瞬目反射在糖尿病患者中的应用

３０例糖尿病患者的瞬目反射（ＢＲ）结果显示，糖尿病组左右两侧Ｒ１、Ｒ２、Ｒ２’各反应波潜伏期均值比较无显著差异（Ｐ＞０．０５），将两侧值平均后与正常人比较，各反应波潜伏期有不同程度的延长，以Ｒ２和Ｒ２’延长显著（Ｐ＜０．０１—０．００１），且各波波幅均值低于正常人（Ｐ＜０．００１）。表明糖尿病性中枢神经系统损害可影响脑干，受损部位以桥脑为主。糖尿病病程与ＢＲ反应波的潜伏期异常率有一定关系，病程长的ＢＲ异常率高（Ｐ＜０．０５），而空腹血糖水平与ＢＲ反应波潜伏期异常率无一定关系（Ｐ＞０．０５）。ＢＲ对揭示临床症状不显的糖尿病性中枢神经系统损害可提供客观而灵敏的指标。     

瞬目反射的临床应用研究

本文对26例无脑部病变患者及26例脑部病变的患者分别作了瞬目反射(BlinkReflex BR)的检测。刺激一侧眶上神经,于两侧下眼轮匝肌记录。同侧的两个波为R_1、R_2,对侧的一个波为R′_2。结果脑部病变组双侧R_1、R_2、R_2潜伏期与无脑部病变组比较P值<0.01,有非常显著性差异。提示BR可帮助临床上了解三叉神经、面神经、脑干、丘脑或皮层的机能,可了解病变范围和异常程度,有助于临床定位诊断及药物疗效观察。     

脑外伤患者瞬目反射的观察研究16例报告

颅脑外伤(traumatic brain injury,TBI)是当今青壮年的第一位死因,且致残率高,危害日渐严重。对于TBI后的各种相关研究日益受到关注,有些神经电生理检测,如躯体感觉诱发电位、脑干听觉诱发电位、脑电图、事件相关电位等方面的研究已在TBI的临床中开展。瞬目反射(BR)检测分别反映了三叉神经、面神经及部分脑干的功能活动,这些结构直接或间接的损害都将引起相应的变化。鉴于以往对TBI患者进行BR检测报道较少,故本文特对此进行观察研究,现报告如下。     

三叉神经分布区带状疱疹患者瞬目反射检测结果分析

目的：观察三叉神经分布区带状疱疹患者瞬目反射(BR)检测结果并分析与预后的关系。方法：对18例临床确诊为三叉神经分布区带状疱疹的患者进行BR检测．刺激病侧及对侧眶上神经，在眼轮匝肌进行记录。结果：急性期11例患者BR潜伏期及波幅无明显异常，6例患者R1、R2及R2′潜伏期延长，波幅降低，另1例患者R1及R2、R2′波形消失。上述7例患者中有部分在恢复期遗留有三叉神经分布区感觉减退及神经痛。结论：部分三叉神经带状疱疹患者可出现BR异常，对预后有一定判断作用。     

正常学龄儿童瞬目反射的初步研究

应用电刺激法研究４０例正常学龄儿童的瞬目反射。通常能诱发出刺激侧快反应（Ｒ１）、迟反应（Ｒ２）及对侧迟反应（Ｒ２＇）。分析Ｒ１的形态、各波的潜伏期、时程、波幅，制定出正常值。瞬目反对的检查结果可作为诊断多种脑干障碍和三叉神经、面神经病变的方法。     

慢性酒精中毒性脑病患者瞬目反射的研究

慢性酒精中毒性脑病（chronic encephalopathy of alcoholism,CEA）是长期、大量饮酒引起的神经精神疾病.酒精中毒患者血脑屏障通透性增加,导致中枢神经系统的广泛而严重损害.CEA患者存在脑干损害.瞬目反射（BR）是脑干反射的一种,对脑干病变的诊断有重要价值.我们回顾分析了31例在我科确诊为CEA患者的BR检测结果,以了解其中的临床意义.     

