Is Babinski sign positive in amyotrophic lateral sclerosis (ALS)?

Correct answer is C. The Babinski sign is a neurological cue observed during the Plantar Reflex test. Normally, when the sole of the foot is stimulated, the toes flex downward. However, in a positive Babinski sign, the big toe (Hallux) extends upward (dorsiflexion) instead of flexing downward. In adults, the presence of a Babinski sign can be indicative of an upper motor neuron (UMN) lesion. ALS is a combination of both upper and lower motor neuron signs, and while a positive Babinski sign is suggestive of UMN involvement, it is not a universal finding in ALS. Bulbar-onset ALS, a subtype of ALS, may not exhibit a Babinski sign. This subtype primarily affects the bulbar region (brainstem), leading to symptoms related to speech, swallowing, and facial muscles. In summary, while a positive Babinski sign can occur in ALS, its absence does not rule out the diagnosis. Clinical evaluation, other signs, and additional tests are crucial for diagnosing ALS.