title: The occurrence of the Babinski sign in complete spinal cord injury.
abstract: The purpose of the present study was to explore factors that influence the occurrence of the Babinski sign (BS) in complete spinal cord injury patients. At Balgrist University Hospital, Zurich, Switzerland, thirty-five subjects suffering from a complete traumatic spinal cord injury (ASIA A) were examined for the occurrence of the BS, tendon reflex excitability and spastic muscle tone (Modified Ashworth Scale). Five subjects were acute/subacute (1-6 months after spinal cord injury (SCI)), 30 were chronic (SCI > 1 year). In one subject, the measures were examined before and after injection of intrathecal Baclofen. Subjects with a negative BS were investigated electrophysiologically for possible peripheral nerve damage. In 17 subjects (49%), the BS was present, while it was absent in 18 subjects (51%). The occurrence of the BS did not depend on the level of lesion. Most patients with a positive BS also presented a high spastic muscle tone, while those with a negative BS showed low level or absent spastic muscle tone. In 11 SCI subjects, absence of the BS was associated with peripheral nerve damage. In one patient, the BS along with spastic signs disappeared after intrathecal injection of Baclofen. In complete SCI subjects, the occurrence of the BS is connected with spastic muscle tone. The absence of the BS is frequently due to associated peripheral nerve damage.
authors.affiliation: Spinal Cord Injury Center, University Hospital Balgrist, Zürich, Switzerland. jens.petersen@balgrist.ch
authors.forename: Jens A
authors.initials: JA
authors.lastname: Petersen
authors.forename: Martin
authors.initials: M
authors.lastname: Schubert
authors.forename: Volker
authors.initials: V
authors.lastname: Dietz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001418:Baclofen; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central; D009128:Muscle Spasticity / Q000175:diagnosis / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology; D012018:Reflex / Q000502:physiology; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000503:physiopathology*; D013710:Tendons / Q000503:physiopathology; D013997:Time Factors; D055815:Young Adult
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen
references.citation: Arch Phys Med Rehabil. 2001 May;82(5):604-7
references.pmid: 11346835
references.citation: Neurology. 2000 Apr 25;54(8):1574-82
references.pmid: 10762496
references.citation: Spinal Cord. 1999 Jun;37(6):402-9
references.pmid: 10432259
references.citation: Prog Brain Res. 1979;50:11-28
references.pmid: 121776
references.citation: Lancet Neurol. 2007 Aug;6(8):725-33
references.pmid: 17638613
references.citation: Acta Neurol Scand. 1992 May;85(5):305-10
references.pmid: 1621492
references.citation: Spinal Cord. 2000 Jul;38(7):389-93
references.pmid: 10962597
references.citation: J Neurol Neurosurg Psychiatry. 1975 Feb;38(2):180-6
references.pmid: 1080188
references.citation: Brain. 1959 Sep;82:321-55
references.pmid: 14413775
references.citation: J Neurol Neurosurg Psychiatry. 1955 Nov;18(4):250-9
references.pmid: 13278753
references.citation: J Spinal Cord Med. 1999 Fall;22(3):199-217
references.pmid: 10685385
references.citation: Spinal Cord. 2004 Jul;42(7):383-95
references.pmid: 15037862
references.citation: Lancet. 1973 Feb 17;1(7799):339-41
references.pmid: 4121935
references.citation: Brain. 2007 Apr;130(Pt 4):985-94
references.pmid: 17264094
references.citation: J Neurol Neurosurg Psychiatry. 1978 Oct;41(10):865-73
references.pmid: 310447
references.citation: Spinal Cord. 1999 Mar;37(3):157-65
references.pmid: 10213324
references.citation: J Neurol. 1996 Oct;243(10):675-83
references.pmid: 8923299