[The incidence and significance of unusual neurologic signs. A clinical study]. 1998

T Müller
Klinik und Poliklinik für Innere Medizin II, Martin-Luther-Universität Halle-Wittenberg.

Little is known about extrinsic-intrinsic reflexes, especially the prototype combinative extensor hallucis response, which become apparent if proprioceptive and exteroceptive afferents of the concerning muscles are stimulated simultaneously as well as successively. With reference to this phenomenon, data from 604 patients were evaluated under neurological aspects. With the exception of the combinative reflex of the peroneal muscles, the occurrence of other combinative reflexes (of tibial posterior, anterior and extensor hallucis muscles) was of clinical relevance. All these characteristics, in the same way as Tramer's reflex and unilateral tibialis posterior reflex, correlated very well statistically with typical symptoms of an upper motor neurone syndrome. In this context the extensor hallucis combinative response is the most important one. This particular sign occurred in a systematically examined population of patients twice as often as Babinski's sign and was the single reflex anomaly in 7 per cent of 200 systematically examined cases. A double-sided manifestation, which could be seen exclusively as physiological, appeared in less than 2 per cent of 604 cases. In respect of the occurrence of combinative responses, patients belonging to different diagnostic groups, infants as well as adults, did not have statistically the same basic probability with regard to the examined neurological signs. Hence, an examination of healthy persons would not yield essential evidence. In our opinion such combinative reflexes and the other symptoms mentioned may be useful in detecting latent upper motor neuron lesion or may be helpful in doubtful cases. Whether or not the phenomenon of a combinative reflex really represents part of the latent pathognomonic flexor withdrawal reflex, cannot be decided with our clinical methods.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009460 Neurologic Examination Assessment of sensory and motor responses and reflexes that is used to determine impairment of the nervous system. Examination, Neurologic,Neurological Examination,Examination, Neurological,Examinations, Neurologic,Examinations, Neurological,Neurologic Examinations,Neurological Examinations
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D001405 Reflex, Babinski A reflex found in normal infants consisting of dorsiflexion of the HALLUX and abduction of the other TOES in response to cutaneous stimulation of the plantar surface of the FOOT. In adults, it is used as a diagnostic criterion, and if present is a NEUROLOGIC MANIFESTATION of dysfunction in the CENTRAL NERVOUS SYSTEM. Babinski Reflex,Extensor Plantar Response,Paradoxical Extensor Reflex, Great Toe,Babinski Reflexes,Babinski Sign,Babinski Sign Absent,Babinski Sign Negative,Babinski Sign Positive,Babinski's Reflex,Babinski's Sign,Extensor Plantar Reflex,Great Toe Paradoxical Extensor Reflex,Reflexes, Babinski,Reflex, Babinski's

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