The most common cause of death in overeating situations is choking. An extreme example of choking to death on food is the example of the British woman who underwent gastric bypass surgery but continued secretly to eat excess food and died after food that could no longer fit into her stomach clogged her throat and led to suffocation. Another common cause of death from acute binge eating episodes is a heart attack. This may have happened in 2011 to a 77-year-old Ukrainian man participating in a speed-eating contest of potato dumplings. Think of this overeating scenario at Thanksgiving when a day and a half's worth of food is consumed in an hour and a half. A rare cause of death from acute massive distension of the stomach can result from complications of cutting off the stomach's own blood supply.
Q: What is the Babinski test checking for? I see a neurologist who does this test that consists of his stroking the sole of my foot.
A: If someone were to stroke the sole of your foot, you would think that your toes would pull up and point upward, but you'd be incorrect. Actually, the normal initial movement is for your toes to point downward. That's due to a reflex beyond your control. It's called the "Babinski response," and was first reported in 1896 by French neurologist Joseph Francois Felix Babinski. It's one of the simplest and easiest tests to look for some sort of injury to the nerve connection between the brain and the spinal cord. It helps doctors figure out whether the injury is to the central nervous system (brain and spinal cord), or to the peripheral nervous system - the nerve connection that runs between a muscle and the nerves that exit the spinal cord to supply that muscle.
In today's world of MRIs, CT scans , and nerve conduction studies, a Babinski test might seem out of date. It's not. As part of a careful history and physical exam, it can help a doctor figure out whether a muscle problem is due to a brain/spinal cord injury such as a stroke or multiple sclerosis - or whether the peripheral nerve is injured, as in a herniated disk problem.
The Babinski test involves stroking the outside part of the sole with the thumbnail or an object like the end of a ballpoint pen barrel or a plastic ruler. Some folks won't show either upgoing toes or downgoing toes. They just have difficulty eliciting reflexes. However, if one foot shows toes that are downgoing (the normal response) and the other foot shows toes that are upgoing, that's not normal. The upgoing toes are letting the doctor know something isn't right. A person who's suffered a stroke affecting the right side of the body will have upgoing toes on the right when the Babinski test is performed.
Mitchell Hecht specializes in internal medicine. Send questions to him at: "Ask Dr. H," P.O. Box 767787, Atlanta, Ga. 30076.