The Babinski-2 sign in hemifacial spasm


  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

Correspondence to: Dr. Matthias Pawlowski, Department of Neurology, University of Muenster, Albert-Schweitzer-Campus 1, 48129 Muenster, Germany;



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.


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.


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


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