Babinski's signe de l'eventail: a turning point in the history of neurology

[Guest guest]

P R Health Sci J. 2008 Mar;27(1):103-5.

Babinski's signe de l'eventail: a turning point in the history of

neurology.

Brau C, Brau RH.

Division of Neurosurgery, Medical Sciences Campus, University of

Puerto Rico.

PURPOSE: The Babinski sign is a finding known since the start of the

teachings of physical diagnosis by almost all medical students. This

reflex is an incredibly helpful phenomenon that enables physicians to

distinguish between central and the peripheral nervous system

diseases right at the bedside. Yet, most students as well as

physicians remain oblivious to the remarkable history behind the

Babinski sign and what it means to evolutional history of the modern

neurological exam. We intend to study the birth of the " signe de

l'eventail " (the fanning sign) and how it transformed medical

diagnosis as we practice it today.

METHODS: An extensive search was conducted through the Internet to

identify historical documents referring to Babinski and other

physicians who also observed the phenomenon as early as the 17th and

18th century. We also conducted a search through medical journals

that examined the Babinski sign and its history.

RESULTS: The Babinski reflex had been observed much earlier than

1896, when Babinski referred to his finding for the first time. The

reflex had been reported in the literature as far back as 1784 and

afterwards reobserved several times before Babinski. However, it was

Babinski who first offered an interpretation of the reflex and

suggested that it was related to an organic disruption in the central

nervous system. By identifying the sign, Babinski separated himself

from Charcot in the sense of creating a new tradition in neurology

where the findings in a neurological exam were of far more importance

than just a plain history as his mentor had relied upon.

CONCLUSIONS: Babinski was not only responsible for suggesting the

significance of such sign, but also transformed the role that

physical diagnosis plays in modern medicine, where physical

examination is key in revealing underlying pathology.