but also the consequences of other equally serious diseases.

What is Babinsky's symptom?

The involuntary reflexes of a person, controlled by his nervous system, are the brain's reaction to various stimuli. The value of this kind of data for making a diagnosis is that a person cannot manage it on his own. It is not possible to conceal such a reaction intentionally or not.

Any qualified neurologist knows what Babinsky's symptom is. For people without medical education, it can be difficult to understand its meaning. It is necessary to have a general understanding of the work of the human central nervous system, its perception of external signals, methods of their processing and return.

Under the influence of external stimuli, nerve endings form impulses that are transmitted to the brain. Analyzing the information received from them, he issues response impulses. Simply put, commands for skeletal muscles with an algorithm for further actions.

Depending on the situation, this may be:

• twitching;
• redistribution of equilibrium;
• block for muscle activity;
• flexion;
• extension.

Babinsky's symptom is a reflex, which is a pathological reaction of the toes, accompanied by their extension. The peculiarity lies in the fact that normally, when acting on a certain zone of the foot, a command must be received to bend its muscles down. The above symptom has age-related exceptions due to insufficient development of the cerebral cortex.

After carrying out manipulations to check the reflex, the result can be positive or negative. In medical practice, there are cases of false-positive interpretation of the result, which were subsequently not confirmed by additional diagnostic methods.

Mechanism of occurrence

What is Babinsky's symptom can be understood by studying the mechanism of its occurrence. An impulse entering the brain with information about the presence of an irritant in the foot area is analyzed by the cells of the cerebral cortex.

In Betz pyramidal cells, a response, motor or inhibitory impulse is formed, which is transmitted along a descending path. As a result of this process, there is a contraction of the muscles of the foot, which speaks of a positive or negative result.

The pathway that ensures the delivery of a response signal to the muscles of the skeleton is called the pyramidal neural tract. When the impulse has passed the ascending pathway to the brain and descending along this pathway without obstruction, the toes bend downward towards the foot. This reaction to a stimulus is considered normal.

It is possible to talk about Babinsky's pathological symptom when the result is the opposite. Namely, the thumb is unbent, the rest are spread wide to the sides, forming a kind of fan in shape.

What does the one-sided and two-sided reflex say?

In medical practice, there are cases when a pathological reflex is observed on both feet of the patient. In an adult, this situation indicates the severity of the disease that led to this result. In most cases, these are infectious or inflammatory processes occurring in the spinal cord or brain, affecting its central motor neuron.

Below are a number of diseases in which the bilateral Babinsky symptom is often manifested:

• meningitis;

  

• spinal tuberculosis;
• chronic progressive diseases of the central nervous system;
• spinal paralysis;
• head trauma;
• increased intracranial pressure;
• damage to the pyramidal tract;
• rabies.

Early detection of the symptom plays an important role. This is due to the fact that many diseases have a high rate of development. The consequences of delay in the diagnosis and treatment of the disease lead to irreversible consequences for the patient's body.

For the completeness of the clinical picture, in addition to the Babinsky reaction itself, concomitant signs are taken into account, with the help of which it is possible to more accurately determine the lesion focus.

Concomitant signs of damage to the brain or spinal cord:

Sign	Spinal cord	Upper motor neuron
Reflex response	Fast and pronounced	Slow and tonic
Extension of the big toe	Long	Short-term
Paresis	Proximal	Distal
Superficial abdominal reflexes	Absent	Normal
Other signs	Pelvic disorders	Hyperreflexia, synkinesis

It is not possible to make a full diagnosis based on reflexes and signs alone. However, this is enough to determine the direction of further diagnosis and early detection of diseases.

The cause of the pathology

Certain cells in the brain are responsible for generating and sending impulses. They also control the inhibition of constant motor impulses of neurons in the anterior horns of the spinal cord.

It is thanks to the constant inhibitory impulse that pathological muscle contractions do not occur. Based on the mechanism of occurrence of Babinsky's symptom, it follows that the causes of pathology can be disturbances in the functioning of the central nervous system of a different nature:

• trauma;
• infections;
• congenital developmental anomalies;
• inflammatory processes;
• hemorrhage;
• tumors of a different nature;
• sclerotic changes;
• swelling of tissues.

Distinguish not only the nature of the lesion, but also the place of its occurrence. The focus of the disease can be located both in the brain itself and in the spinal fibers. This pathological reflex can be interpreted ambiguously when the patients are children, especially those who have not reached the age of two.

In newborns

Babinsky's symptom in newborns and children under 2 years old is not always a pathology. A positive reflex in this case is manifested for physiological reasons. Namely, the poor development of the cerebral cortex, its cells responsible for the formation and processing of impulses.

At this time, the central nervous system, including the pyramidal pathway, is just beginning to improve the system for transmitting impulses to the brain and back to the source of the stimulus.

Other children

In the process of growing up a child, all systems of his body develop and improve their work. In cases where the child is 2 years old or more, the appearance of the extensor reflex may indicate a violation. For a pediatric neurologist, the presence of this symptom will be the basis for regular examinations and monitoring the patient in dynamics.

On the one hand, each organism is unique, and the time required to debug all the processes in it can vary. On the other hand, the earlier a symptom is revealed, the more complete anamnesis a specialist can make. So, to perform additional diagnostics, to appoint a consultation with other narrow specialists, take measures to prevent the progression of the detected disease, prescribe the correct treatment.

In adults

Unlike children, in adults, Babinsky's symptom is always a pathology. If it is identified, a further set of measures will be aimed at diagnosing the cause and severity of the disease.

Causes of Babinsky's symptom in the brain and spinal cord:

Brain	Spinal cord
diseases of large vessels; edema, increased intracranial pressure; hemorrhage in the brain.	displacement of disks; compression; damage to the structure.

