Physical examination showed paraparesia (muscle strength=3/5 based on a 5-point scale of muscle strength score), hyper-reflexia, and a positive Babinski sign
. The patient was unable to walk.
The patient exhibited mild spasticity of lower limbs with positive Babinski sign
, without focalities at neurologic exam.
Deep tendon reflexes were hyperactive in the lower extremities and he had Babinski sign
on the right side.
The deep tendon reflexes were normal, however, the Babinski sign
was positive on the right side.
Deep tendon reflexes were active and the Babinski sign
was positive bilaterally.
A positive Babinski sign
tends to appear soon after the lesion and persists [1-3].
The reasons for not fulfilling UKBB criteria were as follows: five participants had an exclusion criterion on Step 2 (neuroleptic treatment at onset of symptoms, n = 1; presence of the Babinski sign
, n = 1; early severe autonomic involvement, n = 3), and two individuals had less than three supportive prospective positive criteria on Step 3.
Neurological exam was remarkable for left gaze preference, spasticity of all extremities, bilateral lower extremity hyperreflexia, occasional myoclonus, and positive Babinski sign
Positive Babinski sign
was present bilaterally and osteotendinous reflexes were present in the upper limbs and difficult to explore in the lower limbs due to tendon contraction.
Clinical examination revealed no paresis (5/5 on the MRC scale), but unilateral severe asterixis of the right side and fine motor skill disturbances of the right hand were found, as well as reduced muscle tone on the right side and a positive Babinski sign
(see Video 1).
Hyperreflexia and positive Babinski sign
, traditionally thought of as signs of spinal cord pathology, may not be present in cases of acute and severe cord compression.
Consultation physical examination showed: increased muscle tension in the left upper limb and both lower limbs, lower extremity hyperreflexia, and Babinski sign