Pyramidal signs

Source: Wikipedia, the free encyclopedia.

Pyramidal signs indicate that the

Babinski sign.[1]

The presence of these phenomena is nearly always connected with

amyotrophic lateral sclerosis should be considered.[citation needed
]

The pyramidal tractcompletes development and myelinazation between 2 and 3 years of age.[2] Pyramidal signs occur as a normal phenomena until the age of 2, when the myelinization is finished, and so under this age they aren't considered pathological.

Pathophysiology

The

corticospinal tracts), connecting the brain and spinal cord and help in controlling voluntary movement of muscles.[3]

Irritative phenomena on the upper extremity

Babinski sign

The irritative phenomena are present if there is visible flection of the thumb, which goes to opposition:

  • Hoffmann's sign – The patient's middle finger is flicked from the nail side down using the examiners index finger. (see video)
  • Tromner's sign - The patient's middle finger is flicked from underneath using the examiner's index finger. (see video)
  • Juster's sign – A sharp implement is pricked into the hypothenar eminence.

Irritative phenomena on the lower extremity

Extension

Extension phenomena are positive if the

dorsiflexes
(goes up) following the stimulus:

  • Babinski reflex: The plantar aspect of the foot is gently stimulated in a line starting a few centimeters distal to the heel and extended to a point just behind the toes, and then turned medially across the transverse arch. This is done slowly over 5-6 seconds.
  • Roche's sign: Similar to Babinski but done on the external part of the foot.
  • Chaddock's phenomen: Reaction on sharp irritation on the outer ankle.
  • Vitek's sign: Repeatedly scrape the tip of big toe.

Flexion

These phenomena are positive if the toes of the foot flex:

  • Rossolimo – The ball of the foot is struck using a tendon hammer. (see video)

Clinical significance

Pyramidal signs can be a result from different types of damage to the brain or spinal cord, such as strokes, infections, tumors, hemorrhagic events, multiple sclerosis, or trauma.[4]

Parkinsonian-Pyramidal syndrome (PPS) is a combination of both pyramidal and parkinsonian signs that manifest in various neurodegenerative diseases.[5]

See also

  • Motor neurons
  • Amyotrophic Lateral Sclerosis
  • Reflexes

References

  1. ISBN 978-0-323-43140-8
    .
  2. PMID 31082020
    , retrieved 2024-02-16
  3. ^ Rogers, Laura; Wong, Eric. "Cerebral palsy". www.pathophys.org. McMaster Pathophysiology Review. Retrieved 9 September 2020.
  4. PMID 31082020
    , retrieved 2024-02-16
  5. PMID 28256436
    .

External links

Further reading
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