Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research
  Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login  
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 3235       

   Table of Contents      
CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 129

The ‘other Babinski sign’ in child neurology


Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India

Date of Submission19-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Lokesh Saini
Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_2212_19

Rights and Permissions

How to cite this article:
Madaan P, Saini L. The ‘other Babinski sign’ in child neurology. Indian J Med Res 2020;152, Suppl S1:129

How to cite this URL:
Madaan P, Saini L. The ‘other Babinski sign’ in child neurology. Indian J Med Res [serial online] 2020 [cited 2021 Aug 4];152, Suppl S1:129. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/129/316777

Consent to publish clinical information and images obtained from patient's parent.


A 24 month old female child, developmentally normal girl, presented to the Pediatric Neurology Unit, Postgraduate Institute of Medical Education & Research, Chandigarh, India, in July 2019, with near-continuous twitching of the left eyelid, forehead and cheek noted since two months of age. Twitching persisted even in sleep and worsened during crying and eating. She was put on three antiepileptic drugs with no response. Examination revealed left hemifacial spasm (HFS) with 'the other Babinski sign or browlift sign' (Video). This sign occurs as a result of different suprasegmental innervation of these muscles; signifying peripheral co-activation at the level of the seventh nerve. This occurs as a result of different suprasegmental innervation of these muscles; signifying peripheral co-activation at the level of the seventh nerve. Rest of the examination was unremarkable. Electroencephalography [Figure 1] was normal. Neuroimaging revealed fourth ventricular hamartoma. Hence, the final diagnosis of left HFS with fourth ventricular hamartoma was made. She partly responded to carbamazepine and was planned for gamma-knife ablation of the hamartoma.
Figure 1: Sleep electroencephalography epoch of the index child. 10 sec electroencephalography epoch (bipolar montage; sensitivity: 70 uV; sweep speed: 30 mm/s) showing repetitive, abrupt-onset, bursts of fast activity (arrows) over the left frontotemporal electrodes time locked with the event, simulating myogenic artefact.

Click here to view


[Additional file 1]

The 'other Babinski sign' (co-contraction of ipsilateral orbicularis oculi and frontalis resulting in simultaneous eye closure and browlift) is an under-recognized but useful sign in HFS. It helps in distinguishing HFS from epileptic events and blepharospasm.

Conflicts of Interest: None.


    Figures

  [Figure 1]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Article Figures

 Article Access Statistics
    Viewed218    
    Printed0    
    Emailed0    
    PDF Downloaded30    
    Comments [Add]    

Recommend this journal