*3.2.2 Neurological examination*

It is necessary to perform a careful inspection of the lower part of the spine in order to determine the cutaneous manifestations of occult spinal dysraphism and/or sacral agenesis (lipomas, nevi, increased hairiness, low intergluteal cleft, flattened buttocks). After that, it is necessary to test the tendon reflexes on the lower extremities as well as the existence of the Babinski sign. Hyperreflexia, asymmetry in reflexes or positive Babinski indicate spinal cord damage. It is also important to examine the strength of the muscles of the lower extremities, ataxia and gait.
