Physical Exam

Babinski Reflex

also known as Plantar reflex

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Video coming September 2026

How to Perform

Using a blunt object, firmly stroke along the lateral sole of the foot from the heel toward the ball, then curve medially across the forefoot. A positive (extensor) response is upward movement (dorsiflexion) of the great toe, often with fanning of the other toes. The normal response is downward flexion of the toes.

How to Interpret

Upper Motor Neuron Lesion

Babinski reflex positive

Rule in

Very helpful

Rule out

Somewhat helpful

Evidence:Limited

Vascular Parkinsonism

Pyramidal tract signs

Rule in

Very helpfulDerived CI

Rule out

Not helpfulDerived CI

Evidence:Limited

References

Research in progress on one or more findings above; ratings may change.

Isaza Jaramillo SP, Uribe Uribe CS, García Jimenez FA, Cornejo-Ochoa W, Álvarez Restrepo JF, Román GC. Accuracy of the Babinski sign in the identification of pyramidal tract dysfunction. J Neurol Sci. 2014 Aug 15;343(1-2):66-8. doi:10.1016/j.jns.2014.05.028. PMID 24906707
Wenning GK, Ben-Shlomo Y, Hughes A, Daniel SE, Lees A, Quinn NP. What clinical features are most useful to distinguish definite multiple system atrophy from Parkinson's disease? J Neurol Neurosurg Psychiatry. 2000;68(4):434-440. doi:10.1136/jnnp.68.4.434. PMID: 10727478; PMCID: PMC1736862.
Winikates J, Jankovic J. Clinical correlates of vascular parkinsonism. Arch Neurol. 1999;56(1):98-102. PMID: 9923767.
Babinski J. Sur le réflexe cutané plantaire dans certaines affections organiques du système nerveux central. C R Soc Biol (Paris). 1896;3:207-208.

Research last updated September 10, 2026.