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The other Babinski sign in Hemifacial Spasm: a clinical marker of severity and its predictive association with η-like
Gang Wu1, Zihao Zhang1, Qingpei Hao1
1Department of Neurosurgery, Peking University People's Hospital, Beijing, China.
Objective:
To investigate the clinical significance of the other Babinski sign in hemifacial spasm (HFS), focusing on its association with symptom severity and specific neurovascular compression (NVC) patterns.
Methods:
This prospective observational study evaluated 69 consecutive HFS patients undergoing microvascular decompression. The association between the other Babinski sign and HSGS scores was assessed using the chi-square test for independence, with Cramer's V quantifying association strength. Subsequently, univariate and multivariate logistic regression analyses were performed to identify NVC patterns predictive of the other Babinski sign.
Results:
The other Babinski sign was present in 15/69 (21.7%) patients. Its presence was significantly associated with higher HSGS scores (p = 0.011), indicating greater HFS severity (Spearman's rho = 0.355, Cramer's V = 0.434, p = 0.003). Multivariate logistic regression identified the η-like vertebral artery-posterior inferior cerebellar artery (VA-PICA) configuration as a significant independent predictor for the other Babinski sign (Odds Ratio = 4.454, 95% CI: 1.116-17.773, p = 0.034).
Conclusion:
The other Babinski sign is a significant clinical indicator of more severe HFS and is strongly associated with the η-like VA-PICA compression pattern. This sign may aid in preoperative assessment by predicting HFS severity and specific underlying vascular NVC morphologies, potentially informing surgical strategy.
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