Test the plantar response by scraping an object across the sole of the foot beginning from the heel, moving forward toward the small toe, and then arcing medially toward the big toe (see Figure 3.2 in Neuroanatomy through Clinical Cases 3e). The normal response is downward contraction of the toes. The abnormal response, called Babinski's sign, is characterized by an upgoing big toe and fanning outward of the other toes. In some patients the toes are "silent," moving neither up nor down. If the toes are downgoing on one side and silent on the other, the silent side is considered abnormal. The presence of Babinski's sign is always abnormal, but is often present in infants, up to the age of about 1 year.Go to Video 59
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