ABSTRACT
【Objective】 To explore the factors affecting Babinski sign in amyotrophic lateral sclerosis (ALS). 【Methods】 We enrolled 262 patients diagnosed with ALS with adequate data in Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University from 2015 to 2020. The relationship between the clinical characteristics of patients with positive and negative Babinski sign was analyzed for both sides, respectively. Furthermore, for patients with left or right lower limb weakness complaint, the relationship between Babinski sign and the lower limb involvement characteristics was analyzed. 【Results】 Positive Babinski sign was positively correlated with higher diagnostic category (left correlation coefficient 0.297, P<0.001; right correlation coefficient 0.292, P<0.001). Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score was lower in patients with positive Babinski sign (left P=0.001, right P=0.001); the proportion of complaints of ipsilateral lower limb weakness was higher (left P=0.008, right P=0.038); the positive rate of ipsilateral upper limb Hoffmann sign was higher (left P=0.004, right P=0.002). In patients with complaints of lower limb weakness, positive Babinski sign was positively correlated with better foot dorsiflexor muscle strength (left correlation coefficient 0.207, P=0.021; right correlation coefficient 0.264, P=0.003), and the proportion of ipsilateral tibialis anterior atrophy was lower in positive Babinski sign group (left P<0.001, right P=0.008); the ratio of ipsilateral common peroneal nerve compound muscle action potential (CMAP)/tibial nerve CMAP was different in positive Babinski sign and negative groups (left P=0.008, right P=0.015), which were positively correlated (left correlation coefficient 0.246, P=0.007; right correlation coefficient 0.223, P=0.015). 【Conclusion】 Patients with positive Babinski sign usually have a higher diagnostic category and more extensive clinical involvement. In ALS patients with complaints of lower limb weakness, Babinski sign is more likely to be elicited when the degree of weakness and atrophy of the anterior calf muscles is relatively low.
ABSTRACT
ABSTRACT Faustino Monteiro Esposel was a renowned neurologist from Rio de Janeiro, born on October 24, 1888. Together with his mentor, Professor Antônio Austregésilo Rodrigues Lima - the founder of modern Brazilian Neurology -, Professor Esposel described one of the rival signs of the Babinski sign, known as the Austregésilo-Esposel sign, in a study published in the renowned journal L'Encéphale in 1912. This article aims to summarize the life story of this illustrious neurologist as well as to highlight his achievements "beyond medicine".
RESUMO Faustino Monteiro Esposel foi um renomado neurologista do Rio de Janeiro, nascido em 24 de outubro de 1888. Junto de seu mentor, o Professor Antônio Austregésilo Rodrigues Lima, considerado o pai da Neurologia brasileira moderna, descreveu um dos sinais sucedâneos do sinal de Babinski, conhecido como sinal de Austregésilo-Esposel, publicado no renomado periódico L'Encéphale em 1912. Este artigo tem como objetivo trazer a história deste ilustre neurologista, destacando também seus feitos "além da medicina".
Subject(s)
History, 20th Century , Football , Neurology , Spiritualism , Brazil , NeurologistsABSTRACT
ABSTRACT Recognizing the semiologic importance of the second, and most famous, sign described by Joseph Babinski - the extension of the hallux after stimulation of the plantar region in order to differentiate organic from pithiatic paralysis- several authors have tried to find a comparable signal in the hand. After 122 years, no one has succeeded.
RESUMO Reconhecida a importância semiológica do segundo e mais famoso sinal descrito por Joseph Babinski - a extensão do hálux após estimulo plantar visando diferenciar a paralisia orgânica da pitiática - diversos autores vêm tentando encontrar um sinal equiparável na mão. Após 122 anos ninguém conseguiu obter sucesso.
