Pathological plantar response: disturbances of the normal integration of flexor and extensor reflex components

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Abstract
Painful stimuli were applied to various spots on the plantar surface of the foot in 40 patients with spastic hemipareses or parapareses. Babinski signs were ob- served in 28 of these cases. Electromyographic recordings of the reflex patterns obtained in the short hallux flexor and extensor were compared with those previously studied in a group of normal cases. The reflexes obtained from the cases evidencing pathology may show a wide range of transitional forms. A direct relationship may be presumed to exist between the degree of extensor activity in the planter response and the degree of pathological change in the reflex mechanism but this is not definite due to constant extensor activity occurring also in some normal cases. The usual contrast between dominant flexor activity in the plantar response and dominant extensor activity in the hallux pattern is reduced in the pathological cases. Different pathways may be involved in the suprasegmental reflex control and these, independently, may be more or less affected by the pathological process. Individual variations found in the 40 patients studied were too widespread to be attributed solely to lesions of varying degrees of severity. It was concluded that different types of lesion of the reflex mechanism produce different types of deviation from the normal reflex pattern.