Pathological signs of Babinskiy. Babinski's syndrome on both sides in a child treatment

The congenital unconditioned Babinski reflex is determined from the moment the child is born to two years of age and has a positive symmetrical bilateral character. A pathological symptom (positive in children older than two years and in adults) indicates a violation of the connections between the brain and spinal cord. The positive reflex in adults is caused by pathology of the pyramidal tracts, is associated with neurological diseases, and often appears earlier. clinical manifestations underlying pathology. If the Babinski reflex is detected, an examination is necessary for further diagnostic search. The study revealed low awareness and a high frequency of detection of a positive Babinski reflex in students. Persons with positive symptom a consultation with a neurologist is recommended, especially for a student who has a hereditary predisposition to an autosomal recessive disease, Friedreich's ataxia.

Babinski reflex

neurological diseases

pyramid path.

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All organisms with nervous system have the ability to respond to irritation with stereotyped movements - reflexes. Allocate congenital (unconditioned) reflexes - hereditarily transmitted and present throughout the entire period of life, their loss indicates pathology; and acquired (conditioned) reflexes are individual, formed by the body during life. Conditions in which a reflex is detected that is not characteristic of a given period of a person’s life, or an increase or decrease in it is noted, belong to the field of activity of a neurologist.

Congenital pathological reflexes are of diagnostic value for doctors, indicating a violation of the connections between the brain and spinal cord. Usually rated extensor reflex Babinsky (RB), which is considered one of the earliest and most subtle manifestations of the upper central motor neuron syndrome. The neurologist J. Babinsky at the end of the 19th century described in detail the pathophysiological mechanisms of this phenomenon and the connection with the violation of the pyramidal pathways.

This is a skin reflex, in which, in response to dashed irritation of the outer edge of the sole, isolated extension (dorsiflexion) occurs. thumb feet or spreading other fingers ("fan sign"). It can be one- or two-sided. The mechanism of action of the reflex arc can be represented as a diagram. In response to dashed irritation of the skin of the outer edge of the plantar surface of the foot from top to bottom, tactile sensitivity receptors transmit a signal to tibial nerve(lat. nervus tibialis) → further to the sciatic nerve (lat. nervus ischiadicus) → excitation of sensory neurons of the posterior horns spinal cord(segments LIV, LV, SI). Now, the motor neurons of the anterior horns of the spinal cord transmit to the sciatic nerve (lat. nervus ischiadicus) → peroneal nerve (lat. nervus fibularis) (segments LIV, LV, SI) → transmits an impulse to the muscle that extends the big toe. Normally, slight irritation should not cause pain, may be manifested by a lack of reaction - the foot maintains a neutral position, or by involuntary flexion of the thumb or all five fingers.

In children from the moment of birth to one and a half or two years, RB should be positive symmetrical bilateral. The maturation of the cerebral cortex is accompanied by the disappearance of the symptom. In adults, positive RB may appear in the following conditions and diseases: amyotrophic lateral sclerosis or Charcot's disease; Friedreich's ataxia; multiple sclerosis and other diseases with demyelination; encephalopathy various genesis; tuberculosis of the bones and spine with involvement of the spinal cord; syringomyelia; disorders of cerebral circulation; pernicious anemia; rabies and other neurotropic infections; inflammatory diseases, injuries, tumor formations of the spinal cord and brain.

If RB is detected, for further diagnostic search, an examination is necessary: ​​general clinical tests, angiographic examination, CT or MRI of the head and spinal column, spinal puncture with analysis of cerebrospinal fluid and other tests to determine the more accurate cause of the reflex.

Thus, the presence of the Babinsky symptom (reflex) indicates damage to the entire system of the central motor neuron, when there is a violation of supraspinal control and a disorder in the function of inhibitory neurons. This leads to an imbalance of antagonistic spinal centers and the appearance of pathological extensor foot signs. Thus, during the Babinski reflex, the excitability of extensor motoneurons increases, followed by reciprocal inhibition of the flexor center (normally, a-cells of flexors have more low threshold excitations than extensors).

