Patients with symmetrical lower motor neuron paralysis of the extremities require the following tests: The clinical picture is one of slowly progressive tonic muscle weakness, in primary lateral sclerosis it is weakness of muscles in the distal parts of the extremities, and in progressive pseudo medullary paralysis weakness of muscles innervated by the posterior cranial nerves predominates. Muscle fasciculations and muscle atrophy may occur many years later. These disorders usually progress for a number of years before the patient loses all mobility. Babinski’s sign: Babinski’s sign, also known as the metatarsal crossing test, is a pathological reflex. A positive sign is a dorsiflexion of the bunion, with the remaining four toes spread out in a fan-like pattern. Patients with suspected damage to the pyramidal tract and those who need to identify organic or hysterical paralysis. The patient lies supine with both lower limbs straightened, and is instructed to relax the whole body. The examiner holds the patient’s ankle in his hand, and uses a blunt object to gently scratch the skin from the lateral edge of the plantar surface of the foot on that side from the heel forward to the root of the little toe and then turn to the medial side, until near the bunion. When normal, it can cause plantarflexion of the toes. If there is a dorsiflexion of the bunion and the rest of the toes are spread out in a fan shape, it is positive for Babinski’s sign. Random motor examination: Random motor refers to movements under the control of consciousness, and the loss of random motor function is called paralysis. Due to different manifestations, it can be categorized into complete and incomplete paralysis, and in the form of monoparesis, hemiparesis, paraparesis and crossover paralysis. The random movement test is a test to determine the form of paralysis. It is important to calm the patient before the test to prevent him or her from becoming too agitated and preventing the test from proceeding smoothly. Paraplegia test: When a doctor performs a neurological examination, a paraplegia test may be performed to help diagnose mild paralysis that cannot be confirmed by normal methods. Tests for upper limb paralysis include the upper limb extension test, the little finger sign on the side of mild hemiplegia, the finger counting test, and the finger muscle strength test, etc. Tests for lower limb paralysis include the external rotation sign, the knee drop test, the heel-against-the-buttock test, and the lower limb drop test.