The plantar response, also known as the
Babinski response, is an important neurologic examination based upon
what the toes do when the sole (the plantar surface) of the foot is
stroked. If the big toe goes up, that may mean trouble.
The plantar response is obtained by stimulating the external
portion (the outside) of the sole. The examiner begins the
stimulation back at the heel and goes forward to the base of the
toes. There are diverse ways to elicit the plantar response . A
useful way that requires no special equipment is with firm pressure
from the examiner's thumb. Just stroke the sole firmly with the thumb
from back to front along the outside edge.
Too vigorous stimulation may cause withdrawal of the foot or toe,
which can be mistaken as a plantar response .
The normal mature plantar response is characterized by extension
of the great toe and also by fanning of the other toes.
Most newborn babies give a plantar response nervous system is far
from their nervous system is not mature. Upon stimulation of the
sole, they extend the great toe. Many young infants do this, too, and
it is perfectly normal. However, in time during infancy the plantar
response vanishes and, under normal circumstances, should never
return.
A plantar response in an older child or adult is abnormal. It is a
sign of a problem in the central nervous system (CNS), most likely in
a part of the CNS called the pyramidal tract.
Asymmetry of the plantar response -- when it is present on one
side but not the other -- is abnormal. It is a sign not merely of
trouble but helps to lateralize that trouble (tell which side of the
CNS is involved).
The plantar response is known by a number of other names including
the toe or big toe sign or phenomenon and the Babinski reflex,
phenomenon or sign (from the late French neurologist who described
it).
It is, incidentally, quite common but entirely wrong to say that
the plantar response is positive or negative; it is present or
absent.
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