The pathological conditions listed in the table are far from the entire list. There are diseases that can develop in both the brain and the spinal cord.

Having a detrimental effect on their structure and functioning, for example:

• multiple sclerosis;
• tumor;
• cyst;
• trauma;
• infections;
• destruction of the membrane of neurons.

The manifestation of Babinsky's symptom on two feet may indicate a severe degree of the disease or the presence of several foci.

How to check your reflex at home?

Babinsky's symptom is one of the simple reflexes, which does not require sophisticated equipment or tools to test. That is why it is available to everyone at home.

The procedure algorithm is as follows:

1. The patient is positioned horizontally on a couch or bed, lying on his back. In this case, the muscles of the legs are relaxed, and the toes look up.
2. Holding the leg above the ankle joint with a non-sharp object (pen, pencil, toothpick with a cut sharp edge), draw strokes along the outer edge of the foot.
3. The direction of movement of the instrument starts from the heel to the ball of the foot with a twist towards the big toe.
4. The procedure is performed alternately on both legs. Pressing the selected tool should not cause pain.

An important point when checking the reflex is the integrity of the skin of the foot and the absence of injuries. In case of damage, the result may be incorrect.

Checking reflexes at home can be a signal to go to a medical facility. Do not forget that only an experienced neurologist, taking into account the totality of all symptoms and signs, is able to give an adequate assessment of the situation.

Diagnostics in a medical facility

Babinsky's syndrome is the first signal from the body about the need for examination by a neuropathologist. The method of conducting a reflex test at home and in a medical institution differs only in the presence of a qualified specialist.

Experience and knowledge that allow you to take into account the general condition of the patient, various accompanying signals of the human body and decipher them. Despite the fact that the reflex itself already indicates the presence of pathology, a specialist can make a full diagnosis only based on the results of a complete diagnosis.

One of the first methods is laboratory and may include the following list:

• general blood analysis;
• biochemical;
• immunological tests.

There is another laboratory test for diagnosing diseases with the Babinsky reflex. It differs from those listed above in the complexity of its implementation and more informational content. Lumbar or lumbar puncture allows you to examine the composition of the fluid from the spinal cord.

The fluid is taken by a neurologist, anesthesiologist in a medical institution. Sometimes the procedure is carried out for medicinal purposes. Removal of excess cerebrospinal fluid (cerebrospinal fluid), administration of drugs for neuroinfections and oncology.

Cerebral angiography is performed to study the state of the cerebral vessels, its structure, and possible changes. The essence of the procedure is to administer a contrast agent and further monitor its passage through the vessels of the studied area.

At the end of it, the patient receives several pictures and a video recording the results. Vertebral angiography is performed to examine the spinal column.

Diagnostics using magnetic resonance imaging and computed tomography will help to exclude such causes of Babinsky's symptom as:

• a tumor compressing nerve fibers;
• swelling of tissues as a result of injury;
• intracranial hematoma;
• other changes in the structure of human organs.

These methods are similar in informational value, however, tissues are more clearly reflected on MRI, and bone structures are more clearly reflected on CT results. The most suitable research method is selected by a specialist based on the medical history.

Positive result

Neuropathologists call a positive Babinsky symptom a reflex extension of the big toe, as well as fan-like dilution of the rest widely to the sides. Experts consider this response of the central nervous system in adult patients and children over two years of age to a stimulus to be a sign of disorders.

Negative result

Norm is considered a negative result when checking for Babinsky's reaction. That is, a reflex contraction of the skeletal muscles of the foot to the compression of the toes with streak irritation of the skin on its outer side.

False result

A false result or Babinsky's pseudo-reflex occurs with peripheral paresis of the flexor muscles of the toes with neuropathy and myopathy. This reaction is caused by a violation of the tibial nerve and, as a result, paralysis of the flexor muscles.

Often, a false result means the presence of a symptom in newborns, however, experts do not use a similar term in such cases. Since the presence of a positive reflex due to the age of the patient is considered the norm.

What to do if the Babinsky reflex is detected?

At the first symptoms and suspicions, a specialist consultation is necessary. The task of the neuropathologist is to conduct the most detailed examination of all reflexes of a person. By the combination of signs, you can understand which diagnostic methods need to be applied.

Indeed, most often in case of disorders in the brain and central nervous system as a whole, the speed of detection of the disease plays a role. This is important because many of them have a high rate of progression, and the consequences will be irreversible.

Therapy

Babinsky's symptom is one of the pathological reflexes in which the therapeutic effect of treatment can occur only if the root cause of its appearance is found.

Based on the results of a complete diagnosis, the doctor can make an accurate diagnosis. Treatment in this case will depend on the identified disease. The main direction of the fight is to prevent complete muscle paralysis due to the progression of the disease.

Depending on the disease, the following treatment methods can be used:

• immunotherapy (with mild degrees);
• medication (for mild and moderate degrees of severity);
• chemotherapy (malignant tumors);
• physical (massage, radio / UHF therapy, electrophoresis);
• surgical (with the ineffectiveness of conservative treatment).

The choice of method and treatment regimen is strictly individual for each patient. As a rule, in addition to the neuropathologist, other specialists of a narrow direction of medicine, depending on the disease, are involved in this process.

In most cases, even with effective treatment, the patient needs long-term rehabilitation to restore the lost functions. In severe diseases, the recovery process is impossible, the violations can be irreversible damage.

That is why preventive examinations by a neurologist and other specialists are necessary. Timely detected Babinsky's symptom for a person is the ability to prevent consequences destructive for the body.

Video about Babinsky's symptom

Symptom Babinsky and Oppenheim: