• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.25-28
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• 2012

Background: Bell's palsy is the most common disease of cranial nerve. While most electrodiagnostic tests can detect the abnormality of facial nerve several days later in Bell's palsy, blink reflex usually reveals the abnormality earlier than other tests. Therefore, we investigated the diagnostic usefulness of blink reflex in the early stage of Bell's palsy. Methods: We performed a prospective investigation in patients with facial palsy. We enrolled patients with Bell's palsy who were evaluated within 7 days of symptom onset and excluded patients with secondary causes of facial palsy. We analyzed the findings of blink reflex according to age, sex, evaluation time, and severity of facial palsy. Results: Of 320 consecutive patients with facial palsy, a total of 204 patients were enrolled. Blink reflex was normal for 10 patients and abnormal for 194 patients. The time interval between the symptom onset and the evaluation time was not associated with the result of blink reflex, but House-Brackmann grade was significantly related to the result of blink reflex (P<0.001). Patients with mild Bell's palsy often showed normal blink reflex. Conclusions: Our study shows that blink reflex is useful diagnostic test regardless of evaluation timing in the early stage of Bell's palsy, although it could be normal in patients with mild Bell's palsy.

• Biomedical Science Letters
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• v.18 no.4
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• pp.391-398
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• 2012

The conventional blink reflex has limited clinical application since it displays a wide range of change in the responses. Thus, we studied the blink reflex using the averaging process which is engaged in evoked potential studies in order to measure various responses such as latency, amplitude, and duration, which have been difficult to measure due to their wide ranges of changes. Among the Bell's palsy patient group, 13 patients who had the symptoms of incomplete palsy were examined to assess the results of the blink reflex through the averaging process. The subjects were 54 people in a normal group (108 eyes) and 18 patients (36 eyes) with Bell's palsy. For the study method, the conventional blink reflex and the blink reflex using the averaging process were measured for the people in the normal group, while in the Bell's palsy group, only the blink reflex using the averaging process was analyzed. In the case of the normal group, the blink reflex using the averaging process could measure all of the latency, amplitude, and duration. It was also observed that the latency, amplitude, and duration of R1, ipsilateral R2, and contralateral R2 significantly differed on the affected side of the Bell's palsy patients, compared to the unaffected side. The blink reflex using the averaging process should be more effective than the conventional method since the former can evaluate the latency, amplitude, and duration for Bell's palsy, while the latter can only assess latency.

• Archives of Plastic Surgery
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• v.47 no.6
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• pp.559-566
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• 2020

Background Infraorbital nerve dysfunction is commonly reported after zygomaticomaxillary complex fractures. We evaluated sensory changes in four designated areas (eyelid, nose, zygoma, and lip) innervated by the infraorbital nerve. This evaluation was conducted using the static two-point discrimination test and the vibration threshold test. We assessed the diagnostic significance of the blink reflex in patients with infraorbital nerve dysfunction. Methods This study included 18 patients, all of whom complained of some degree of infraorbital nerve dysfunction preoperatively. A visual analog scale, the infraorbital blink reflex, static two-point discrimination, and the vibration threshold were assessed preoperatively, at 1 month postoperatively (T1), and at a final follow-up that took place at least 4 months postoperatively (T4). The results were analyzed using a multilevel generalized linear mixed model. Results Scores on the visual analog scale significantly improved at T1 and T4. The infraorbital blink reflex significantly improved at T4. Visual analog scale scores improved more rapidly than the infraorbital blink reflex. Two-point discrimination significantly improved in all areas at T4, and the vibration perception threshold significantly improved in the eyelid at T4. Conclusions Recovery of the infraorbital blink reflex reflected the recovery of infraorbital nerve dysfunction. We also determined that the lip tended to recover later than the other areas innervated by the infraorbital nerve.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.88-92
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• 2005

Blink reflex could be a useful tool to differentiate facial synkinesis as one of complications of facial neuropathy, from volitional associated movements. We had performed applied blink reflex test for 23 patients with objective evidence of hemifacial weakness in which orbicularis oculi muscle(zygomatic branch) and mentalis muscle(mandibular branch) are electrophysiologically evaluated in response to supraorbital stimulation of trigeminal nerve. For an unaffected side of face there is no evidence of positive blink reflex from the mentalis muscle. We concluded that a positive blink reflex from mentalis muscle is almost always suggestive of chronic facial neuropathy even in clinical silence of facial synkinesis, or an aberrant reinnervation after peripheral facial neuropathy, and does not electrophysiologically correlate with the severity of facial palsy.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.779-782
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• 2010

Purpose: As the evaluation of the preoperative sensibility in the orbitozygomatic complex fracture, used by most surgeons, depends on the patient's subjective judgements, it is difficult to make generalization and to use it as an objective evaluation method. We used the blink reflex study to objectively evaluate injury to the infraorbital nerve. Methods: From December 2008 to November 2009, a total of 16 patients underwent the patient's subjective report on sensory symptoms and the blink reflex study preoperatively. Among patients having orbitozygomatic complex fracture of type III or more according to Henderson's classification and simultaneously suspected as being injured along the infraorbital nerve pathway, patients who had difficulty in checking preoperative sensibility and said 'normal sensibility' were selected as candidates. Results: Fifteen patients showed abnormal R1 on the fracture side. These results suggested that most of patients had injury to the infraorbital nerve. Conclusion: Contrary to the existing tests, the blink reflex study is a useful diagnostic tool in reflecting injury to the infraorbital nerve objectively.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.144-147
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• 2018