It is important for clinicians to determine the diagnostic value of RP to determine the level of upper motor neuron involvement. A bright, fast, fan-shaped reflex response with a possible prolonged extension of the thumb and a strong tonic tension of its extensor muscle and tendon, combined with proximal paresis, pelvic disorders and the absence of superficial abdominal reflexes, tells the neurologist about the pathological focus at the level of the spinal cord, Slow tonic reaction with causing RB in combination with predominantly distal paresis, hyperreflexia and synkinesis - refers the diagnostician to the cerebral level of the upper motor neuron lesion. Therefore, such a combination of components as a certain "motor pattern" in the induction of RP, the distribution of paresis and isolated symptoms in patients with lesions of the upper motor neuron can be useful for a differentiated approach to the diagnosis of the pathological focus.

The purpose of this study was to study the representation of the Babinsky reflex in students of the Perm State medical university them. Academician E.A. Wagner (PGMU) and Perm State National Research University (PGNIU).

Tasks. To study the literature on the Babinski reflex and its diagnostic significance. Conduct a survey. Analyze the received data.

Materials and methods

75 students of PSMU and PSNIU took part in the remotely conducted study at will. A survey was conducted according to specially designed original questionnaires, laid out in groups of universities in social network"In contact with". Participants in the study were asked to test for the detection of RB. The technique was proposed in the form of a text and was accompanied by schematic drawings. Additionally, video materials were offered demonstrating the technique for identifying a symptom. A comprehensive scoring questionnaire in the Google Form program allows you to quantify (in points) the presence of pathology, and also takes into account age, gender, awareness of the issue under discussion among respondents, neurological diseases and predisposition to them. From the total number of students, persons who answered the questions incorrectly were eliminated. Average age students in the study group (54 people) was 21±0.35 years, among them 40 girls and 14 boys.

The Babinski reflex, depending on its representation and severity, was assessed as follows: 1 - pronounced or extension of all toes, 2 - absent, 3 - difficult to answer. Another evaluation principle provided for the following characteristics: 1 - there is a unilateral reflex, 2 - there is a two-sided reflex, 3 - there is no reflex, 4 - it is difficult to answer. All data were entered into a table. Statistical data processing was carried out using the computer program STATISTICA 10.0. For data processing, parametric and nonparametric statistical methods were used using the Student's and Wilcoxon-Mann-Whitney tests, respectively. When comparing variational series, significant differences were taken into account (p<0,05).

Results and its discussion

Among the respondents, there are 3 times more women than men and 2.5 times more people over 20 years old (p<0,03). Половина участников исследования не имеет представления о РБ. Почти все, исключая 2-х человек, выразили желание узнать о нем. Среди студентов медицинского ВУЗа 36% ничего не знают про симптом, 2/3 из них - учащиеся 1 курса. Среди студентов ПГНИУ неинформированных о рефлексе ожидаемо больше - 80% (р<0,03).

A positive Babinski reflex was observed in 22.2% of the study participants. The symptom was equally common among students from both universities (p>0.05). No significant gender and age differences were found in the groups (p>0.05). Only girls revealed a positive symptom, half of them were over 20 years old. Among them there are 16% of PSMU students, and 60% of PSNIU students. In 11 people it was bilateral. Another 18% of students found it difficult to interpret the test results. The subjects did not note painful or unpleasant sensations during the test.

2 students of PSNIU and 9 students of the Medical University (20%) have neurological diseases or predisposing factors: concussion, dorsopathy, impaired coordination of movements, anemia. There is no RB in this group of respondents. 1 student has a genetic predisposition - Friedreich's ataxia and at the same time a positive bilateral RB is determined.

Interest in the problem was shown mainly by girls over the age of 20, receiving a medical education. Half of the respondents do not know about the Babinski reflex. Perhaps this is due to the fact that the study of the Babinski reflex and its diagnostic significance is not a frequently discussed and widely covered topic. Mostly senior students receiving special medical education were informed.

The high frequency of detection of positive RB in students of Perm State National Research University is probably due to the lack of medical skills, incorrect interpretation of the results.

