O reflexo cutâneo-plantar em extensão (Babinski, 1896/1898)

Oliveira-souza, R.; De Figueiredo, W. Martignoni

doi:10.1590/S0004-282X1995000200026

Resumos

A dois anos do centenário da identificação do reflexo cutâneo-plantar em extensão como sinal de afecção do sistema nervoso central, pareceu-nos oportuno traduzir passagens relevantes de Babinski sobre o fenômeno que descreveu. Há indícios de que um dos motosmais influentes na criação do espírito de época que facilitou a valorização clínica do "fenômeno dos artelhos", deveu-se à exigência pragmática de se distinguir paralisias "histéricas" de "orgânicas" para aplicação médico-legal imediata.

Babinski; hemiplegia; reflexos; sistema piramidal

The extensor plantar reflex was described by Babinski in 1896. Given the obvious relevance of the sign for internal medicine as well as the paucity of translations of the original sources into Portuguese, we thought it timely to recall the ingenious arguments Babinski used to demonstrate his views on the "toe phenomenon", as he would call it. A careful analysis of Babinski's writings suggests, further, that he was driven by keen intuition as well as by medico-legal interests.

Babinski; hemiplegia; reflexes; pyramidal system

O reflexo cutâneo-plantar em extensão (Babinski, 1896/1898)

The extensor plantar reflex (Babinski, 1896/1898)

R. Oliveira-souza^I; W. Martignoni De Figueiredo^II

^IProfessor Assistente, Serviço de Clínica Médica C (Prof. Omar da Rosa Santos), Hospital Universitário Gaffrée e Guinle, Universidade do Rio de Janeiro (HUGG - UNI-RIO)

^IIProfessor Adjunto, Serviço de Clínica Médica C (Prof. Omar da Rosa Santos), HUGG - UNI-RIO

RESUMO

A dois anos do centenário da identificação do reflexo cutâneo-plantar em extensão como sinal de afecção do sistema nervoso central, pareceu-nos oportuno traduzir passagens relevantes de Babinski sobre o fenômeno que descreveu. Há indícios de que um dos motosmais influentes na criação do espírito de época que facilitou a valorização clínica do "fenômeno dos artelhos", deveu-se à exigência pragmática de se distinguir paralisias "histéricas" de "orgânicas" para aplicação médico-legal imediata.

Palavras-chave: Babinski, hemiplegia, reflexos, sistema piramidal.

SUMMARY

The extensor plantar reflex was described by Babinski in 1896. Given the obvious relevance of the sign for internal medicine as well as the paucity of translations of the original sources into Portuguese, we thought it timely to recall the ingenious arguments Babinski used to demonstrate his views on the "toe phenomenon", as he would call it. A careful analysis of Babinski's writings suggests, further, that he was driven by keen intuition as well as by medico-legal interests.

Key words:Babinski, hemiplegia, reflexes, pyramidal system.

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Agradecimento

Agradecemos aos funcionários das bibliotecas do Instituto Oswaldo Cruz e do Centro de Ciências da Saúde da Universidade Federal do Rio de Janeiro pela diligência na localização dos textos originais, que permitiram a realização do presente estudo.

Aceite: 1-outubro-1994.

Dr. Ricardo de Oliveira Souza - Rua General Belford 226 - 20961-000 Rio de Janeiro RJ - Brasil.