Subject(s)
Humans , History, 19th Century , History, 20th Century , Reflex, Babinski , Movement Disorders/history , France , History , Movement Disorders/diagnosisABSTRACT
Marcel Proust was one of the greatest French writers of all times. Since early in his life, Proust was interested in arts and particularly literature. He also demonstrated a great knowledge of medicine, particularly neurology. His father was a doctor, and contributed to neurology through studies on aphasia, stroke, hysteria, and neurasthenia. During his childhood, Proust had the first asthma attack, initially considered a manifestation of neurasthenia. Regarding his illness, Proust was in touch with several renowned neurologists, such as Brissaud, Babinski and Sollier, and other disciples of Charcot. Proust spent the last three years of his life mostly confined to his bedroom since his health had badly deteriorated. In one moment, Babinski was called, examined Proust and after leaving his bedroom, announced to his brother that Proust was practically dead. Few hours later, Proust developed vomica and died.
Marcel Proust foi um dos maiores escritores franceses de todos os tempos. Desde jovem, Proust era interessado em artes e especialmente literatura. Ele também demonstrava um grande conhecimento sobre medicina, especialmente neurologia. Seu pai era um médico, e contribuiu para a neurologia através de estudos sobre a afasia, acidente vascular cerebral, histeria, neurastenia. Durante sua infância, Proust teve o primeiro ataque de asma, inicialmente considerado uma manifestação da neurastenia. Devido à sua doença, Proust estava frequentemente em contato com vários neurologistas renomados, tais como Brissaud, Babinski e Sollier, entre outros discípulos de Charcot. Proust passou a maior parte do tempo nos últimos três anos da sua vida confinado em seu quarto, após deterioração da sua saúde. Em um determinado momento, Babinski foi chamado, examinou Proust e depois de sair de seu quarto, anunciou a seu irmão que Proust estava praticamente morto. Poucas horas depois, Proust desenvolveu vômica e faleceu.
Subject(s)
History, 19th Century , History, 20th Century , Neurology/history , France , Medicine in Literature , Mental Disorders/history , Nervous System Diseases/historyABSTRACT
The main objective of this paper is to present the importance of hysteria on Babinski's oeuvre, and the conceptions of pithiatism from Babinski until the one of conversion disorder. Babinski gave a mental basis for hysteria in the place of Charcot's encephalopatic one, and several important semiotic tools to differentiate organic from hysterical manifestations based on studies from 1893-1917/8. His teachings were spread worldwide, and in Brazil they were also appreciated in the work on hysteria by Antonio Austregesilo, the first Brazilian neurology chairman. The neurobiological basis of hysteria conceived by Charcot is nowadays reappraised, and Babinski's neurosemiological contribution is everlasting. The patients believed to be hysterical, and the two outstanding neurologists, Charcot and Babinski, gave support for the development of the modern neurology.
O objetivo principal deste trabalho é apresentar a importância da histeria na obra de Babinski e a concepção de pitiatismo de Babinski até a de transtorno de conversão. Babinski deu uma base mental para histeria no lugar da encefalopática de Charcot, e várias ferramentas semiológicas importantes para diferenciar manifestações orgânicas de histéricas, com base em estudos de 1893-1917/8. Seus ensinamentos foram disseminados em todo o mundo, e no Brasil eles também foram apreciados no trabalho sobre a histeria por Antonio Austregésilo, o primeiro catedrático da neurologia brasileira. A base neurobiológica da histeria concebida por Charcot é reavaliada hoje em dia, e a contribuição neurosemiológica de Babinski é perene. Os pacientes considerados histéricos e os dois grandes neurologistas, Charcot e Babinski, deram suporte para o desenvolvimento da neurologia moderna.
Subject(s)
History, 19th Century , History, 20th Century , Conversion Disorder/history , Hysteria/history , Brazil , Conversion Disorder/physiopathology , Hysteria/physiopathology , Medical Illustration , Neurology/historyABSTRACT
Several assumptions about the function of the cerebellum and semiotic signs have been described over the centuries. Among the long list of famous researchers who have provided a strong contribution and who have left their names on the highway of cerebellar research, Joseph Babinski appears as a prominent name. The description of various forms of cerebellar symptomatology was a major part of Babinski's work, and clinical terms that he introduced, namely hypermetry , diadochokinesia , and asynergy , remain part of contemporary clinical vocabulary. Babinski studied cerebellar signs in many patients and was able to conduct longitudinal studies that permitted him to understand the evolution of cerebellar dysfunction. Babinski contributions to cerebellar symptomatology continue to influence the most modern theories, including functional and neuropathological studies.
