Barraquer-Bordas L
Service de Neurologie, Hôpital de la Santa Creu i Sant Pau, Barcelona, Catalogne, Espagne.
Rev Neurol (Paris). 1998 Jan;154(1):22-7.
One hundred years after its description, the Babinski sign remains a faithful and precise indicator of dysfunction in the pyramidal tract. Unlike a normal plantar reflex, which is a local reflex (S1), the Babinski sign is an integral part, though with its own specificity and thus value, of the defense reflectivity of the lower limbs. It should be triggered, preferably in the lateral region of the foot, by a non-painful stimulation. The characteristic response is a dorsal flexion of the greater toe by recruitment of the extensor hallucis. The pathological response is related to a dysfunction involving a precise fraction of the pyramidal tract (van Gijn. 1996), responsible for a monosynaptic stimulation of the extensor hallucis motor neurons, but also, via interneurons, for inhibition of the extensor hallucis. Its relationship with defense reflexes is certain (Walshe, etc.) put quite complex. We refer here to the "fanning" sign or Babinski "equivalents", plantar areflexia, peripheral "pseudo-Babinski", responses obtained by stimulating the plantar aspect of the foot in the newborn, and to global hyperflexion. We also discuss the role of the Lundberf dorsal reticulospinal tract.
在被描述后的一百年里,巴宾斯基征仍然是锥体束功能障碍的可靠且精确的指标。与正常的足底反射(一种局部反射,S1)不同,巴宾斯基征是下肢防御反射的一个组成部分,尽管有其自身的特异性及相应价值。它最好通过在足部外侧区域进行无痛刺激来引发。特征性反应是通过拇长伸肌的募集导致大脚趾背屈。病理反应与锥体束特定部分的功能障碍有关(范·吉恩,1996年),该部分负责对拇长伸肌运动神经元进行单突触刺激,但也通过中间神经元对拇长伸肌产生抑制作用。它与防御反射的关系是确定的(沃尔什等人),但相当复杂。这里我们提到“扇形”征或巴宾斯基“等效征”、足底无反射、周围性“假性巴宾斯基征”、在新生儿中通过刺激足底获得的反应以及全身性过度屈曲。我们还讨论了伦德伯格背侧网状脊髓束的作用。