Babinski's brow lift sign

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Babinski’s brow lift sign is seen only in hemifacial spasm (HFS) and consists of co-contraction of the frontalis and orbicularis oculi muscles causing simultaneous eye closure and paradoxical elevation of the eyebrow during a spasm (Video).(1) This movement is impossible to execute voluntarily and does not occur in blepharospasm, tic or psychogenic movement disorders. It seems very specific for HFS. The brow lift sign is a key feature helping to separate psychogenic from organic HFS.(2)

The brow lift sign has been referred to as the “other Babinski sign,” but at least nine signs bear Babinski’s name and this designation has been used for other signs as well, most notably Babinski’s platysma sign.(3)

Video courtesy of Dr. Stephen Reich, Department of Neurology, University of Maryland


1. Stamey, W and Jankovic, J. The other Babinski sign in hemifacial spasm. Neurology. 2007; 69:402-404. 2. Baizabal-Carvallo JF, Jankovic J. Distinguishing features of psychogenic (functional) versus organic hemifacial spasm. J Neurol. 2016 Dec 9. [Epub ahead of print] 3. Leon-Sarmiento FE, Prada LJ, Torres-Hillera M. The first sign of Babinski. Neurology 2002;59:1067