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Is there a such thing as a "Mild Babinksi" sign?
pharmacogirl posted:

Okay, for the MD types on this site...Is there a such thing as a mild Babinski sign, where the big toe does not necessarily point backwards, but the rest of the toes do some downward turning?

hackwriter responded:
No MD here, lol, but I did ask my neuro about Babinski's Sign not long ago. This won't directly address your question about the big toe staying put while the others turned down, however.

Either you have Babinski's Sign or you don't, was her short answer. And, you can have it some visits and not have it on others. I've had this happen myself, and that's why I asked about it. To complicate matters more, she performed more than one Babinski test on me while we were talking and got different results depending on what tool she used to evoke the sign.

The way doc explained it, it is just one diagnostic tool to check for neurological damage. If you had no sign during one visit but had it during the next one, it could be an indication of inflammation kicking up for MSers, and if you have no dx it can signal CNS nerve damage. But if you don't have the sign, that doesn't necessarily mean you don't have inflammatory activity or CNS nerve damage. Obviously, since we RRMSers have an incurable neuro inflammatory disease, we've got inflammation going on constantly.

So, mild? Hmm...I'd be interested to hear from Dr. Lava on this one...

pharmacogirl replied to hackwriter's response:
YEs, that all makes perfect sense actually. I had watched a video (for training practitioners) and the patient's toes splayed and the big toe sort of mildly moved. It may have been one of the students with no CNS issues so it was an illustration of a neg Babinksi. But they did not say.

Sometimes, because I am a nurse, I think I am almost too inquisitive because I know the scary clinical implications of things... A little clinical knowledge can be dangerous (e.g. in nursing school when your kid got a headache you were sure he had a brain tumor).

Neil S Lava, MD responded:
Babinski sign is when the big toe goes up and the other toes fan downward when the bottom of the foot is appropriately scratched.
Sometimes we see a response where the big toe goes up, but the rest of the toes do not move.
As mentioned in the note by hackwriter there are other maneuvers that can bring out this response (stroking the side of the foot, pressing on the shin, etc).
If the big toe does not go upwards we usually don't call the response a Babinski.
This sign tells us that there is an abnormality of the pyramidal tracts (usually associated with spasticity and can help us understand what is happening clinically with our patients).
nikkib68 replied to Neil S Lava, MD's response:
This has been happening to me. Latest was 2 nights ago. I am also experiencing severe muscle pain, mostly in my legs, deteriorating vision, hand numbness (mostly on ring and pinky side of both hands) leg numbness, severe fatigue, very bad memory, pausing long periods before speaking, no interest at all in sexual activity.....

I don't even know where to start so I came here trying to find answers...something. My boyfriends mom has MS and he says this is how hers began. Now I'm getting worried.

Advice or suggestions please? How do I approach my doctor about this?

Thank you very much!!
hackwriter replied to nikkib68's response:
Dear nikki,

If you'd like to address a question to Dr. Lava, make a new post with his name in the heading. He usually answers questions on Fridays.


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