Differentiating extensor plantar response in pathological and normal population
Introduction: Approximately 5%–11% of neurologically normal population has extensor plantar response (EPR). Method: This study is aimed to identify differentiating features of EPR between physiological and pathological population. Results: A total of 43 patients with pyramidal lesions and 113 normal...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Annals of Indian Academy of Neurology |
| Subjects: | |
| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2018;volume=21;issue=2;spage=144;epage=149;aulast=Loo |
| _version_ | 1811294530632155136 |
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| author | Shweh Fern Loo Nicole Kelsie Justin Ri An Lee Yin Cheng Hew Kheng Seang Lim Chong Tin Tan |
| author_facet | Shweh Fern Loo Nicole Kelsie Justin Ri An Lee Yin Cheng Hew Kheng Seang Lim Chong Tin Tan |
| author_sort | Shweh Fern Loo |
| collection | DOAJ |
| description | Introduction: Approximately 5%–11% of neurologically normal population has extensor plantar response (EPR). Method: This study is aimed to identify differentiating features of EPR between physiological and pathological population. Results: A total of 43 patients with pyramidal lesions and 113 normal controls were recruited for this study. The pathological EPRs were more reproducible, with 89.4% having at least two positive Babinski responses and 91.5% having two positive Chaddock responses (vs. 14.3% and 4.8% in controls, P < 0.001). The pathological EPR was more sensitive to stimulation, in which 89.1% were elicited when the stimulation reached mid-lateral sole (vs. 11.9% in controls, P < 0.001). Most (93.6%) pathological cases had sustained big toe extension throughout stimulation (vs. 73.8% in controls, P < 0.001). As compared to those with brain lesion, the plantar responses in those with spinal lesion are less likely to have ankle dorsiflexion (5.3% vs. 25%, P < 0.05) more likely to have sustained extensor response with Babinski (94.7% vs. 71.4%, P < 0.05), Chaddock (89.5% vs. 64.3%, P < 0.05), and Schaefer (26.3% vs. 3.6%, P < 0.05) methods. A scoring system was computed using four variables, i.e., two consecutive positive Babinski or Chaddock responses, extensor response at mid-lateral sole, and sustained extension throughout stimulation. A score ≥3 is predictive of pathological origin, with sensitivity and specificity of 78.7% and 95.2%, respectively. Conclusion: The pathological EPR is more reproducible, sensitive to stimulation, and sustainable compared to physiological extensor response. |
| first_indexed | 2024-04-13T05:18:55Z |
| format | Article |
| id | doaj.art-004dc0d8dc6b45c0a99cebbb055e1bb1 |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-04-13T05:18:55Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-004dc0d8dc6b45c0a99cebbb055e1bb12022-12-22T03:00:48ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492018-01-0121214414910.4103/aian.AIAN_254_17Differentiating extensor plantar response in pathological and normal populationShweh Fern LooNicole Kelsie JustinRi An LeeYin Cheng HewKheng Seang LimChong Tin TanIntroduction: Approximately 5%–11% of neurologically normal population has extensor plantar response (EPR). Method: This study is aimed to identify differentiating features of EPR between physiological and pathological population. Results: A total of 43 patients with pyramidal lesions and 113 normal controls were recruited for this study. The pathological EPRs were more reproducible, with 89.4% having at least two positive Babinski responses and 91.5% having two positive Chaddock responses (vs. 14.3% and 4.8% in controls, P < 0.001). The pathological EPR was more sensitive to stimulation, in which 89.1% were elicited when the stimulation reached mid-lateral sole (vs. 11.9% in controls, P < 0.001). Most (93.6%) pathological cases had sustained big toe extension throughout stimulation (vs. 73.8% in controls, P < 0.001). As compared to those with brain lesion, the plantar responses in those with spinal lesion are less likely to have ankle dorsiflexion (5.3% vs. 25%, P < 0.05) more likely to have sustained extensor response with Babinski (94.7% vs. 71.4%, P < 0.05), Chaddock (89.5% vs. 64.3%, P < 0.05), and Schaefer (26.3% vs. 3.6%, P < 0.05) methods. A scoring system was computed using four variables, i.e., two consecutive positive Babinski or Chaddock responses, extensor response at mid-lateral sole, and sustained extension throughout stimulation. A score ≥3 is predictive of pathological origin, with sensitivity and specificity of 78.7% and 95.2%, respectively. Conclusion: The pathological EPR is more reproducible, sensitive to stimulation, and sustainable compared to physiological extensor response.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2018;volume=21;issue=2;spage=144;epage=149;aulast=LooBabinskiChaddockphysiological plantar responseplantar responsereflexSchaefer |
| spellingShingle | Shweh Fern Loo Nicole Kelsie Justin Ri An Lee Yin Cheng Hew Kheng Seang Lim Chong Tin Tan Differentiating extensor plantar response in pathological and normal population Annals of Indian Academy of Neurology Babinski Chaddock physiological plantar response plantar response reflex Schaefer |
| title | Differentiating extensor plantar response in pathological and normal population |
| title_full | Differentiating extensor plantar response in pathological and normal population |
| title_fullStr | Differentiating extensor plantar response in pathological and normal population |
| title_full_unstemmed | Differentiating extensor plantar response in pathological and normal population |
| title_short | Differentiating extensor plantar response in pathological and normal population |
| title_sort | differentiating extensor plantar response in pathological and normal population |
| topic | Babinski Chaddock physiological plantar response plantar response reflex Schaefer |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2018;volume=21;issue=2;spage=144;epage=149;aulast=Loo |
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