长期服用苯妥英钠的癫癎患者瞬目反射检测

为探讨长期服用苯妥英钠对神经系统传导功能的影响,我们从１９９８年１月至２０００年１月对２０例长期口服苯妥英钠的癫 患者和１８例健康对照组进行瞬目反射检测（ＢＲ）,现将结果报告如下。１资料和方法服药组：本研究包括长期口服苯妥英钠（１年以上）的癫　患者２０例,其中男１２例,女８例,年龄５～６９岁,平均２３５岁。服用苯妥英钠时间为１～１０年。对照组：为年龄与服药组基本一致的正常人１８例,男１２例,女６例,年龄８～６５岁,平均２５５岁。检测方法：被检查者于安静房间里,室温控制在２５～３０℃,保持清醒…     

瞬目反射检查对面神经炎的诊断价值

笔者对我院临床诊断为面神经炎的 115例患者进行瞬目反射 (ＢＲ)检查 ,现分析报告如下。1　资料及方法临床资料 :本组 115例中 ,男性 6 3例 ,女性 5 2例 ,年龄17～ 80岁 ,平均 4 3 7岁 ,其中≤ 2 0岁 3例 ,2 0～ 5 9岁 82例 ,6 0岁以上 30例。左侧病变 5 8例 ,右侧病变 5 7例。ＢＲ检测时病程最短半天 ,最长 2 0年 ,其中半天～ 3天 6 0例 ,4～ 7天32例 ,2～ 3周 8例 ,1月～ 1年 13例 ,10年 1例 ,2 0年 1例。检测方法 :采用美国ＮｉｃｏｌｅｔＶｉｋｉｎｇⅡｅ神经电生理检测仪 ,患者仰卧放松 ,轻轻闭眼 ,于 2 0～ 30℃室温下 ,在铜网屏蔽室…     

瞬目反射检查在慢性肾功能衰竭患者中的应用

目的：观察慢性肾功能衰竭患者瞬目反射（ＢＲ）的特点并探讨其临床意义。方法：检测１７例慢性肾功能衰竭患者及３０名健康成人ＢＲ。结果：慢性肾功能衰竭患者ＢＲ的各期反应即Ｒ１、Ｒ２、Ｒ′２的潜伏期分别为１１９３±１３２、３６０９±４２１、３６４７±４５５ｍｓ，均较对照组明显延长（Ｐ＜００５）。结论：ＢＲ检测有助于慢性肾功能衰竭患者神经系统异常的早期诊断     

慢性肾功能不全患者的瞬目反射

本文报道10例慢性肾功能不全患者的瞬目反射(BR)结果,并和正常对照组进行对照分析,以探讨慢性肾功能不全对BR的影响.     

Long-term depression of the human blink reflex

Long-term depression (LTD) of synaptic transmission is reliably induced by low-frequency stimulation (LFS) of presynaptic nerve fibers in vitro. Many experiments suggest that LTD of basal transmission is not readily induced either in awake or anesthetized animals in vivo. In order to fill the gap between the in vitro cell studies and the in vivo situation, the effect of LFS on trigeminal somatosensory processing in healthy volunteers was investigated. Excitability of trigeminal sensory neurons was tested by applying the blink reflex (BR) elicited by electric stimulation of supraorbital nerve afferents. LFS of these afferents induced a significant reduction of the BR integral, a significant increase of the BR onset latency and a significant decrease of the stimulus intensity ratings. This depressive effect on the BR lasted for at least 1 h after the end of LFS. Thus, this study documented for the first time a long-term depression of trigeminal somatosensory processing in healthy volunteers. Electronic Publication     

瞬目反射与神经电图对Bell麻痹的诊断价值

目的：研究瞬目反射（BR）与面神经的神经电图（electroneurogram,ENG）对Bell麻痹（特发性面神经麻痹）的诊断价值。方法：对246例Bell麻痹患者在发病后10d内行BR和ENG检查。结果：BR检测阳性率为100％,ENG检测阳性率为63．8％（P〈0．01）。结论：BR与ENG均能反映面神经损害的严重程度、部位及预后,其中BR在早期诊断中更为敏感,两者结合的临床价值更大。     

