探讨脑卒中患者瞬目反射的变化

Blink reflex in stroke

目的 探讨脑卒中患者瞬目反射的变化。方法 采用日本MEM 312 0型肌电图检查仪 ,室温2 0～ 2 5℃ ,对 4 0例脑卒中患者于眶上切迹处以方波脉冲电刺激眶上神经 ,记录双侧眼轮匝肌的反应 ,测定刺激同侧的R1、R2 波和对侧的R2′波的潜伏期及波幅变化 ,同时对 2 3例正常对照组进行测定。结果 脑卒中组瞬目反射各波的潜伏期延长 ,而波幅减低 ,与对照组比较有显著性差异 ;R1、R2 、R2′的异常率分别为6 7.5 %、81.3%和 76 .3%。结论 脑卒中患者的瞬目反射异常可能是锥体束损害后脑干内的冲动传递速度减慢或三叉神经和面神经的滋养血管硬化引起营养障碍的结果 ,且其异常与病变性质、部位和病程无明显关系。

Objective In order to approach change of blink reflex(BR) in patients with stroke. Methods Forty patients with cerebral stroke were examined. Electrical pulse was used to stimulate the supraorbital nerve at the supraobital notch. The responses of bilateral orbicular muscle of eye were recorded. The latency and amplitude of R 1 and R 2 were recorded on the side of stimulation, mean while the latency and amplitude of R 2′ were measured on the contralateral side. Results There was significant prolongation in the latency and decrease in the amplitude of R 1, R 2 and R 2′ in the patients with cerebral stroke comparing with the control gruop. The abnormality rate of different components of BR accounted for 67.5% in R 1, 81.3% in R 2, 76.3% in R 2′ respectively.Conclusions This study indicates that the abnormalities of BR in patients with stroke may be related to the decrease of conduct speed in brain stem and the sclerosis of nutritional vascular in trigeminal and facial nerves. The abnormalities of BR were poor correlated with the following conditions: lesion site, cause and time of onset.