Diversas teorias sobre a função do cerebelo e a semiologia dos sinais cerebelares têm sido descritas ao longo dos séculos. Dentre a longa lista de pesquisadores renomados que apresentaram importantes contribuições nesse assunto e que deixaram seus nomes na história, Joseph Babinski aparece com destaque. A descrição dos mais variados sintomas e sinais cerebelares foi peça importante do trabalho de Babinski e algumas nomenclaturas introduzidas por ele, tais como hipermetria , disdiadococinesia e assinergia , continuam a fazer parte do vocabulário contemporâneo. Babinski estudou os sinais cerebelares em muitos pacientes e foi capaz de realizar pesquisas que lhe permitiram compreender a disfunção cerebelar. As contribuições de Babinski para a caracterizar a sintomatologia cerebelar continuam a influenciar as teorias mais modernas, a despeito de estudos funcionais e neuropatológicos.
Subject(s)
History, 19th Century , History, 20th Century , Neurology/history , FranceABSTRACT
Objective The aim of this study was to validate a simple and reproducible method for assessing gait deviation on the Babinski-Weill test in a representative sample of healthy Brazilians. Methods Gait deviations were measured in 75 individuals (median=30 years, 41 women) for forward, backwards, and Babinski-Weill steps. The test entailed blindfolded individuals walking 10 paces at a frequency of 1 Hz with deviations subsequently measured by a protractor. Results Mean gait deviation forward was 0.53° with standard deviation (SD)=4.22 and backwards was 2.14° with SD=4.29. No significant difference in deviation was detected between genders (t test p=0.40 forward and p=0.77 backwards) or for age (ANOVA, p=0.33 forward and p=0.63 backwards). On the Babinski-Weill test, mean gait deviation was 5.26°; SD=16.32 in women and -3.11°; SD=12.41 in men, with no significant difference between genders (t test, p=0.056). Discussion Defining normative gait patterns helps distinguish pathological states. .
Objetivo O objetivo deste trabalho foi validar para uso no Brasil um método simples e reprodutível para avaliação do desvio no teste da marcha de Babinski-Weill. Métodos As medidas de desvio da marcha foram realizadas em 75 indivíduos (mediana=30 anos, 41 mulheres) na marcha para frente, para trás e no teste da marcha Babinski-Weill. Durante os testes, indivíduos com olhos vendados andavam 10 passos na freqüência de 1 Hz, sendo os desvios mensurados com transferidor. Resultados O desvio para frente teve média de 0,53° com desvio padrão (DP)=4,22 e para trás 2,14° com DP=4,29. Não houve diferença nos desvios entre os gêneros (teste t p=0,40 frente e p=0,77 trás) e entre as idades (ANOVA, p=0,33 frente e p=0,63 trás). No teste da marcha de Babinski-Weill as mulheres desviaram em média 5,26°; DP=16,32 e os homens -3,11°; DP=12,41, sem diferença entre os gêneros (teste t, p=0,056). Discussão O estabelecimento de padrões de normalidade possibilita a identificação de estados patológicos. .
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Gait/physiology , Vestibular Diseases/diagnosis , Vestibule, Labyrinth/physiology , Age Distribution , Analysis of Variance , Brazil , Neurology/methods , Reference Values , Reproducibility of Results , Sex DistributionABSTRACT
There is controversy in the neurological literature about where Joseph Babinski was born, including a myth propounded by various important authors that he was born in Lima, Peru. However, according to the most consistent biographical data, he was in fact born in Paris, France, and became a medical celebrity there and in Poland as well as around the world.
