THE OTHER BABINSKI SIGN IN HEMIFACIAL SPASM

Abstract

Joseph Babinski is known for his description of the abnormal plantar reflex bearing his name. Rarely attributed to Babinski is another phenomenon, observed in patients with hemifacial spasm (HFS), which he first described in 1905. This “other Babinski sign”1 is manifested as follows: “when orbicularis oculi contracts and the eye closes, the internal part of the frontalis contracts at the same time, the eyebrow rises during eye occlusion,” and “this set of occurrences is impossible to reproduce by will.”2 In this study we examined the utility of the “other Babinski sign” in differentiating HFS from blepharospasm (BSP). All patients who presented to the Baylor College of Medicine Movement Disorders Clinic between July 1989 and July 2006 and were diagnosed with HFS or BSP by a movement disorders expert were included in this study. As part of our routine evaluation, all patients with HFS or BSP are videotaped before treatment. The diagnosis of HFS was based on the presence of unilateral involuntary facial muscle contractions affecting one …