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Differentiating Extensor Plantar Response in Pathological and Normal Population.

Shweh Fern Loo1, Nicole Kelsie Justin1, Ri An Lee2

  • 1Department of Medicine, Division of Neurology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Annals of Indian Academy of Neurology
|August 21, 2018
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Summary
This summary is machine-generated.

Pathological extensor plantar responses (EPR) are more reproducible and sensitive to stimulation than physiological EPR. A new scoring system can differentiate pathological EPR with high accuracy.

Keywords:
BabinskiChaddockSchaeferphysiological plantar responseplantar responsereflex

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Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Assessment

Background:

  • Extensor plantar response (EPR) occurs in 5%-11% of the neurologically normal population.
  • Differentiating physiological EPR from pathological EPR is crucial for accurate diagnosis.

Purpose of the Study:

  • To identify distinct features that differentiate pathological EPR from physiological EPR.
  • To develop a reliable method for distinguishing between normal and abnormal EPR.

Main Methods:

  • Recruited 43 patients with pyramidal lesions and 113 neurologically normal controls.
  • Assessed EPR reproducibility, sensitivity to stimulation, and response characteristics (e.g., Babinski, Chaddock, sustained extension).
  • Developed and validated a scoring system based on key differentiating variables.

Main Results:

  • Pathological EPRs were significantly more reproducible (Babinski: 89.4%, Chaddock: 91.5%) and sensitive to stimulation (mid-lateral sole: 89.1%) compared to controls (P < 0.001).
  • Pathological cases exhibited sustained big toe extension more frequently (93.6% vs. 73.8%, P < 0.001).
  • A scoring system (≥3) demonstrated high sensitivity (78.7%) and specificity (95.2%) in predicting pathological EPR.

Conclusions:

  • Pathological EPR is characterized by greater reproducibility, sensitivity, and sustained response compared to physiological EPR.
  • The developed scoring system provides a valuable tool for clinical differentiation of pathological EPR.