Beevor Sign

Original Editor - Umamah Ejaz
Top Contributors - Umamah Ejaz

Introduction

Beevor sign, named after British neurologist Charles L. Edward Beevor (1854–1908).

Purpose

Rectus abdominis muscle

Beevor sign in clinical neurology refers to an abnormal upward movement of the umbilicus when a patient attempts to lift their head while lying on their back. This sign occurs because of paralysis in the lower part of the rectus abdominis muscle, allowing the upper muscle fibers to pull the umbilicus upwards. In contrast, in healthy individuals, the umbilicus typically remains in place during this movement.

Technique

These steps should be followed when performing the test:

1. Position the patient:

Have the patient lie flat on their back (supine position).

2. Instruct the patient:

Ask the patient to either: Flex their neck (raise their head) or sit up without using their arms (arms can be crossed over the chest).

3. Observe the umbilicus:

• If the umbilicus moves upward, the test is positive for Beevor sign.
• If the umbilicus stays in place, the test is negative.

The videos below shows how to use the test

Evidence

Beevor sign, characterized by a noticeable upward movement of the umbilicus when sitting up, results from lower rectus abdominis paralysis. This sign indicates a spinal cord lesion between T10 and T12 or its nerve roots. It is also observed in myopathies affecting the abdominal muscles, particularly Facioscapulohumeral Muscular Dystrophy (FSHD), where the lower rectus abdominis is often more affected.

Studies show Beevor sign has a sensitivity of 95% and specificity of 93% for FSHD among neuromuscular disorders, and a specificity of 100% in neurological controls. While it is highly specific for FSHD (97% in some studies), sensitivity can be lower (54%), suggesting Beevor sign is common in FSHD but not as universally sensitive. Nonetheless, it remains a valuable clinical marker for localizing spinal cord lesions.