What do positive Babinski and Hoffman signs indicate?

Question

Hello doctor,

I am a 29-year-old male. I was previously diagnosed with essential tremor, for which I have been taking Propranolol 160 mg for six years. My current symptoms are constant tingling, soreness, and restlessness of the legs. I get spasms in the legs as well as arms. My right eye goes blurry when it is too hot or if I am in the bath.

Also, I have been really sensitive to heat recently, and there is slurring of speech. My right eye also droops sometimes. My legs are weak, and I have balance issues. I have a positive Babinski and Hoffman sign.

I would appreciate some advice on what condition this could be.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Your symptoms are not easily explained by one problem. A positive Babinski and Hoffman sign indicates that you might be having a spinal cord lesion. But slurring of speech and blurring of the eye signify a brain lesion. Intermittent drooping of one eye may point towards myasthenia gravis.

As you mentioned, to be sensitive to heat, there may be a possibility of multiple sclerosis. The following investigations will give a conclusive diagnosis:

Magnetic resonance imaging (MRI) of the brain.
MRI spine with contrast.
Repetitive nerve stimulation test. I suggest you meet a neurologist in person for a detailed history and clinical examination.

I hope this helps.

Thank you.