| The cutaneous plantar reflex is obtained by stimulating the lateral border of the foot from a posterior-anterior direction (from heel to toes), with a blunt firm object (for example, with the handle of a reflex hammer). The normal response consists of flexion of all toes. In a pathological response, in contrast, the great toe extends dorsally and the others open in a fan-like fashion.
One can see an extensor response up until two years of age without the implication of a neurological lesion. Past this age, the extensor response becomes pathological, and implies the existence of a lesion at any level of the pyramidal tracts.
Other similar signs in which there are changes in the area of stimulation include the Gordon (pressure into the muscle mass of the calf) and Oppenheim (vigorously brush the tibio-peroneal muscles in a downward direction). Other signs suggesting pyramidal tract lesions are clonus in the patellar or achilles tendon reflexes, and hypertonia and hyperreflexia.
In the case presented in the video, the cause was a cerebral vascular accident with acute ischaemia in the left sylvian matter.
http://www.uam.es/personal_pdi/medicina/algvilla/ref/r1.htm
http://www.nlm.nih.gov/medlineplus/ency/article/003294.htm
Author:
Juan Ignacio Pérez Calvo
Servicio de Medicina
Interna
Hospital Clínico Universitario "Lozano
Blesa"
Zaragoza
Translation: Kelly
Watt |
