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November 22, 2011
Babinski described the trunk-thigh test to differentiate organic weakness from "hysterical paralysis." A patient lying supine is asked to sit up holding the arms crossed across the chest. If a hemiparesis due to corticospinal tract injury is present, the hip flexes and there is involuntary elevation of the paralyzed leg off the bed. The toes may fan out as in the plantar reflex. With a paraparesis, both legs rise equally. This occurs due to weakness of muscles that stabilize the pelvis, such as the gluteus maximus, which extends the hip. In functional weakness only the normal leg rises or neither leg rises.
Submitted by: Seby John MD, Dimitrios A. Nacopoulos MD; Neurology Residents, Cleveland Clinic, Cleveland, Ohio
Disclosures: Drs. Seby and Nacopoulos have nothing to disclose.
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