Oppenheim's Sign on Physical Exam There are some alternative maneuvers to search for the classic Babinski sign, which is an indicator of pyramidal injury. In the video I show you the Oppenheim Sign (friction over the crest of the tibia, in a downward direction). Dr. Felipe Duarte Augusto @semiologianeurologica #Oppenheims #Sign #Reflex #Neurology #clinical #video #physicalexam #pyramidal