Babinski response prompts concern

Published 5:00 am Monday, July 30, 2018

DEAR DR. ROACH: I am a 70-year-old woman in good health. I recently saw a neurologist about my almost daily migraines. I also noted a feeling across the top of my right foot (and partway around it) that feels like a slightly tight band. It doesn’t affect any part of my life.

During the examination, he noted an abnormal Babinski response. The big toe on my left foot went down, and the big toe on my right foot went up. He appeared concerned, but said we would follow up on it after my migraine was under control. When I returned a month later feeling somewhat better (after taking Depakote), he retested and said my responses were normal. I wasn’t convinced, as he applied almost no pressure to the bottom of my foot at that time. I read that among the possible causes of an abnormal Babinski reflex are multiple sclerosis and Lou Gehrig’s disease, and I am concerned. Should I follow up with another neurologist? — S.C.

ANSWER: The Babinski reflex, also called the plantar response, is a physical examination tool used evaluate possible damage to the parts of the brain responsible for control of movement. An abnormal response is not specific: There are several other really horrible neurological conditions that may have an abnormal response to the test. However, with no other symptoms of movement problems and a test result that is normal on repeat makes me suspect that the first test result was misleading.