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September 21, 2015: The other Babinski sign

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September 21, 2015

The other Babinski sign

In 1905 Joseph Babinksi described a particular exam feature of hemifacial spasm, the so-called “other Babinski sign.” In hemifacial spasm, muscles innervated by the seventh cranial nerve contract irregularly. The “other Babinski sign” consists of eyebrow rising during eye closure, or co-contraction of the orbicularis oculi and frontalis muscles. If present, the “other Babinski sign” or “brow-lift sign” is a reliable tool with a 100% positive predictive value for differentiating hemifacial spasm from both blepharospasm and non-physiologic movement disorders.

References

  1. Devoize JL. “The other” Babinski’s sign: paradoxical raising of the eyebrow in hemifacial spasm. J Neurol Neurosurg Psychiatry 2001; 70: 516.
  2. Stamey W, Jankovic J. The other Babinski sign in hemifacial spasm. Neurology 2007; 69: 402-404.

Submitted by Marian L. Dale MD, Movement Disorders Fellow, Oregon Health and Science University, Portland, Oregon.

Disclosures: Dr. Dale received research support from the Oregon Medical Research Foundation and has received educational conference travel support from Medtronic, Abbvie, and the International Parkinson and Movement Disorder Society.

For more clinical pearls and other articles of interest to neurology trainees, visit Neurology. Listen to this week's Neurology Podcast.

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