The plantar reflex

Araújo, Rui; Firmino-Machado, João; Correia, P.; Leitão-Marques, Mariana; Carvalho, João Luís Nunes; Silva, Marta; Nogueira, A. R. de A.; Nunes, Carla

doi:10.1212/cpj.0000000000000155

Cited by 4 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One experienced spine surgeon (KO) performed the neurologic examinations to evaluate the finger flexion reflexes (i.e., Hoffmann's sign [22], Trömner's sign [30], and Wartenberg's sign [31]); patellar tendon reflex (PTR); Achilles tendon reflex (ATR); ankle clonus [38]; and the pathological reflexes (i.e., Babinski's sign [32] and Chaddock's sign [33]). The finger flexion reflex was considered positive when flexion of the thumb was observed.…”

Section: Objective Findingsmentioning

confidence: 99%

Epidemiological study of cervical cord compression and its clinical symptoms in community-dwelling residents

et al. 2021

View full text Add to dashboard Cite

Background Degenerative compressive myelopathy (DCM) is caused by cervical cord compression. The relationship between the magnitude and clinical findings of cervical cord compression has been described in the literature, but the details remain unclear. This study aimed to clarify the relationship between the magnitude and clinical symptoms of cervical cord compression in community-dwelling residents. Methods The present study included 532 subjects. The subjective symptoms and the objective findings of one board-certified spine surgeon were assessed. The subjective symptoms were upper extremity pain and numbness, clumsy hand, fall in the past 1 year, and subjective gait disturbance. The objective findings were: Hoffmann, Trömner, and Wartenberg signs; Babinski’s and Chaddock’s signs; hyperreflexia of the patellar tendon and Achilles tendon reflexes; ankle clonus; Romberg and modified Romberg tests; grip and release test; finger escape sign; and grip strength. Using midsagittal T2-weighted magnetic resonance imaging, the anterior–posterior (AP) diameters (mm) of the spinal cord at the C2 midvertebral body level (DC2) and at each intervertebral disc level from C2/3 to C7/T1 (DC2/3-C7/T1) were measured. The spinal cord compression ratio (R) for each intervertebral disc level was defined and calculated as DC2/3-C7/T1 divided by DC2. The lowest R (LR) along C2/3 to C7/T1 of each individual was divided into 3 grades by the tertile method. The relationship between LR and clinical symptoms was investigated by trend analysis. Results The prevalence of subjective gait disturbance increased significantly with the severity of spinal cord compression (p = 0.002812), whereas the other clinical symptoms were not significantly related with the severity of spinal cord compression. Conclusions The magnitude of cervical cord compression had no relationship with any of the neurologic findings. However, subjective gait disturbance might be a better indicator of the possibility of early stage cervical cord compression.

show abstract

Section: Objective Findingsmentioning

confidence: 99%

Epidemiological study of cervical cord compression and its clinical symptoms in community-dwelling residents

et al. 2021

View full text Add to dashboard Cite

show abstract

“…With over 30 surrogate or substitute signs for the original Babinski sign 4 , it has become a common rite of passage in some centers to test trainees on how many signs they can remember. Despite their widespread use as markers of corticospinal disease, their diagnostic yield remains and their sensitivity for detecting pyramidal tract dysfunction and inter observer agreement remains low 5 . Thus, regardless of the eponym remembered when eliciting the plantar response, it is paramount to interpret it in the patient's context and not in isolation.…”

mentioning

confidence: 99%

Another one that extends the toe: the Austregésilo-Esposel sign

Castillo‐Torres

Flores-Alfaro

Góngora‐Rivera

2021

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Finger tapping impairments are highly sensitive for evaluating upper motor neuron lesions

2017

View full text Add to dashboard Cite

BackgroundIdentifying highly sensitive and reliable neurological exam components are crucial in recognizing clinical deficiencies. This study aimed to investigate finger tapping performance differences between patients with CNS demyelinating lesions and healthy control subjects.MethodsTwenty-three patients with multiple sclerosis or clinically isolated syndrome with infratentorial and/or cervical cord lesions on MRI, and 12 healthy controls were videotaped while tapping the tip of the index finger against the tip and distal crease of the thumb using both the dominant and non-dominant hand. Videos were assessed independently by 10 evaluators (three MS neurologists, four neurology residents, three advanced practice providers). Sensitivity and inter-evaluator reliability of finger tapping interpretations were calculated.ResultsA total of 1400 evaluations (four videos per each of the 35 subjects evaluated by 10 independent providers) were obtained. Impairments in finger tapping against the distal thumb crease of the non-dominant hand, identified by neurologists, had the greatest sensitivity (84%, p < 0.001) for detecting impairment. Finger tapping against the thumb crease was more sensitive than the thumb tip across all categories of providers. The best inter-evaluator reliability was associated with neurologists’ evaluations for the thumb crease of the non-dominant hand (kappa = 0.83, p < 0.001).ConclusionsImpaired finger tapping against the distal thumb crease of the non-dominant hand was a more sensitive technique for detecting impairments related to CNS demyelinating lesions. Our findings highlight the importance of precise examinations of the non-dominant side where impaired fine motor control secondary to an upper motor injury might be detectable earlier than the dominant side.

show abstract

The plantar reflex

Cited by 4 publications

References 13 publications

Epidemiological study of cervical cord compression and its clinical symptoms in community-dwelling residents

Epidemiological study of cervical cord compression and its clinical symptoms in community-dwelling residents

Another one that extends the toe: the Austregésilo-Esposel sign

Finger tapping impairments are highly sensitive for evaluating upper motor neuron lesions

Contact Info

Product

Resources

About