Talk:Plantar reflex

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[edit] Soapboxing

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The plantar reflex may indicate a CVA or a [[hemiplegic migraine. The neurologist should ascertain, before ordering tests, that the patient will survive them. Some patients have potentially lethal allergies to the iodinated contrast media that are used in T scans.

(A physician who observes an abnormal plantar reflex ["positive Babinsky"] and a "blown" pupil [pupil dilated and unresponsive to light] may think the patient is having a stroke and order a CT scan with iodinated contrast medium, even if the patient reports an allergy to the medium. In such a situation, the patient may have no alternative other then leaving "against medical advice" and going to another hospital; with luck, the patient will encounter an experienced and rational neurologist who will conclude that it's a hemiplegic migraine--alarming but not rare--and order the standard treatment [50-100 mg Demerol and 50 mg [[diphenhydramine]|Benedryl]], injected IM] and send the patient home when symptoms improve.)^{[citation needed]}

All of this is soapboxing. Unenhanced CTs are adequate to identify cerebral bleed, and encountering a rational neurologist without being referred formally may be quite hard indeed. There is no standard treatment for hemiplegic migraine, but most neurologists would like to rule out haemorrhage in a new severe headache with lateralising signs. JFW | T@lk 23:52, 20 March 2007 (UTC)