A student with a genetic predisposing factor has not previously identified RP in herself. In the medical record, according to the girl, there is no information about the presence of the symptom. In our opinion, this may be due to the lack of her appeals to a neurologist. The student is recommended to be examined by a specialist in the near future.

Bibliographic link

A prerequisite for the successful survival of any living creature on earth is the complex structure and well-coordinated functioning of the central nervous system. However, under the influence of certain negative factors, a failure occurs in it. To determine it and select the appropriate treatment, a specialist examines a person with an assessment of his reflexes. One of them is Babinski's symptom, a pathological disorder in the pyramidal nerve tract that accompanies many neurological diseases. According to the degree of its severity, the doctor decides on the severity of the patient.

The structure of the central nervous system in humans involves a complex scheme of subordination of some structures - on the periphery, to others - the cerebral cortex and subcortical centers. To accomplish the task - the transmission of an electrical impulse, or command, the so-called nerve tracts are provided. One of the most important is the pyramidal path. On it, impulses move from the brain to the muscle groups of the skeleton.

The mechanism of control over movements in a person provides for the execution of not only voluntary contractions - on command, but also involuntary - unconscious, as well as a ban on motor activity. For example, in a situation where a sharp foreign object gets into the shoe, a pain signal immediately arrives at the cerebral cortex - but in order for the person not to fall, the leg muscles stop bending after the first involuntary contractions. The balance is not broken.

If damage to the pyramidal tract occurs, Babinski's symptom will be positive. This means that the inhibitory function of the motor nerve pathway has been lost. Such disorders are possible both on one side and on both sides at once - bilateral damage.

Main reasons:

• neuroinfections - inflammation of the nerve fiber of a bacterial or viral nature;
• vascular accidents - strokes;
• traumatic brain injury;
• autoimmune disorders - multiple sclerosis;
• neoplasms - benign / malignant tumors;
• intracranial hypertension.

To assess the value of the Babinski reflex is only possible for a specialized doctor - a neuropathologist. Indeed, in people's lives there are periods when a failure in the pyramidal tract is a sign of a nervous system that has not yet fully matured. In a number of situations, the symptom accompanies injury to the tendons of the extremities.

Features of manifestations in adults

If the Babinski reflex is detected in a person after reaching the age of 18, this indicates a pathological process in the central nervous system. Such a symptom cannot be a physiological norm.

Normally, when applying stroke-like movements along the sole of the lower limb, the toes must be bent. In some people, they can maintain a neutral position - the required reaction is absent. However, in a situation with a divergence in adult fingers to the sides, this is only a pathology. It requires clarification and differential diagnosis.

The pathological Babinski reflex is characterized by a combination with other symptoms - impaired cerebellar coordination, or muscle self-control over the limbs. People seek medical advice because of difficulties with movement, frequent injuries, paresis. On examination, they will have not only Babinsky's symptoms, but also others - in direct proportion to the cause of the disorder and the level of damage to the pyramidal tract.

Provoking factors for the Babinsky symptom can be:

• amyotrophic lateral sclerosis - motor neuron disease;
• a tumor in any area of ​​the spinal cord / brain;
• Friedreich's ataxia;
• toxic encephalopathy;
• hemorrhagic type of stroke;
• demyelization of the nerve fiber;
• consequences of meningitis;
• spinal injuries;
• tuberculosis of the meninges.

In the case of a neurological deficit - a symptom of motor neuron damage, the study of the symptom in adults requires an integrated approach. Delaying differential diagnosis means exposing a person to additional danger. As the disease progresses, the prognosis is poor.

Manifestations in children

The situation with the Babinski reflex in children is far from unambiguous - a symptom up to a certain age can be attributed to a variant of the immaturity of nervous structures. It will definitely be tested in babies who have just been born. Normally, it is positive, and on both sides. A negative result of the Babinsky study may indirectly indicate such pathologies of the nervous system as cerebral palsy or a congenital tumor.

As the connections between nerve cells and fibers strengthen, reflexes in newborns change - some of them weaken, while others strengthen. Up to two or three years, the system is constantly rebuilding and adapting to changes inside and outside the body.