1. Babinski J. Sur le réflexe cutané plantaire dans certaines affections organiques du systčme nerveux central. C R Soc Biol (Paris) 1896, 48: 207-208.
2. Babinski J. Valeur pathogénique et séméiologique des reflexes (discussion). Bull Méd 1897, 11: 896.
3. Babinski J. Du phénomčne des orteils et de sa valeur sémiologique. Sem Méd 1898, 18: 321-322.
4. Babinski J. Diagnostique différentiel de l'hémiplégie organique et de 1'hémiplégie hystérique (1900). Reproduzido em Oeuvre Scientifique. Paris: Masson 1934, p 91-111.
5. Babinski J. De 1'abduction de orteils. Rev Neurol (Paris) 1903, 11: 728-729.
6. Babinski J. Sur la transformation du regime des reflexes cutanés dans les affections du systčme pyramidal. Rev Neurol (Paris) 1904, 12: 58-62.
7. Babinski J. Introduction ŕ la sémiologie des maladies du systčme nerveux: des symptômes objectifs que la volonté est incapable de reproduire.(De leur importance en médecine legale). Reproduzido em Oeuvre Scientifique. Paris: Masson 1934, p3-14.
8. Castro A. Semiótica nervosa. Ed 2. Rio de Janeiro: F. Briguiet & Cia, 1935, p201.
9. Dohrmann GJ, Nowack WJ. The upgoing great toe: optimal method of elicitation. Lancet 1973, 1: 339-341.
10. Fujiki A, Shimizu A, Yamada Y, Yamamoto Y, Kaneko Z. The Babinski reflex during sleep and wakefulness. EEG Clin Neurophsyiol, 1971, 31:610-613.
11. Gijn J. The Babinski sign and the pyramidal syndrome. J Neurol Neurosurg Psychiatry 1978, 41: 865-873.
12. Gowers WR. A manual of diseases of the nervous system, Vol I: Diseases of nerves and spinal cord. Ed 2 (1893). Darien, Conn: Hafner Publ Co 1970, p 440.
13. Gowers WR. A manual of diseases of the nervous system, Vol II: Diseases of the brain and cranial nerves. General and functional diseases of the nervous system. Ed 2 (1893). Darien, Conn: Hafner Publ Co 1970, p 86.
14. Hawthorne CO. On the occurrence of a bi-lateral extensor response in states of unconsciousness. Practitioner 1914, 93: 330-333.
15. King LS. Signs and symptoms. JAMA 1968, 206: 1063-1065.
16. Littré E. Dictionaire de médecine, de chirurgie, de pharmacie et des sciences qui s'y rapportent. Ed 21. Paris: J.-B Bailličre et Fils, 1908.
17. Louis ED, King D, Sacco RL, Mohr JP. Upper motor neuron signs: frequency and temporal development in patients with acute motor strokes. Ann Neurol 1993, 34: 291.
18. Noďca D, Sakelaru. Le réflexe plantaire et le phénomčne des orteils (signe de Babinski) au point de vue physiologique et physio-pathologique. Sem Méd 1906, 51: 601-602.
19. Oldendorf WH. The quest for an image of the brain: a brief historical and technical review of brain imaging techniques. Neurology 1978, 28:517-533.
20. Oliveira-Souza R. Motor hemiplegia and the cerebral organization of movement in man: I. The "pyramidal concept" - a restatement. Arq Neuropsiquiatr 1989, 47: 8-15.
21. Remak E. Zur Localisation der spinalen Hautreflexe der Unterextremităten. Neurologisches Centralblatt 1893, 12: 506-512.
22. Sawyer RN, Hanna JP, Ruff RL, Leigh RJ. Asymmetry of forearm rolling as a sign of unilateral cerebral dysfunction. Neurology 1993, 43:1596-1598.
23. Wartenberg R. The Babinski reflex after fifty years. JAMA 1947, 135:763-767.
24. Yakovlev PI, Farrell MI. Influence of locomotion on the plantar reflex in normal and in physically and mentally inferior persons: theoretical and practical implications. Arch Neurol Psychiat 1941, 46:322-330.

Datas de Publicação

Publicação nesta coleção
20 Jan 2011
Data do Fascículo
Jun 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Babinski J. Sur le réflexe cutané plantaire dans certaines affections organiques du systčme nerveux central. C R Soc Biol (Paris) 1896, 48: 207-208.

[2] 2. Babinski J. Valeur pathogénique et séméiologique des reflexes (discussion). Bull Méd 1897, 11: 896.

