Objective: To investigate the role of the “Other Babinski Sign” in differentiating HFS from blepharospasm and to determine its prevalence in HFS patients.

Background: The “Other Babinski Sign”, described by Joseph Babinski in 1905, is characterized by simultaneous eye closure and eyebrow elevation. (Figure 1) This sign is valuable for diagnosing Hemifacial Spasm (HFS) but is often under-recognized.

Method: We enrolled 142 patients with HFS and 105 patients with blepharospasm at a botulinum toxin clinic. The diagnosis of HFS was based on the presence of unilateral involuntary facial muscle contractions affecting at least one or more areas innervated by the ipsilateral facial nerve, while all blepharospasm patients exhibited bilateral contractions of the periorbital muscles. We assessed the Other Babinski Sign in consecutive patients attending the clinic and re-evaluated them approximately three to four months after their last treatment. We also compared response rates (self-reported improvement of over 50%) to botulinum toxin injections between HFS patients with and without the sign.

Results: Among the 142 HFS patients (97 females, 45 males; mean age: 66.93 years old), 113 (79.6%) exhibited the Other Babinski Sign, while it was absent in all 105 blepharospasm patients (81 females, 24 males; mean age: 66.7 years old). In female patients with HFS, 80 (82.5%) patients showed the sign, compared to 33 (73.3%) patients in males. (Table 1)

    Response rates to botulinum toxin treatment were similar: 98/113 (86.7%) in HFS patients with the sign and 25/29 (86.2%) in those without the sign. There is no significant difference between these two groups.

Conclusion: Our findings confirm that the Other Babinski Sign is a useful diagnostic tool for HFS. Increasing awareness among neurologists may lead to earlier diagnosis and timely transfer to movement disorder specialists for appropriate treatment.

[table1]

[figure1]

References: Sara Varanda, Sofia Rocha, Margarida Rodrigues, Álvaro Machado, Gisela Carneiro, Role of the “other Babinski sign” in hyperkinetic facial disorders,
Journal of the Neurological Sciences, Volume 378,2017, Pages 36-37

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MDS Abstracts - https://www.mdsabstracts.org/abstract/role-of-the-other-babinski-sign-in-hemifacial-spasm/