Later, the manifestations of the Babinski reflex after 3-4 years should cause a natural alarm - by this age, the symptom gradually fades away. However, its presence may indicate either an underdevelopment of the nervous system, or a hidden pathology. It is often caused by trauma to the brain in children.

The prognosis will depend on the timing of the diagnosis - the detection of Babinsky's symptom, as well as the implementation of therapeutic measures with subsequent rehabilitation. The child's body is flexible and has great potential for recovery. Therefore, with appropriate therapy, the child will develop according to age.

Diagnostics

As a rule, a positive Babinsky test is the result of a special examination performed by a neurologist. After all, people themselves without a medical education may not be aware of the presence in their body of a failure of an impulse to skeletal muscles.

In order to clarify what was the root cause of the pathological symptom, it will be necessary to carry out a number of clarifying diagnostic procedures:

• various blood tests - general, biochemical, for autoimmune processes;
• angiography of cerebral vessels - previous headaches may indicate vascular lesions, for example, atherosclerosis with ischemic foci;
• magnetic resonance imaging - a change in the nerve impulse due to compression of the fiber by a tumor, traumatic tissue edema, intracranial hematoma;
• spinal puncture to take cerebrospinal fluid for examination - exclusion of an infectious lesion of the system;
• according to individual indications - a tissue biopsy, more precisely the motor roots of the spinal cord, for the purpose of differential diagnosis with cancer.

Only after a careful comparison of information and analysis of the results of the study, the neuropathologist will make an accurate diagnosis and select an effective therapy.

Bilateral Babinski's symptom

Evidence of severe damage to the nervous system, both in adults and in children, will be the appearance of Babinski's symptom on both sides. Most often, it is based on the course of the infectious process. For example, this may be a sign of meningitis - a severe pathology of the meninges as a result of bacterial damage.

While the pathological focus in the spinal cord often occurs due to tuberculosis of the bones with the transition to the meninges. As a result of a functional failure in the pyramidal tract, the motility of nerve endings will be impaired on both sides, and not only on the right, as, for example, with a direct blow to the back.

Spinal paralysis is another common cause of the Babinski reflex. If at first it appears on the left, the sign at the same time coincides with a feverish state. However, over time, the muscles will become paralyzed on both sides. They involuntarily contract and provoke a pronounced pain syndrome.

Less often, a severe course of anemia - a decrease in the concentration of hemoglobin in the bloodstream, also contributes to the development of a bilateral Babinsky symptom. Especially with the B12 deficient form of the disease. The symptom will not appear on only one side in such a situation. The final diagnosis will be established after laboratory and instrumental diagnostics.

Types of reflexes

Healthy people will have physiological and pathological reflexes from the moment they are born. They should only be assessed by a physician.

In the field of neurology, reflexes and symptoms, including Babinsky's, are usually divided into congenital - they are also unconditional, and acquired - developed over a number of years. Their loss or re-development can tell a specialist a lot about the state of the central nervous system.

So, in the absence of congenital reflexes, it is necessary to immediately conduct an in-depth diagnosis of the brain - often its anatomical underdevelopment is detected. If children's reflexes were suddenly detected in adults, it is necessary to exclude infectious, post-traumatic, oncological foci in the brain structures.

Whereas the loss of acquired reflexes is a frequent result of demyelization of nerve fibers, for example, in multiple sclerosis, Alzheimer's disease. With the definition of Babinsky's symptom, the doctor will begin a neurological examination of the patient. Subsequent diagnostic studies will allow you to put everything in its place and choose a treatment regimen.

The achievements of modern medicine make it possible to fight even with severe neurological diseases, the sign of which is the Babinski reflex, and to achieve positive results.