Although dysgeusia can occur as a consequence of stroke attacks, many physicians and patients tend to overlook it. A 50-year old woman complained of a 2-week history of abnormal sense of taste on the anterior two-thirds of right tongue. Blink reflex test demonstrated prolonged ipsilateral and contralateral R2 responses with the right supraorbital nerve stimulations, which suggest the lesion on the descending pathway. Brainstem magnetic resonance imaging (MRI) demonstrated abnormal findings in the right lower dorsal pons, anterior to 4th ventricle, lateral to inferior colliculus, and at the level of the pontomedullary junction, which was compatible with solitary tract nucleus and spinal trigeminal nucleus. Brainstem infarction should be considered in patients who have abnormal sense of taste. Additionally, blink reflex test may be helpful for the detection of central origin dysgeusia.

• Journal of Acupuncture Research
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• v.31 no.4
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• pp.121-131
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• 2014

Objectives : This study was performed to find the relation between prognosis of peripheral facial palsy and blink reflex. Methods : Data was collected from patients who were admitted and treated by East-West Collaborative Treatment of Facial Palsy Center in Kyung Hee University Hospital at Gangdong from January 2012 to June 2013. Patients were screened by inclusion/exclusion criteria and 163 patients' medical records were reviewed including blink reflex performed $14{\pm}2$ days after onset and House-Brackmann grade. Patients were divided into three groups, normal, delayed and absent group by blink reflex test. Trends of each recovery rate to House-Brackmann grade II and I depending on three group were analyzed at 1 month, 3 months and 6 months after onset using Linear by linear association. Results : At 1 month, 3 months and 6 months after onset, both recovery rate to House-Brackmann grade II and I had a tendency to be decreased statistically significantly in order of normal, delayed and absent group. Conclusions : We could find feasibility of blink reflex as a prognostic factor of peripheral facial palsy. Further study will be necessary.

• Journal of Korean Physical Therapy Science
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• v.4 no.3
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• pp.499-509
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• 1997

The facial nerve have a long pathway. Thus facial nerve fibers easily involved at any point along their course will lead to a facial palsy of lower motor neuron type and upper motor neuron type. The electrophysiologic examination can evaluate and anticipating that prognosis of facial nerve palsy. The electrophysiologic examination are Nerve Excitability Test(NET), Elecctroneurography(ENG), Electro-myography(EMG), Blink Reflex, and Electrogustometry et.al. The NET is very useful method for assessment of prognosis and distinguish between nerve degeneration and physiological block as early as 72 hour after onset of the facial palsy. And other examination also give objectively information of facial nerve for prognosis and treatment. Treatment goal of physiotherapy are prevent contracture and disuse atrophy of facial muscle with muscle reeducation and strengthening and maintain symmetry facial motion. The treatment better start as early as possible.

• Annals of Clinical Neurophysiology
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• v.4 no.2
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• pp.146-148
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• 2002

Progressive systemic sclerosis (PSS) is a multi-systemic disorder characterized by abundant fibrosis of the skin, blood vessels, and visceral organs. But it rarely affects the peripheral nervous system. We report a 36-year-old man of painful trigeminal neuropathy as a complication of PSS. He was referred from Rheumatology for the evaluation of abruptly developed bilateral facial pain. He had facial hypesthesia and paresthesia on neurologic examinations. In the blink reflex, ipsilateral and contralateral R1 and R2 responses were not detected during bilateral supraorbital stimulation. But normal latency and CMAP amplitude of facial NCV were found. Under the impression of trigeminal neuropathy caused by PSS, steroid therapy was tried, and his clinical symptoms and electrophysiologic findings were improved. PSS could be the cause of the painful trigeminal neuropathy.

• Annals of Clinical Neurophysiology
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• v.1 no.2
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• pp.126-146
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• 1999

In clinical neurology various different electrophysiological tests are widely used to demonstrate the unsuspected malfunctioning in the nervous system and to monitor over time the clinical status of patients. In addition clinical neurologists and neurosurgeons take advantage of the intraoperative monitorings to increase the quality of neurosurgical operations in the posterior fossa, in the spinal cord, or in visual pathways. In the field of movement disorders, elecrophysiolgical tests provide neurologists with making accurate differential diagnoses with useful therapeutic stratergies as well as with investigating the pathophysiological machanisms. By using the electromyographic tests it could be possible for us to evaluate the types of blephalospasm, the extent of hemifacial spasm, the level of myoclonus, and the prime muscles of torticollis etc. Sometimes the myographic guidance may be critical for choosing the exact injecting site of botulinum toxin. These several decades various electroencephalographic and evoked potential tests has been utilized in the electrophysiological laboratories to understand the basic pathophysiology of myoclonus, spasticity and other central motor dysfunctions. It could be one of the breakthroughs in the area of behavorial neurology that the brain function can be mapped by the spontaneous or evoked electrical activities of nervous system since the movement related potentials (MRPs) had been studies for several decades. Various reflex tests such as masseter reflex, blink reflex, click evoked vestibulocollic reflex, facial reflex, stretch reflex, flexor reflex, H-reflex, H-reflex recovery curve, vestibular inhibition of H-reflex, reciprocal inhibition, recurrent or Renshaw reflex, Ib inhibition, cutaneous reflex have been also used to understand normal or abnormal physiology in movement disorders. Polysomnography, posturography and gait studies are also applied in clinical neurology in association with with movement disorders which are useful in deciding the treatment regimen.