The "bedsheet" Babinski

BACKGROUND: Babinski's reflex (dorsiflexion of the hellus and fanning of the toes in response to plantar stimulation) is a classic sign in neurology. Although typically elicited by stroking the plantar surface of the foot with a firm object, other means of obtaining the response have been described. METHODS: We assessed the frequency of the Babinski response after plantar stimulation by exposing the feet by removal of the bedsheet or socks in 10 patients with neurologic disease and 10 control subjects. These results were compared with those obtained by traditional means of stimulation. RESULTS: We found a high correlation between the two responses (sensitivity of 80% and specificity of 90%). CONCLUSION: Although this study is small and requires a larger study to verify its accuracy, it appears that simple observation of the toe response at the time that the feet are exposed frequently provides evidence of pyramidal tract dysfunction.