The Babinski‐2 sign in hemifacial spasm

Pawlowski, Matthias; Gess, Burkhard; Evers, Stefan

doi:10.1002/mds.25472

Cited by 21 publications

(11 citation statements)

References 12 publications

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“…The "other Babinski sign" was frequent in primary hemifacial spasm, less common in post-paralytic facial syndrome and absent in blepharospasm, which confirms the results of previous studies [8][9][10]. The prevalence in hemifacial spasm found in our study was intermediate to others published.…”

Section: Discussionsupporting

confidence: 89%

“…Maybe a categorization of the patients in present, absent and possible sign, would allow more comparable results. Our statistical measures of the sign's performance did not differ significantly from the ones previously reported [8,9]. To our knowledge, this is the first study pointing to a negative correlation between the "other Babinski sign" and past facial paralysis.…”

Section: Discussioncontrasting

confidence: 60%

“…The prevalence in hemifacial spasm found in our study was intermediate to others published. Stamey and Jankovic detected the sign in 25.3% of 75 hemifacial spasm patients [8] and Pawlowski and colleagues determined a prevalence of 86% in 35 patients [9]. The first authors relied on video records to assess the presence of the sign, while the latter used direct observation.…”

Section: Discussionmentioning

confidence: 99%

“…We joined these patients with the hemifacial spasm group to guarantee a reliable statistical analysis. Interrater reliability could be an interesting point to address, but it was already demonstrated in another study [9].…”

Section: Limitationsmentioning

confidence: 98%

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Role of the “other Babinski sign” in hyperkinetic facial disorders

Varanda

Rocha

Rodrigues

et al. 2017

Journal of the Neurological Sciences

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Background: The "other Babinski sign" consists in the co-contraction of the orbicularis and frontalis muscles, causing an eyebrow elevation during ipsilateral eye closure. It cannot be voluntarily reproduced. Aims of the study: To determine the utility of this sign in the differential diagnosis of hyperkinetic facial disorders. Methods: The presence of the sign was assessed in consecutive patients with blepharospasm, primary hemifacial spasm or post-paralytic facial syndrome treated in a botulinum toxin outpatient clinic. Results: Of the 99 patients identified, 86 were included, 41 with blepharospasm (32 female, mean age 71 ± 11 years), 28 with hemifacial spasm (16 female, mean age 65 ± 12 years) and 17 with post-paralytic facial syndrome (14 female, mean age 50 ± 17 years). The sign was detected in 67.9% of the patients with hemifacial spasm, in 23.5% of the post-paralytic facial syndrome group and in none of the patients with blepharospasm, exhibiting a sensitivity of 51% and a specificity of 100% for the diagnosis of hemifacial spasm/post-paralytic facial syndrome and a specificity of 76% for hemifacial spasm, compared to post-paralytic facial syndrome. Conclusions: This sign is highly specific for the diagnosis of peripherally induced hyperkinetic facial disorders. Its assessment should integrate the routine examination of patients with abnormal facial movements.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 98%

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Role of the “other Babinski sign” in hyperkinetic facial disorders

Varanda

Rocha

Rodrigues

et al. 2017

Journal of the Neurological Sciences

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“…The “Babinski-2 sign,” “other Babinski sign,” or “brow-lift sign” is a physical exam maneuver that is positive when a patient lifts his/her eyebrow with ipsilateral eye closure, signaling the synchronized activity of the frontalis and orbicularis oculi muscle during HFS [42–44]. This technique has been shown in one study to have high sensitivity (86%), specificity (100%), and interrater reliability (92%) for HFS diagnosis [45]. …”

Section: Diagnosismentioning

confidence: 99%

Hemifacial Spasm and Neurovascular Compression

Yeung

Gerrard

et al. 2014

The Scientific World Journal

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Hemifacial spasm (HFS) is characterized by involuntary unilateral contractions of the muscles innervated by the ipsilateral facial nerve, usually starting around the eyes before progressing inferiorly to the cheek, mouth, and neck. Its prevalence is 9.8 per 100,000 persons with an average age of onset of 44 years. The accepted pathophysiology of HFS suggests that it is a disease process of the nerve root entry zone of the facial nerve. HFS can be divided into two types: primary and secondary. Primary HFS is triggered by vascular compression whereas secondary HFS comprises all other causes of facial nerve damage. Clinical examination and imaging modalities such as electromyography (EMG) and magnetic resonance imaging (MRI) are useful to differentiate HFS from other facial movement disorders and for intraoperative planning. The standard medical management for HFS is botulinum neurotoxin (BoNT) injections, which provides low-risk but limited symptomatic relief. The only curative treatment for HFS is microvascular decompression (MVD), a surgical intervention that provides lasting symptomatic relief by reducing compression of the facial nerve root. With a low rate of complications such as hearing loss, MVD remains the treatment of choice for HFS patients as intraoperative technique and monitoring continue to improve.

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Overview of Hemifacial Spasm

Park

2020

Hemifacial Spasm

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The Babinski‐2 sign in hemifacial spasm

Abstract: Increased awareness of the Babinski-2 sign may aid diagnosis and potentially prompt earlier initiation of appropriate treatment. © 2013 Movement Disorder Society.

Cited by 21 publications

References 12 publications

Role of the “other Babinski sign” in hyperkinetic facial disorders

Role of the “other Babinski sign” in hyperkinetic facial disorders

Hemifacial Spasm and Neurovascular Compression

Overview of Hemifacial Spasm

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