The Brissaud sign

O sinal de Brissaud

A 65-year-old man has a three-month history of lumbar back pain and progressive lower extremity weakness due a T6 spinal cord compression secondary to hepatic metastatic carcinoma. Examination revealed, paraplegia, urinary incontinence, T10 sensory level, lower limbs hyperactive deep reflex, and hallux indifferent cutaneous plantar response but with an exuberant fascia lata reflex (Figure). The Brissaud sign¹, a succedaneum published only 22 days after Babinski’s famous lecture, is a twitch in the lateral portion of the quadriceps muscle on tickling the sole of the foot and represents a proximal component of the flexion reflex synergy owing to pyramidal tract disfunction².

Figure
. Right plantar cutaneous stimulation. In the beginning (A). Right fascia lata muscle contraction (Brissaud sign) (arrow) (B), at the end and (amazing) without Babinski sign. (Images taken from movie).

References

• ¹
  Brissaud E. Le réflexe du fascia lata. Gaz Hebdo Méd Chirurg 1896;43:253-256.
• ²
  J. van Gijn. The Babinski sign - a centenary. Universiteit Utrecht (publiscation dept.) Utrecht. Netherlands. 1996:83.

Publication Dates

• Publication in this collection
  June 2014

History

• Received
  14 Oct 2013
• Reviewed
  17 Jan 2014
• Accepted
  07 Feb 2014