Existe uma controvérsia na literatura neurológica acerca do local de nascimento de Joseph Babinski, incluindo a lenda nutrida por vários autores de importância, de que ele teria nascido em Lima no Peru. Contudo, os dados biográficos mais consistentes definem que ele nasceu de fato, na cidade de Paris, França, tornando-se uma celebridade da medicina francesa, polonesa e mundial.
Subject(s)
History, 19th Century , History, 20th Century , Neurology/history , ParisABSTRACT
Este artigo tem como finalidade contar um pouco da história daquele que é considerado o pai de semiologia neurológica, e relembrar doze dosseus sinais, a maioria dos quais voltados para a diferenciação entre as doenças orgânicas e conversivas.
This article aims to tell a small story of who is considered the ?father of neurological examination?, and remember twelve of his signs, most of which focused on the differentiation between organic diseases and hysteria.
Subject(s)
Neurology/history , Reflex, Babinski/diagnosis , Reflex, Babinski/history , FranceABSTRACT
In addition to the famous sign described by Joseph Babinski, which is also known as Babinski's reflex, there are references in the literature to various other signs described by this famous disciple of J-M Charcot. This article reviews all the neurological signs described by Babinski.
Além do famoso sinal descrito por Joseph Babinski, também definido como reflexo de Babinski, existem referências na literatura mundial de vários outros sinais descritos pelo famoso discípulo de J-M Charcot. Este artigo apresenta uma revisão de todos os sinais neurológicos descritos pelo professor Babinski.
Subject(s)
History, 19th Century , History, 20th Century , Neurology/history , Reflex, Babinski/history , France , PolandABSTRACT
Tropical spastic paraparesis (TSP) may or may not be associated to HTLV-I antibodies and is usually characterized by clinical and pathological spinal cord abnormalities at thoracic levels. We present here five Brazilian patients who had typical chronic idiopatic spastic paraparesis; two of them were HTLV-I seropositive (HAM) and three HTLV-I seronegative (TSP) - associated-myelopathy. Three out of these five patients also displayed clinical supraspinal involvement, indeed, platysma muscle hypotrophy or atrophy (the Babinski plus sign). These findings support the view that clinical involvement in HAM and TSP is wider than the spinal cord abnormalities usually considered. Possible non-infectious co-factors (e.g., mycotoxins) may be involved in disease pathogenesis in a multistep process of viruses, toxins and environment which may account for serological differences found in this group of patients.
La paraparesia espástica tropical (PET), puede o no estar asociada con anticuerpos contra el HTLV-I y se caracteriza, usualmente, por alteraciones clínicas y patológicas a nivel de region dorso-lumbar de la medula espinal. Presentamos cinco pacientes brasileros, quienes tuvieron hallazgos típicos de paraparesia espástica crónica idiopática; dos de ellos tuvieron (HAM) y tres no tuvieron (TSP) anticuerpos, en el suero, contra el HTLV-I. En tres pacientes se encontró hipotrofia o atrofia del músculo platisma (signo de Babinski plus), demostrando que el compromiso clínico en pacientes con HAM y TSP se extiende más allá de la médula espinal torácica. Cofactores (por ejemplo, micotoxinas) podrían estar involucrados en la patogénesis de esta enfermedad, en una interacción compleja de virus, toxinas y medio ambiente, lo cual explicaría las diferencias serológicas encontradas en este grupo de pacientes.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Paraparesis, Spastic/complications , Paraparesis, Tropical Spastic/complications , Reflex, Babinski/etiology , Chronic Disease , HTLV-I Antibodies/blood , Human T-lymphotropic virus 1/immunology , Paraparesis, Spastic/diagnosis , Paraparesis, Tropical Spastic/diagnosisABSTRACT
La evaluación semiológica apropiada es uno de los aspectos más importantes para realizar un adecuado diagnóstico neurológico. Presentamos una paciente colombiana de 60 años de edad, quien padeció un infarto de la arteria cerebral media izquierda, originándole hemiplejía derecha, afasia motora, parálisis facial "central" derecha y atrofia del músculo platisma derecho. Este último hallazgo, originalmente descrito por Joseph Babinski, el cual es el verdadero signo de Babinski, no fue identificado sino hasta dos años y siete meses después de haberse presentado el ictus, aunque había sido evaluada, previamente, por diferentes especialistas en ciencias neurológicas. La no identificación de signos como el mencionado aquí lleva, en ocasiones, a realizar diagnósticos erróneos o incompletos afectando no sólo la localización apropiada de las lesiones sino, también, las eventuales medidas que se deben tomar en la neurorrehabilitación de estos pacientes.
