Beevor’s sign

Named after: Charles Edward Beevor

Definition: Upward (Cephalad) movement of the umbilicus in a supine patient attempting either to flex the head onto the chest against resistance or performing a sit-up. It is not a pathologic reflex, but a sign resulting from imbalance in muscle strength between the upper and lower abdominal muscles.

Beevor's sgin

Mechanism: Normally, the rectus abdominis muscle contracts as a single unit with no predominance of upper half over the lower part or left over the right side. Therefore, normally on trunk flexion, the navel does not move.

  • Weakness of upper part of rectus abdominis (Navel moves upward): Beevor’s sign
  • Weakness of lower part of rectus abdominis (Navel moves downward): Inverted Beevor’s sign

The nerve supply to the rectus abdominis muscle at the level of the umbilicus is T10 nerve roots.

Eliciting Beevor’s sign:

  1. Patient is initially in supine position
  2. Ask the patient to either flex his neck or to sit-up without using the arms
  3. Watch for the movement of navel

Conditions where Beevor’s sign is positive:

  1. Spinal lesions (e.g. tumor, syringomyelia) between T10-T12 segment
  2. Myopathies affecting abdominal muscles, particularly Fascio-scapulo-humeral dystrophy (FSHD)
  3. Observed less frequently in other conditions:
    • Pompe disease
    • Myotonic dystrophy
    • Amyotrophic lateral sclerosis
    • Adult form of acid maltase deficiency

References:

  1. Althagafi A, Nadi M. Beevor Sign. [Updated 2022 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545262/
  2. A Dictionary of Neurological Signs By A.J. Larner


Write your Viewpoint 💬

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.