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Although this symptom is considered to be the most well-known neurological symptom, there is still controversy as to which reaction is normal and when abnormal reactions should be observed. The following considerations are only one possible explanation.

plantar reflex (PR)(so-called Babinski's symptom ) is a primitive reflex found in newborns. It consists in extension of the thumb in response to painful irritation of the foot. The movements of the remaining fingers are inconsistent and therefore have no clinical significance. PR disappears at ≈ 10 months (range: 6-12 months), probably under the influence of inhibitory control, as CNS myelination occurs. Then plantar flexion of the thumb becomes a normal reaction. The defeat of the upper motor neuron at any level of the pyramidal (corticospinal) tract from the motor strip to ≈L4 leads to the elimination of the inhibitory effect and "unmasks" the PR, causing extension of the thumb. With such damage to the upper motor neurons, there may also be an increase in flexion synergy, leading to simultaneous dorsiflexion of the foot (dorsiflexion), flexion of the knee and hip (the so-called triple flexion reaction).

neuroanatomy

The afferent knee of the reflex arc starts from the skin receptors related to the first sacral dermatome (S1) and runs proximally along the tibial nerve. Segments L4-S2 of the CM participate in the reflex arc. The efferent knee reflex is carried out via the peroneal nerve.

Etiology

Lesions that cause PR are not necessarily structural. They can be functional and therefore reversible. Possible causes of PR are given in Table. 3-11.

Tab. 3-11. Differential diagnosis for plantar reflex

* with lesions of the spinal cord, the PR may initially be absent during the period of spinal "shock"

Ways of calling PR and its variants

Optimal is the stimulation of the lateral edge of the plantar surface of the foot and the transverse arch in one movement lasting 5-6 seconds. Other modes of pain stimulation can also cause PR (even outside the S1 dermatome, although they do not normally cause finger flexion). Other methods of causing PR: Chaddok - irritation of the lateral surface of the foot (it is positive in 3% of cases when the usual irritation of the sole does not cause PR); Shaffer - squeeze the Achilles tendon; Oppenheim - hold the knuckles along the chin; Gordon - momentarily squeeze the lower part of the calf muscle; Binga - light tingling of the dorso-lateral surface of the foot; Gond or Stronsky - take the 4th or 5th finger down and outward, and then abruptly release it so that it returns to its original position.

Hoffmann's symptom

May reflect a similar lesion of the upper motor neuron for the upper extremities. It is caused by clicking on the distal phalanx of the middle finger. The pathological response consists in flexion of the thumb (to a slight degree, it can also be observed in the norm).

Greenberg. Neurosurgery

All multicellular organisms that have a nervous system are able to respond to various stimuli with certain stereotyped movements, which are called reflexes. This is the basis of the activity of the central nervous system. Everyone has reflexes, including newborn babies. The presence of reflexes and their strength depends on the state of the nervous system, which is why neuropathologists use them to make certain diagnoses.

What are reflexes

In a normal situation, all reflexes appear and disappear at their own time. They are divided into congenital (unconditional) and acquired (conditional). The first ones are always with us, their loss means illness. As for the second group, some of them are lost with age, others appear. If the presence of a reflex is not characteristic of a given period of a person’s life or there is an increase (weakening) of it, this is a pathology related to the field of activity of a neuropathologist.

It is important to be able to correctly evoke and evaluate reflexes, so this should be done by specialists who can distinguish physiology from pathology. Pathological signs in neurology always mean illness and occur when the pyramidal system (central motor neuron) is damaged.

Both unconditioned and conditioned reflexes can be pathological in nature. Acquired (conditioned) reflexes are considered pathological if they cause an inadequate response to the action of a simple stimulus. The pathological nature of congenital reflexes is said if they do not fit into the neurological status of a given age or are inappropriate from a biological point of view.

In the practice of neurologists, various unconditioned pathological reflexes are studied, which indicate damage to the connections between the brain and spinal cord. Most often, these are signs from the lower extremities. The response to the stimulus is manifested in the extension of the first finger (extensor reflexes) or the flexion of all toes (flexion group). The main pathological extensor reflex is the Babinski reflex.

What does the Babinski reflex mean?

It got its name after the French neuropathologist of Polish origin Joseph Babinski, who described this simple sign and its diagnostic value in determining the state of the human nervous system. No special equipment is required for this, only a hammer is needed, which is passed along the outer side of the sole from the bottom up, causing involuntary slow extension of the thumb, the other fingers fan out or remain motionless.

