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J Neurol Neurosurg Psychiatry 70:516 doi:10.1136/jnnp.70.4.516
  • Neurological picture

“The other” Babinski's sign: paradoxical raising of the eyebrow in hemifacial spasm

  1. J L DEVOIZE
  1. Service de Neurologie, Centre Hospitalier d'Angoulême
  2. 16470 Saint-Michel, France
  1. jldevoize{at}wanadoo.fr

    Joseph Babinski is famous for his description, in 1896, of the abnormal plantar reflex as an indicator of dysfunction in the pyramidal tract. After the works of Brissaud and Meige, his contribution to description of hemifacial spasm is much less well known.

    He reported for the first time paradoxical syncinesis in hemifacial spasm in a lecture given at the Société Neurologique de Paris on 6 April 1905.1 “The most singular is the following: 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 … this set of occurrences is impossible to reproduce by will …”

    From these observations, Babinski concluded that hemifacial spasm is neither the result of a psychological problem nor of a cortical lesion, but instead is due to a lesion that affects directly the facial nerve.

    This “other” Babinski's sign can, occasionally, be useful in distinguishing hemifacial spasm from other craniofacial movement disorders.

    References

    Figure 1

    Left hemifacial spasm. Paradoxical raising of the eyebrow as the eye closes (the “other” Babinski's sign) (with permission).