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Types of Babinski sign

The plantar reflex (PR) is one of the most useful  reflex in the body;. It is basically a polysynaptic superficial reflex, designed to withdraw the stimulated part, i.e., the foot from a potentially dangerous stimulus. Joseph Babinski, a French neurologist, first differentiated between a normal and a pathologic plantar response and described the Babinski sign in 1896
The Babinski’s sign 
It is seen  in patients with pyramidal tract dysfunction and is characterised by a dorsiflexion or extension of the great toe with or without fanning or abduction of the other toes. The fully developed response is characterised  by

  • Dorsiflexion of the ankle 
  • Flexion of the hip   Knee joint 
  • Slight abduction of the thigh, leading to a withdrawal of the leg on plantar stimulation.

1.True Babinski sign 
 It includes all the components of the fully developed extensor plantar response.link
2.Minimal Babinski sign 
 It is characterised by contraction of the hamstring muscles and the tensor fasciae latae which can   be detected by palpation of the thigh.
 3.Exaggerated Babinski sign :
 It can either be in the form of 'flexor spasm' or 'extensor spasm', depending upon the muscles i.e. whether flexors or extensors, have excess of tone.
 Flexor spasms can occur in the following conditions

  •  Spinal cord disease
  •  Bilateral upper motor neuron lesion at a supraspinal level
  •  Multiple sclerosis
  •  Subacute combined degeneration of the cord

Flexor spasms can occur in patients with bilateral UMN lesion at the supraspinal or spinal cord level. Extensor spasms can occur in patients with bilateral corticospinal tract lesion but preserved posterior column function.
4.Spontaneous Babinski sign 
This is seen in infants and children following manipulation of the foot. It is seen in patients with extensive pyramidal tract lesions. Passive flexion of the hip and knee or passive extension of the knee may produce a positive Babinski sign in adults
5. Pseudo Babinski sign 
6.Crossed extensor response/bilateral Babinski sign
This is seen in cases with bilateral cerebral lesions
Unilateral stimulation will  bilateral  Babinski in patients with bilateral cerebral disease and spinal cord disease.r spinal cord disease.
7.Tonic Babinski reflex
It is characterised by a slow prolonged contraction of the toe extensors. observed with combined frontal lobe lesions and extrapyramidal involvement.
This is  seen in frontal lobe lesions and extrapyramidal involvement.
8. Inversion of plantar reflex :
If the short flexors of the toe are paralysed or flexor tendons are severed accidentally, an extensor response may be observed