Doze sinais de Babinski: História da Neurologia e Neurossemiologia / Babinski’s twelve signs: History of Neurology and Neurosemiology

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.

How many Babinski's signs are there? / Quantos sinais de Babinski existem?

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.

Babinski's signe de l'eventail: a turning point in the history of neurology

PURPOSE: The Babinski sign is a finding known since the start of the teachings of physical diagnosis by almost all medical students. This reflex is an incredibly helpful phenomenon that enables physicians to distinguish between central and the peripheral nervous system diseases right at the bedside. Yet, most students as well as physicians remain oblivious to the remarkable history behind the Babinski sign and what it means to evolutional history of the modern neurological exam. We intend to study the birth of the "signe de l'eventail" (the fanning sign) and how it transformed medical diagnosis as we practice it today. METHODS: An extensive search was conducted through the Internet to identify historical documents referring to Babinski and other physicians who also observed the phenomenon as early as the 17th and 18th century. We also conducted a search through medical journals that examined the Babinski sign and its history. RESULTS: The Babinski reflex had been observed much earlier than 1896, when Babinski referred to his finding for the first time. The reflex had been reported in the literature as far back as 1784 and afterwards reobserved several times before Babinski. However, it was Babinski who first offered an interpretation of the reflex and suggested that it was related to an organic disruption in the central nervous system. By identifying the sign, Babinski separated himself from Charcot in the sense of creating a new tradition in neurology where the findings in a neurological exam were of far more importance than just a plain history as his mentor had relied upon. CONCLUSIONS: Babinski was not only responsible for suggesting the significance of such sign, but also transformed the role that physical diagnosis plays in modern medicine, where physical examination is key in revealing underlying pathology.

The Babinski sign--a critical review.

In 1896, Josph Babinski, a French neurologist, first described the best known neurologic eponym--"the Babinski sign". This sign is characterised by dorsiflexion of the big toe, by recruitment of the extensor hallucis longus muscle, on stimulating the sole of the foot. He himself emphasised from the outset the intimate relationship between this sign and the shortening movement in other leg muscles, which forms the flexion synergy of the lower limb. The Babinski sign is not a new reflex, rather it is released as a result of breakdown of the harmonious integration of the flexion and extension component of the normal defence reflex mechanism, due to pyramidal tract dysfunction. A pathological Babinski sign should be clearly distinguished from upgoing toes that may not always be a part of the flexion synergy. This article reviews the Babinski sign in detail, focusing on the historical perspectives, role of pyramidal tract dysfunction, art of elicitation and interpretation. The significance of assessing this phenomenon in the entire leg and the clinical clues that will help to dispel the myths regarding the Babinski sign has been emphasized.

Babinski y su signo / Babinski and his sign

Hace 90 anos el 22 de febrero de 1896, Joseph Felix Babinski a la edad de 39 anos describio por primera vez en un breve pero historico informe de solamente 28 lineas, dirigido a la Sociedad de Biologia de Paris, el reflejo de la dorsiflexion del artejo mayor a la estimulacion de la planta del pie. Su trabajo se llamo "El reflejo cutaneo plantar en ciertas enfermedades organicas del sistema nervioso central". Ningun otro signo de la neurologia ha tenido y continua teniendo la importancia y trascendenica del signo de Babinski; su sola simplicidad, su importancia clinica y sus implicaciones fisiologicas asi lo demuestran. Sinembargo el reflejo de Babinski no fue reconocido inmediatamente, ni tampoco se le dio la importancia que hoy tiene en todo el mundo. Babinski tuvo que publicar dos informes mas para elucidar el fenomeno; uno de ellos en la Semaine Medicale de 1898 y decia que "este signo indica la presencia de un trastorno del sistema piramidal, aunque no indica la severidad, a veces puede ser el unico signo que indica tal anormalidad". Muchos han sido los neurologos que han descrito pequenas variaciones del signo de Babinski y que han recibido el nombre de sucedaneos o equivalentes del Babinski; pero todos ellos son solo modificaciones pequenas para pasar a la posteridad, tales como el Oppenheim, Schaefer, Gordon, Gonda, etc.