Neurological signs and symptoms are very important to establish a correct neurological diagnosis. We present here a Colombian female patient, 60 yearsold, who had ischaemic stroke in the left cerebral media artery. It produced right hemiplegia, motor aphasia, "central" facial palsy and atrophy of right platysma muscle. This latter finding, described originally by Joseph Babinski as "The Babinski Sign" was observed only two years and seven months after the ictus even when she had, previously, been evaluated by several neurologists. The underdiagnosis of clinical signs like the one described here may lead to erroneous diagnosis that will, ultimately, affect neurorehabilitation measures.
Subject(s)
Humans , Female , Middle Aged , Hemiplegia/diagnosis , Reflex, Babinski/diagnosis , Diagnostic Errors , Facial Paralysis/diagnosis , Hemiplegia/etiology , Stroke/complicationsABSTRACT
@#Objective To study the factors which influence persistence time of pathologic reflexes and the most sensitive locus that eliciting them.Methods106 patients with first pyramidal tract injured were elicited Babinski sign once a day.The time and locus of hand-motion of examiner,the time and angle of hallux-dorsiflexion,the muscle strength of the patients were recorded.Results and ConclusionThe lower the muscle strength be,the longer the hallux-dorsiflexion persist,the larger the angle of hallux-dorsiflexion be,the nearer the sensitive locus to heel.
ABSTRACT
No abstract available.
Subject(s)
Guillain-Barre Syndrome , Ophthalmoplegia , Reflex, BabinskiABSTRACT
PURPOSE: Extensor toe signs are neurologic abnormal finding in upper motor neuron impairment, such as spastic diplegia in cerebral palsy. Though classic Babinski sign is widely used, many other methods elicit extensor toe signs are used as substitutes. However, these methods are not tried whether they are clinically valuable or not. So, we carried out these methods to spastic cerebral palsy patients, compared the sensitivities of these extensor toe sign tests and estimated their clinical value. METHODS: From April, 2000 to August, 2001, thirty patients who had been diagnosed spastic cerebral palsy at Chungnam National University Hospital were tested for extensor toe signs at restful supine position. The sensitivity of every extensor toe sign was compared with each other. RESULTS: The sensitivity of Babinski sign is 76%, Gonda-Allen sign 86%, Allen- Cleckley sign 63%, Chaddock sign 63%, Oppenheim sign 50%, Gordon sign 22% and the others less than twenty percent. Although the sensitivity of Gonda-Allen sign is higher than Babinski sign, it is not statistically significant. But these two methods are superior than the others. CONCLUSION: In patients having upper motor neuron impairments, Gonda-Allen sign and classical Babinski sign are more useful and more sensitive than the other tests, which elicit of extensor toe signs.
Subject(s)
Child , Humans , Cerebral Palsy , Motor Neurons , Reflex, Babinski , Supine Position , ToesABSTRACT
When recovery of specific reflexes after acute spinal cord injury are delayed or absent, we should consider an acute local complication or other factors that influence reflex function. We observed three spinal cord injury cases with a long-standing delayed plantar reflex and no evolution of Babinski sign despite enough recovery time had passed for the flexor spasm and all deep tendon reflexes of the lower extremities. In these cases we confirmed common peroneal nerve neuropathy at the fibular head by the nerve conduction study and electromyography. Long-standing delayed plantar reflex without evolution of Babinski sign, beyond expected recovery period, would be considered as a sign of local complication such as common peroneal nerve injury.