Work

The other Babinski sign in Hemifacial Spasm: a clinical marker of severity and its predictive association with η-like vA-PICA compression

Year: 2025

Type: article

Abstract: 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.

Source: Annals of Medicine

DOI: 10.1080/07853890.2025.2596480