Improving the Diagnostic Accuracy in Parkinsonism
Improving the Diagnostic Accuracy in Parkinsonism
Pathological reflexes, including hyperreflexia and Babinski's sign, can be seen in VP and MSA. The Babinski sign should be distinguished from the striatal toe, which reflects dystonia of the extensor hallucis longus muscle (common in PD). Differentiation can be difficult, but generally a sustained extensor response is indicative for a striatal toe, while a Babinski response includes an immediate return of the big toe to the neutral position after stroking the foot sole. The Babinski response is also associated with fanning of the other toes, unlike the striatal toe. Furthermore, a striatal toe can present spontaneously, especially during walking on bare feet.
Pyramidal Involvement
Pathological reflexes, including hyperreflexia and Babinski's sign, can be seen in VP and MSA. The Babinski sign should be distinguished from the striatal toe, which reflects dystonia of the extensor hallucis longus muscle (common in PD). Differentiation can be difficult, but generally a sustained extensor response is indicative for a striatal toe, while a Babinski response includes an immediate return of the big toe to the neutral position after stroking the foot sole. The Babinski response is also associated with fanning of the other toes, unlike the striatal toe. Furthermore, a striatal toe can present spontaneously, especially during walking on bare feet.
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