The Babinski reflex in children up to one and a half or two years old is considered a variant of the norm. Its presence must be checked in the maternity hospital; in healthy babies, it is always positive and symmetrical on both sides. A negative result in infants indicates various neurological disorders. This may be the first sign of cerebral palsy, as well as a symptom of a brain tumor, cerebrovascular disorders, etc. As the child grows older and the cerebral cortex matures, the reflex disappears. If it persists after three or four years of age, this indicates a pathology of the motor neuron.

A positive Babinski reflex in adults is always a pathology. Normally, when the sole is irritated, the toes should bend, some people may have a neutral position of the foot (no reaction), but if the toes diverge, this is a neurological pathology, and it can be both unilateral and bilateral. It is often combined with other disorders of the nervous system (impaired coordination, muscle control, etc.), so these patients have difficulty moving, are likely to be injured, and may need outside help. The appearance of such a symptom in adults indicates a violation of the relationship between different levels of the spinal cord and brain. The motor neuron stops receiving impulses, which causes this syndrome.

Why does the Babinski reflex appear in an adult

These can be various disorders, for example:

• motor neuron disease (named after the author - Charcot or amyotrophic lateral sclerosis) - severe degeneration of the nervous system, in which the motor neurons of the brain and spinal cord are affected, in the future - muscle atrophy and paralysis;
• neoplasms of the brain;
• hereditary nature of the disease (Friedreich's ataxia);
• consequences of traumatic head injuries;
• strokes;
• liver failure with the development of encephalopathy;
• chronic demyelinating diseases (such as multiple sclerosis), these diseases are characterized by transient detection of Babinskiy's sign;
• consequences of meningitis;
• malignant nature of anemia;
• viral infections (eg, rabies);
• spinal injuries;
• tumor formations in the spinal cord;
• tuberculosis of the bones and spine with involvement of the spinal cord;
• syringomyelia syndrome.

The reflex can be called from one or two sides. The presence of a unilateral reflex more often indicates the presence of diseases such as stroke, myelopathy, multiple sclerosis with damage to one hemisphere, etc. The bilateral Babinski reflex in adults is observed with diffuse pathology of brain structures, for example, with encephalopathy. The revealed reflex is usually quite persistently preserved, with the exception of disseminated encephalopathy (the sign either appears or disappears).

As a rule, the patients themselves are not aware that they have a positive Babinski reflex, it is detected by a neurologist. For this, the following studies are being carried out:

• clinical analyzes of peripheral blood;
• angiographic examination of the head;
• CT or MRI of the head and spine;
• spinal puncture with cerebrospinal fluid analysis;
• other tests according to indications to find out a more accurate cause of the pathological reflex.

After the examination, the neuropathologist prescribes the appropriate course of treatment. The volume of therapeutic measures depends on the identified cause of the appearance of an age-inappropriate reflex.

Thus, pathological Babinski's reflexes appear when the central motor neuron is damaged, which can later lead to the development of paralysis. Undoubtedly, the diagnostic value of this neurological sign is important, often preceding the identification of more serious symptoms that require long-term treatment.

Negative changes in the central nervous system are characterized by the presence of pathological symptoms. These symptoms include the Babinski reflex. This reflex is a symptom of a neurological nature, which is expressed in the fact that with a hard touch or impact on the foot, the thumb unbends, and all other fingers move apart in different directions. The reflex can be found on one leg, and on two. Babinsky's symptom is always diagnosed in children under two years of age, after an attack of epilepsy, stroke, with irreversible changes in the pyramidal pathway.

No special instruments are required to detect the Babinski reflex. For its diagnosis, only a neurological hammer is needed. The patient takes off his shoes and socks and, straightening up, lies down on the couch. The doctor runs the hammer along the sole from the heel to the toes. During the movement of the hammer, involuntary extension of the thumb occurs. At this time, the remaining fingers, like a fan, diverge in different directions. The procedure is necessarily carried out on two feet.

