Tenosinovitis infecciosa del aparato extensor del pie / Infectious tenosynovitis of the foot extensors

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The babkin reflex in infants: clinical significance and neural mechanism.

BACKGROUND: There have been very few studies concerning the Babkin reflex-opening of the mouth and flexion of the arms in response to stimulation of the palms. We attempted to clarify the clinical significance and neural mechanism of the reflex through systematic review. METHODS: Searches were conducted on Medline, Embase, and Google Scholar from their inception through August 2012. RESULTS: In normal term infants, the Babkin reflex can be elicited from the time of birth, becomes increasingly suppressed with age, and disappears in the great majority by the end of the fifth month of age. A marked response in the fourth or fifth month of age and persistence of the reflex beyond the fifth month of age are generally regarded as abnormal. On the other hand, because there are some normal infants showing no response during the neonatal period or early infancy, the absence of the response during these periods is not necessarily an abnormal finding. CONCLUSIONS: Infants with these abnormal findings should be carefully observed for the appearance of neurological abnormalities including cerebral palsy and mental retardation. It is most likely that the Babkin reflex is mediated by the reticular formation of the brainstem, which receives inputs from the nonprimary motor cortices. On the basis of the hand-mouth reflex, more adaptive movement develops as control of the nonprimary motor cortices over the reflex mechanism in the reticular formation increases. Soon it evolves into the voluntary eye-hand-mouth coordination necessary for food intake as the control of the prefrontal cortex over the nonprimary motor cortices becomes predominant.

Cortical versus non-cortical lesions affect expression of Babinski sign.

This study was conducted to investigate the relationship between the pattern of pathological plantar response (Babinski sign), and the focus of the lesions of pyramidal tract. We examined 107 subjects with definite lesions of the pyramidal tract recruited from inpatients at the Neurology Department of the Xuanwu Hospital of Capital Medical University (Beijing, China). We found that patients with sub-cortical lesions (corona radiata to spinal cord) showed different patterns of Babinski sign than those with lesions within the primary motor cortex. Specifically, dorsiflexion of the big toe without recruitment of the other toes was seen in 71.4 % of patients with cortical pyramidal tract lesions, while 93 patients with lesions lower than cortex (corona radiata to spinal cord) showed movement of other toes in addition to the big toe, which showed movement due to contraction of the extensor hallucis longus tendon in all patients. There were no differences in patterns of Babinski sign between the different sub-cortical lesion foci. We conclude that the patterns of Babinski sign can be used to predict cortical lesions of the pyramidal tract.