The Babinski Sign, What It Means With Multiple Sclerosis

Learning what the Babinski Sign is for Multiple Sclerosis

Why Does My Doctor Scratch The Bottom Of My Foot During MS Appointment?

I was in my neurologist office the other day when the usual pin sticks on extremities, reflex test, and then another test called Babinski test was performed. These are done on every visit with my doctor checking for abnormalities. Having Multiple Sclerosis now for many years these are routine for me, but with each visit, depending on how I am doing, different results occur. The Babinski test on this visit was positive, which didn’t surprise me due to having increased weakness on my left side and active MS symptoms going on.

This test is when a blunt instrument is used, like the metal end of a percussion hammer, is rubbed on the bottom of your foot from heel to the toes. In children above of the age of 2 to adults, when this test is performed the reflex for a normal reading is the downward curve of the toes. For a positive sign to occur, the big toe turns upward with the remaining toes fanning out. This is seen in different conditions like ALS, (Amyotrophic Lateral Sclerosis), Meningitis, Brain tumor, Stroke, Spinal Cord Injury or tumor, and Multiple Sclerosis, (MS). An upward toe response can also be known as the Koch Sign, Babinski response, or just Babinski sign.

It was named after a French researcher named Joseph Babinski (1857-1932) who studied MS, tumors in the spinal cord, Post Traumatic Stress Disorder (PTSD), Syphilis, and other diseases. In newborns up to the age of two the toe going upward is normal, it isn’t until after that age that it is seen as abnormal and requires tests such as a CT scan, MRI, and spinal tap to test the fluid to check for diseases mentioned above. When the test is performed too hard against the bottom of the foot, it can provide a false positive. It is recommended that a percussion hammer not be used due to possible breaking of the skin which can cause an infection, so an orange stick or a  thumb nail used with moderate strength is suggested. The three different results that can occur from this test is the Flexor which is normal and toes point down, Indifferent where there is zero response, and the Extensor which is the positive upward pointing of big toe and fanning out of other toes. A normal response is usually seen while asleep or after long walks.

When it is positive, this means that a lesion from the upper motor neuron has caused damaged to the Corticospinal tract. This tract is the long nerve axon which starts in the brain, (cerebral cortex) travels down the brainstem, and down the spinal cord also known as the pyramidal tract. A positive sign can be temporary or permanent depending on the damage.

The next time that you are in your physician’s office pay attention to the results of this test. It could provide you with a clue as to how your MS is progressing.

MS Blogger and Multiple Sclerosis Activist shares her journey living with MS, tips for others living MS and her husband, Steve, offers his insight as a caregiver for MS.