First you need to understand what the pyramidal nerve tract is. The term "pyramidal nerve tract" means a nerve pathway, the main function of which is the transmission of a nerve impulse responsible for the motor function of the body from the brain to the muscles of the skeleton. It is the longest nerve tract in the human body. The impulse begins to move from the cells of the cerebral cortex to the cortico-spinal region, falling into the anterior part (the so-called horns) of the spinal cord. Further, the impulse passes through the spinal cord through the motor nerve endings to the muscles of the skeleton, causing them to contract. This process leads to a contraction of the muscles of the lower extremities and back, allowing the person to move independently.

Pyramidal Betz cells not only send impulses that set the skeletal muscles in motion, but also stop these impulses in a timely manner, which does not allow the muscles to contract spontaneously, that is, they contract only when necessary. Also, this mechanism allows the muscles not to contract when exposed to various factors that cause pain on the skin. For example, if a person steps on a nail, then the brain blocks the contraction of the leg muscles at the first pain. This is necessary so that a person does not lose balance and does not fall, because the brain models the situation that there may be several such nails, and accordingly there will be more damage. If there is any damage to the pyramidal tract, then the inhibitory function is lost. With any mechanical impact on the soft tissues of the lower limb, uncontrolled pathological movements in the skeletal muscles are caused. This is the Babinski reflex.

Very often, during the examination, the doctor reveals a bilateral symptom (appears on both legs). This indicates damage to the pyramidal tract on both sides, that is, there are pathological changes in both hemispheres or along the entire length of the spinal cord. Pathological changes can be caused by such diseases of the central nervous system:

• diseases of the large cerebral vessels of the diffuse type;
• destruction of the myelin sheath of neurons in the brain or spinal cord;
• infections in the brain or spinal cord;
• a significant increase in pressure inside the skull with the presence of swelling of the cerebral cortex;
• bleeding in the brain as a result of rupture of a blood vessel;
• a severe head injury that led to a violation of the integrity of the brain.

In the case of the manifestation of the Babinski reflex, only on one side, a decrease in muscle tone of this part of the body is observed. The unilateral manifestation of the Babinski reflex occurs against the background of such diseases that are localized in one of the hemispheres of the brain:

• stroke;
• complex traumatic brain injury;
• infections;
• tumors (both benign and malignant);
• intracranial hematoma;
• cyst in the spine or brain.

The manifestation of the Babinski reflex depends on the age of the patient. It is not always the result of diseases of the brain or spinal cord, because during the period of development of the human body there are periods when the pyramidal tract reflex is an indicator of an unformed nervous system.

It is worth noting that before conducting a diagnosis to identify the Babinski reflex, the doctor should examine the lower limbs, because the pathology can manifest itself if there are even small cuts on them that send constant signals to the brain. This leads to a failure in the pyramidal tract. Babinski's symptom may be present in the presence of a high degree of tendon reflexes. This happens during tendon sprains or recent ruptures where they have not fully regained their functionality. Therefore, a complete diagnosis of the brain and spinal cord is very important for making the correct diagnosis.

Presses in the chest: causes and methods of treatment of the disease.

In infants, the positive Babinski reflex is the result of an incompletely formed nervous system. All the systems of a small person will be fully formed only after three years of life.

Every day, the nervous tissue will be strengthened, forming strong connections between the cerebral cortex and all body systems. The nervous system of a small child during the first two years of life is constantly rebuilt and adapts, so this pathology in newborns is the norm. Many parents, unknowingly and incorrectly informed by a doctor, are frightened and panicked. The reflex will gradually disappear.

In children older than three years, the detection of this symptom is not so unambiguous and should be alarming. The presence of a reflex indicates a pathology or underdevelopment of the spinal cord or brain. The earlier the pathology and its focus are detected, the more likely it is to be corrected by special treatment.

If Babinski's symptom is detected in adults during the examination, then this is considered a pathology, because this symptom should not appear in people over 16 years of age. In this case, it is necessary to undergo a complete examination of the spinal cord and brain in order to identify the focus of the disease, which leads to changes in the pyramidal tract, and to determine the cause of the pathological changes.

