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Wednesday, March 15, 2017

Babinski

Joseph Babinski (1857–1932), a French neurologist of Polish descent, first described the Babinski sign, the best known neurological eponym and one of the most important signs in clinical neurology, in 1896.1 Babinski was the favourite pupil of Jean-Martin Charcot, who markedly influenced Babinski's research. He appears in the famous painting of Charcot's lesson at Salpêtrière hospital (“Une leçon clinique à la Salpêtrière” by Pierre Aristide André Brouillet [1857–1914]), helping to support a patient who was being treated for hysteria. Babinski would later spend much of his career searching for objective clinical signs that cannot be mimicked by the patient, consciously or unconsciously.
Babinski's historical report on the abnormal cutaneous plantar reflex, a concise note of only 28 lines, was published on Feb 22, 1896. Copies of Babinski's original publication1 are quite rare because the report was never reprinted. However, we were able to gain privileged access to the report, which is not available for public viewing, in an old bookstore in Paris, France (figure). In this report,1 Babinski describes the dorsiflexion of the great toe on stimulation of the sole of the foot in patients with hemiplegia or lower limb paralysis. 2 years later, he narrowed the definition of lesions associated with the toe sign from brain or spinal cord to the pyramidal tract.2 In 1903, Babinski also reported on the signe de l'éventail (the fan sign), describing how the other toes fan out on stimulation of the sole of the foot. Babinski's contribution to the description of neurological symptoms was not restricted to the plantar skin reflex, but extended to other areas such as epilepsy or the effects of strychnine poisoning. Although the Babinski reflex did not immediately gain recognition, he continued to try to distinguish neurological syndromes from psychiatric syndromes.
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Figure

Photograph of the original paper by Babinski
A trend of abolishing eponymous names for neurological signs is emerging, but they serve to remind us of the important work of great neurologists of the past.
We declare no competing interests.

References

  1. Babinski, J. Sur le réflexe cutané plantaire dans certaines affections organiques du système nerveux central. C R Seances Soc Biol Fil189648207–208
  2. Van Gijn, J. The Babinski sign: the first hundred years. J Neurol1996243675–683

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