Remembering the Rossolimo Sign

The Rossolimo sign is the flexion of the toes responding to tapping the ball of the foot, percussing the plantar surface of the great toe, tapping or stroking the balls of the toes, or giving a quick, lifting snap to the tips of the toes. Like the Babinski sign, it is a clinical reflex that demonstrates pyramidal tract dysfunction [1] (Video 1).

Vídeo 1: Rossolimo sign.

Grigorii Ivanovich Rossolimo (1860–1928) was a Russian neurologist, who published his observations of increased flexion of the toes in 1902 [2]. The Rossolimo reflex has a high diagnostic sensitivity for neurological examination of cervical and thoracic spondylotic myelopathy patients [3]. In our opinion, it may be useful when the plantar response is inconclusive due to withdrawal or avoidance (Video 2).

Vídeo 2: Dissociation of abdominal reflexes.

The patient in the video has tropical spastic paraparesis (HTLV-1-associated myelopathy) with progressive limb weakness, spasticity and urinary incontinence. There are evident bilateral Rossolimo sign, dissociation of abdominal reflexes and hyperreflexia in the limbs.

None.

No conflict of interest.

1. Campbell WW, DeJong RN (2012) Philadelphia, In: Lippincott Williams, Wilkins (7th edn), DeJong’s the neurologic examination.
2. Satran R (2005) Chekhov and Rossolimo, careers in medicine and neurology in Russia 100 years ago. Neurology 64(1): 121-127.
3. Chang CW, Chang KY, Lin SM (2011) Quantification of Rossolimo reflexes: a sensitive marker for spondylotic myelopathy. Spinal Cord 49(2): 211- 214.