A symptom on both sides is most often observed in the presence of infectious and inflammatory processes in the brain (meningitis). The symptom begins to appear only after a series of ailments that are very similar to the flu.

Tuberculosis of the spinal cord also causes a bilateral Babinski reflex, which provokes a violation of the functionality of nerve endings, the body's motility. This leads to loss of sensation in the lower extremities, pain and temperature.

Diseases of the central nervous system of a chronic nature, which tend to progress, lead to the formation of voids in the spinal cord. This causes a bilateral reflex, which is complemented by muscle atrophy. Over time, the muscles become paralyzed. They spontaneously shrink. There is a lack of coordination of movements and severe pain.

Spinal paralysis causes Babinski's symptom. At first it appears only on one side, and then it becomes bilateral. The symptom begins to appear on the fifth day after the onset of fever, which is complemented by severe weakness, bouts of numbness of the lower extremities, muscle atrophy and their spontaneous contraction.

With head injuries, intracranial pressure increases, which leads to a violation of the passage of an impulse along the pyramidal tract. Babinsky's symptom manifests itself during the examination simultaneously with the loss of elasticity of the tendons and unauthorized muscle contractions. The patient complains of severe weakness and loss of coordination.

When a severe spinal cord injury is received at the primary stage, almost all reflexes of the body disappear. This is the result of a strong shock. After the shock has passed, the Babinski reflex can be diagnosed, which can be either a result of damage to the pyramidal tract or a violation of neurological function. A detailed diagnosis will determine the cause of the symptom.

A significant decrease in hemoglobin in the blood in the last stages of the disease leads to the appearance of a bilateral Babinsky symptom. It manifests itself as a result of vitamin B12 deficiency, which leads to gradual damage to the central nervous system.

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Pathology also occurs with such an infectious disease as rabies. It causes inflammation of the brain and damage to the pyramidal tract. The reflex occurs against the background of malaise, a significant increase in body temperature. After a while, muscle atrophy begins, and then paralysis follows.

The Babinski reflex is the most tested symptom in neurology, which allows you to identify pathological changes in the pyramidal tract.

Identification and treatment of the disease

The Babinski reflex is the first and very important sign all over the world that signals the doctor about the need for a complete examination of the patient. In most cases, before visiting a neurologist, a person may not suspect that he has a disease of the brain or spinal cord. The present malaise is attributed to stress, flu, overwork. To establish the lesion of the pyramidal tract, the following diagnostic methods are used:

• magnetic resonance imaging of the spinal cord and brain;
• spiral computed tomography of the spinal cord and brain;
• positron emission tomography;
• angiography of cerebral vessels;
• duplex brain scan;
• needle and stimulation electroneuromyography;
• taking cerebrospinal fluid for analysis;
• detailed clinical blood test.

Based on the results of the tests, the doctor makes a diagnosis, indicating the disease and the area of ​​\u200b\u200bdamage to the pyramidal tract. Further treatment is prescribed. In each individual case, the treatment regimen is developed according to an individual method. During the development of a treatment regimen, the main role is played not only by the disease that caused pathological changes, but also by the age of the patient. In some diseases (meningitis, rabies, severe injuries of the spine and brain), it is impossible to restore the pyramidal tract. A person loses the ability to move independently (muscle paralysis), there is a violation of the sensitivity of the skin, etc. In this case, the patient is assigned psychological and physical rehabilitation. At this time, the support of loved ones is very important.

In most cases, when a focus of damage to the brain or spinal cord is detected, modern medicines make it possible to restore the pyramidal tract, removing the reflex. However, the process of recovery and recovery can take a long time.

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Preventive measures

It is impossible to protect your body from all diseases (and especially from injuries of the brain and spinal cord). Preventive measures include proper nutrition, a healthy lifestyle and an annual visit to a neurologist. It is very important to check a child under three years of age several times a year to identify violations in the formation of the nervous system. Children under 16 are required to visit a neurologist annually.