E-Pearl of the Week: The Trunk-Thigh Test of Babinski

November 22, 2011

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November 22, 2011

The Trunk-Thigh Test of Babinski

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.

References

  1. Babinski J. De quelques mouvements associe´s du membre infe´rieur paralyse´ dans l'he´miple´gie organique. Bulletins et Memoires de la Socie´te´ me'dicale des Hospitaux de Paris 1897; 14: 1098-1103.
  2. Koehler PJ, Okun MS. Important observations prior to the description of the Hoover sign. Neurology 2004; 63: 1693-1697.

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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