Teaching Video NeuroImages: Missing toe: The relevance of the Brissaud reflex.

A 70-year-old man who was admitted to neurointensive care with spastic tetraparesis and altered level of consciousness due to acute subdural hematoma and who had a history of left forefoot amputation presented right Babinski sign and left Brissaud reflex (video at [Neurology.org][1]). The Brissaud reflex is characterized by a contraction of the tensor fasciae latae due to stimulus over the plantar aspect of the foot, which is better visualized on the lateral aspect of the thigh.1,2 This is a useful neurologic sign in patients with suspected upper motor neuron disease and absent hallux. It was named after Edouard Brissaud, a pupil of Charcot, who described the reflex in 1896 a few days after Babinski’s famous lecture. [1]: http://neurology.org/lookup/doi/10.1212/WNL.0000000000004263