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...
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Medknow Publications
2018
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| author | Loo, Shweh Fern Justin, Nicole Kelsie Lee, Ri An Hew, Yin Cheng Lim, Kheng Seang Tan, Chong Tin |
| author_facet | Loo, Shweh Fern Justin, Nicole Kelsie Lee, Ri An Hew, Yin Cheng Lim, Kheng Seang Tan, Chong Tin |
| author_sort | Loo, Shweh Fern |
| collection | UM |
| 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 | 2024-03-06T05:54:03Z |
| format | Article |
| id | um.eprints-21400 |
| institution | Universiti Malaya |
| last_indexed | 2024-03-06T05:54:03Z |
| publishDate | 2018 |
| publisher | Medknow Publications |
| record_format | dspace |
| spelling | um.eprints-214002019-05-29T07:06:42Z http://eprints.um.edu.my/21400/ Differentiating extensor plantar response in pathological and normal population Loo, Shweh Fern Justin, Nicole Kelsie Lee, Ri An Hew, Yin Cheng Lim, Kheng Seang Tan, Chong Tin R Medicine 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. Medknow Publications 2018 Article PeerReviewed Loo, Shweh Fern and Justin, Nicole Kelsie and Lee, Ri An and Hew, Yin Cheng and Lim, Kheng Seang and Tan, Chong Tin (2018) Differentiating extensor plantar response in pathological and normal population. Annals of Indian Academy of Neurology, 21 (2). pp. 144-149. ISSN 0972-2327, DOI https://doi.org/10.4103/aian.AIAN_254_17 <https://doi.org/10.4103/aian.AIAN_254_17>. https://doi.org/10.4103/aian.AIAN_254_17 doi:10.4103/aian.AIAN_254_17 |
| spellingShingle | R Medicine Loo, Shweh Fern Justin, Nicole Kelsie Lee, Ri An Hew, Yin Cheng Lim, Kheng Seang Tan, Chong Tin Differentiating extensor plantar response in pathological and normal population |
| 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 | R Medicine |
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