[3] 3. Babinski J. Du phénomčne des orteils et de sa valeur sémiologique. Sem Méd 1898, 18: 321-322.

[4] 4. Babinski J. Diagnostique différentiel de l'hémiplégie organique et de 1'hémiplégie hystérique (1900). Reproduzido em Oeuvre Scientifique. Paris: Masson 1934, p 91-111.

[5] 5. Babinski J. De 1'abduction de orteils. Rev Neurol (Paris) 1903, 11: 728-729.

[6] 6. Babinski J. Sur la transformation du regime des reflexes cutanés dans les affections du systčme pyramidal. Rev Neurol (Paris) 1904, 12: 58-62.

[7] 7. Babinski J. Introduction ŕ la sémiologie des maladies du systčme nerveux: des symptômes objectifs que la volonté est incapable de reproduire.(De leur importance en médecine legale). Reproduzido em Oeuvre Scientifique. Paris: Masson 1934, p3-14.

[8] 8. Castro A. Semiótica nervosa. Ed 2. Rio de Janeiro: F. Briguiet & Cia, 1935, p201.

[9] 9. Dohrmann GJ, Nowack WJ. The upgoing great toe: optimal method of elicitation. Lancet 1973, 1: 339-341.

[10] 10. Fujiki A, Shimizu A, Yamada Y, Yamamoto Y, Kaneko Z. The Babinski reflex during sleep and wakefulness. EEG Clin Neurophsyiol, 1971, 31:610-613.

[11] 11. Gijn J. The Babinski sign and the pyramidal syndrome. J Neurol Neurosurg Psychiatry 1978, 41: 865-873.

[12] 12. Gowers WR. A manual of diseases of the nervous system, Vol I: Diseases of nerves and spinal cord. Ed 2 (1893). Darien, Conn: Hafner Publ Co 1970, p 440.

[13] 13. Gowers WR. A manual of diseases of the nervous system, Vol II: Diseases of the brain and cranial nerves. General and functional diseases of the nervous system. Ed 2 (1893). Darien, Conn: Hafner Publ Co 1970, p 86.

[14] 14. Hawthorne CO. On the occurrence of a bi-lateral extensor response in states of unconsciousness. Practitioner 1914, 93: 330-333.

[15] 15. King LS. Signs and symptoms. JAMA 1968, 206: 1063-1065.

[16] 16. Littré E. Dictionaire de médecine, de chirurgie, de pharmacie et des sciences qui s'y rapportent. Ed 21. Paris: J.-B Bailličre et Fils, 1908.

[17] 17. Louis ED, King D, Sacco RL, Mohr JP. Upper motor neuron signs: frequency and temporal development in patients with acute motor strokes. Ann Neurol 1993, 34: 291.

[18] 18. Noďca D, Sakelaru. Le réflexe plantaire et le phénomčne des orteils (signe de Babinski) au point de vue physiologique et physio-pathologique. Sem Méd 1906, 51: 601-602.

[19] 19. Oldendorf WH. The quest for an image of the brain: a brief historical and technical review of brain imaging techniques. Neurology 1978, 28:517-533.

[20] 20. Oliveira-Souza R. Motor hemiplegia and the cerebral organization of movement in man: I. The "pyramidal concept" - a restatement. Arq Neuropsiquiatr 1989, 47: 8-15.

[21] 21. Remak E. Zur Localisation der spinalen Hautreflexe der Unterextremităten. Neurologisches Centralblatt 1893, 12: 506-512.

[22] 22. Sawyer RN, Hanna JP, Ruff RL, Leigh RJ. Asymmetry of forearm rolling as a sign of unilateral cerebral dysfunction. Neurology 1993, 43:1596-1598.

[23] 23. Wartenberg R. The Babinski reflex after fifty years. JAMA 1947, 135:763-767.

[24] 24. Yakovlev PI, Farrell MI. Influence of locomotion on the plantar reflex in normal and in physically and mentally inferior persons: theoretical and practical implications. Arch Neurol Psychiat 1941, 46:322-330.