The Babinski-2 sign in hemifacial spasm.

BACKGROUND

Hemifacial spasm is a common movement disorder. Differential diagnosis relies on clinical examination and is often difficult. The Babinski-2 sign is an underrecognized physical sign specifically found in patients with hemifacial spasm, although its prevalence and usefulness are a matter of debate.

METHODS

We examined 35 patients with hemifacial spasm prospectively for the presence of the Babinski-2 sign. We evaluated its correlation with severity of hemifacial spasm, concomitant facial nerve paralysis, and response to botulinum toxin. Twelve patients with blepharospasm served as the control population.

RESULTS

The data for the Babinski-2 sign demonstrated high prevalence (86%), high specificity (100%), and high interrater reliability (92%).

CONCLUSIONS

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