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Gordon Finger Spreading Sign – Neurological Sign

The Gordon finger spreading sign is a neurological reflex sign that may indicate damage to the central nervous system. It is assessed during a clinical neurological examination.

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The Gordon finger spreading sign is a neurological reflex sign that may indicate damage to the central nervous system. It is assessed during a clinical neurological examination.

What Is the Gordon Finger Spreading Sign?

The Gordon finger spreading sign (also referred to as the Gordon sign) is a pathological reflex used in neurological examination. It was named after the British neurologist Alfred Gordon and belongs to the group of so-called pyramidal tract signs. These signs occur when the pyramidal tract (corticospinal tract) – the main descending motor pathway in the brain and spinal cord – is damaged.

Unlike normal reflexes present in healthy individuals, a positive Gordon finger spreading sign indicates a dysfunction of the central nervous system (CNS).

Examination Technique

During the examination, the clinician applies a specific stimulus to the hand or fingers of the patient. The sign is considered positive when an involuntary spreading of the fingers (abduction and extension) occurs in response. This reaction is reflexive and cannot be voluntarily controlled by the patient.

In some descriptions, the Gordon sign refers to pressure applied to the calf muscle that elicits dorsiflexion of the big toe – similar to the Babinski reflex. In clinical practice, however, the term is commonly used for the finger spreading phenomenon described above.

Causes and Clinical Significance

A positive Gordon finger spreading sign indicates a lesion of the pyramidal tract (tractus corticospinalis). Possible underlying causes include:

Stroke (ischemic or hemorrhagic)
Multiple sclerosis
Amyotrophic lateral sclerosis (ALS)
Brain tumors
Spinal cord injuries or spinal cord diseases
Cerebral palsy and other early childhood brain damage
Encephalitis or other inflammatory CNS conditions

The sign alone is not sufficient to diagnose a specific condition. It must always be interpreted in the context of other clinical findings and additional diagnostic investigations.

Classification Among Pyramidal Tract Signs

The Gordon finger spreading sign belongs to a group of reflex signs that collectively indicate damage to the upper motor neuron (first motor neuron). Other well-known pyramidal tract signs include:

Babinski sign: Dorsiflexion of the big toe when the sole of the foot is stroked
Hoffmann sign: Flexion of the thumb when the middle finger is flicked
Tromner sign: Similar to the Hoffmann sign, triggered by tapping the fingertips
Oppenheim sign: Dorsiflexion of the big toe when pressure is applied along the tibial crest

When several of these signs are found simultaneously, diagnostic certainty for a pyramidal tract lesion increases significantly.

Diagnosis and Further Investigations

If the Gordon finger spreading sign is positive, further diagnostic steps are typically required to identify the underlying cause:

MRI of the brain and spinal cord: Imaging to detect structural changes
CT scan of the head: Particularly useful when acute stroke or bleeding is suspected
Lumbar puncture: Cerebrospinal fluid analysis when inflammation or multiple sclerosis is suspected
Electrophysiological studies (e.g., evoked potentials, EMG): Assessment of nerve conduction
Laboratory tests: To rule out metabolic or inflammatory causes

When to See a Doctor

Neurological abnormalities such as unusual reflexes, muscle weakness, coordination problems, or signs of paralysis should always be taken seriously. Immediate medical evaluation is necessary in the following situations:

Sudden paralysis or weakness affecting one side of the body
Speech or swallowing difficulties
Visual disturbances
Severe headache of unknown origin
Gait disturbances or balance problems

A neurologist can perform a comprehensive clinical examination, including assessment of pyramidal tract signs, to establish a diagnosis and initiate appropriate treatment.

References

Mumenthaler M., Mattle H.: Neurology. 13th Edition. Georg Thieme Verlag, Stuttgart, 2013.
Masuhr K. F., Masuhr F., Neumann M.: Dual Series Neurology. 7th Edition. Georg Thieme Verlag, Stuttgart, 2013.
Campbell W. W.: DeJong's The Neurologic Examination. 7th Edition. Lippincott Williams and Wilkins, Philadelphia, 2013.

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