Babinski Sign to screen for Upper Motor Neuron Lesions

This test has a reported sensitivity of 51 % and specificity of 99 % in the detection of an upper motor neuron lesion as reported in a study by Jaramillo et al. in the year 2014.

To test for the Babinski reflex run a pointed object from the heel along the lateral aspect of the foot forward, towards the great toe.

In a normal human being, it will result in the flexor reflex or grasping of the toes.

This is a pathological reflex and is characterized by extension of the big toe and abduction of the other toes which is also called the fan sign or signe de Levante.

In severe cases, the Babinski sign may be accompanied by hip and knee flexion.

A positive Babinski sign indicates disturbance of the pyramidal system either from structural damage or temporary disturbance due to epilepsy or intoxication.

 
Other common test to screen for upper motor neuron lesions are:

BhattacJaramillo SP, Uribe CS, Jimenez FA, Cornejo-Ochoa W, Restrepo JF, Román GC. Accuracy of the Babinski sign in the identification of pyramidal tract dysfunction. Journal of the neurological sciences. 2014 Aug 15;343(1-2):66-8.haryya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngology–Head and Neck Surgery. 2017 Mar;156(3_suppl):S1-47.

van Gijn J. The Babinski sign. Practical Neurology. 2002 Feb 1;2(1):42-4.