瞬目反射在诊断多发性硬化中的意义

Significance of blink reflex in the diagnosis of multiple sclerosis

目的 观察多发性硬化 (MS)时瞬目反射 (BR)的变化 ,了解BR对于MS诊断价值。方法 于眶上切迹处以方波脉冲电刺激眶上神经 ,双侧眼轮匝肌记录 ,测定刺激同侧所记录的R1 、R2 和对侧R′2 的潜伏期及波幅的改变。结果 MS的BR异常率高达 64.7% ,以R1 异常表现突出。有脑桥病损临床表现者R1 异常率 87.5 %、R2 5 0 % ,其它脑干部位病损的R1 异常率5 8.3%、R2 33.3% ,临床亚脑干病损的R1 异常率 42 .9%、R2 2 8.6%。结论 亚脑干病损的高异常率BR ,提示BR可作为评价MS脑干功能的一个客观指示 。

Objective To observe the variations of blink reflex (BR) for understanding its dignostic value in multiple sclerosis(MS). Methods Electrical pulse was used to stimulate the supraorbital nerve at the supraorbital foramen. The responses of bilateral orbicularis oculi were recorded, the variations of the latency and amplitude of R 1 and R 2 recorded on the side of stimulation (i.e. ipsilaterally), and of R 2 recorded on the contralateral side were measured. Results The abnormality rate of MS accounted for 64.7% and abnormality rate of R 1 was obvious. Abnormality rate of R 1 and R 2 in the patients with clinical signs of pontine lesion accounted for 87.5% and 50%, respectively. Abnormality rate of R 1 and R 2 in the patients with brainstem lesion, except for the pontine, accounted for 58.3% and 33.3%. Abnormality rate of R 1 and R 2 in the patients without brainstem lesion accounted for 42.9% and 28.6%. Conclusion The high abnormality rate of BR in patients without brainstem lesion suggests that BR can serve as an objective index and that BR examination is helpful in early diagnosis of MS.