面瘫患者面神经电图和瞬目反射的应用比较

目的:比较面瘫患者瞬目反射和面神经电图的应用价值。方法:这些面瘫患者经过四周基础治疗和(或)针灸治疗后,进行健、患侧瞬目反射(207例)和面神经电图(205例)检查比较。结果:瞬目反射治疗前健、患侧R1值的差异有极显著意义(P<0．01);治疗后健、患侧R1值的差异无显著意义 (P>0．05)。面神经电图患侧潜伏期延长者于治疗后均有所好转(P<0．05),波幅降低者治疗后无明显改善(P>0．05)。结论:面瘫患者治疗后瞬目反射改善非常明显,而面神经电图恢复存在明显的滞后现象,早期诊断(发病第一周)瞬目反射检查优于面神经电图,中后期面神经电图检查优于瞬目反射。     

椎基底动脉供血不足和脑干梗死患者的瞬目反射检测

目的：探讨瞬目反射(BR)对椎基底动脉供血不足(VBI)及脑干梗死的临床应用价值。方法：用表面电极刺激三叉神经眶上支，在双侧眼轮匝肌进行记录。对BR异常者治疗1、3、6个月后复查。结果：VBI组80例治疗前BR异常者58例(72．5％)，治疗一个月后复查BR恢复正常者39例，BR正常或治疗后恢复正常者近期都能获得基本痊愈，而BR持续异常者则预后较差。脑干梗死组26例，：BR全部异常且异常程度重于VBI组。结论：在对VBI及脑干梗死诊断、疗效观察及预后评价中，BR是一项极为客观有用的指标。     

Somatosensory eye blink reflex in peripheral facial palsy

To investigate the association between somatosensory blink reflex (SBR) and peripheral facial palsy (PFP) severity and trigeminal blink reflex (BR) changes in cases with PFP and subsequent postparalytic facial syndrome development (PFS). One hundred and twenty subjects with peripheral facial palsy and post-facial syndrome and 44 age and gender matched healthy volunteers were enrolled to this study. Blink reflexes and somatosensory blink reflex were studied in all. The association between R1 and R2 responses of the BR and SBR positivity was investigated. SBR was elicited in 36.3% of normal subjects, in 18.3% of PFP and in 65.3% of PFS patients. In the paralytic side, the frequency of SBR positivity was significantly lower in PFP group compared to controls and SBR was most frequently observed in patients with PFS. Compared to PFP and control groups, SBR positivity on the non-paralytic side significantly revealed a higher rate in PFS patients. SBR positivity of patients in whom R1 or R2 were absent, was significantly lower than those subjects with prolonged or normal R1 or R2 responses. PFP and successive PFS are good models for the sensory motor gate mechanisms and/or excitability enhancement of brainstem neurons responsible for SBR.     

三叉神经诱发电位与瞬目反射在特发性三叉神经痛中的应用比较

目的：探讨三叉神经诱发电位（TSEP）与瞬目反射（BR）检查在特发性三叉神经痛（ITN）中的临床应用比较.方法：采用丹麦产Dantic keypoint多道肌电图-诱发电位仪,对168例ITN患者进行患侧与健侧的TSEP与BR检查,并对其结果进行对比分析. 结果： TSEP提示患侧三叉神经的短潜伏期延长、波幅降低,与健侧比较差异有显著意义（P〈0.01） TSEP的变化与ITN的病程长短及临床表现严重程度有关.而BR提示三叉神经潜伏期与健侧比较差异无显著意义（P〉0.05）,说明患者ITN三叉神经第一支受损较少.TSEP的异常率明显高于BR,是因为TSEP刺激为上颌神经与BR刺激为眼神经的刺激点不同,所以在三叉神经周围结构病变中不具有可比性.结论：TSEP与BR检查是评价三叉神经周围结构和脑干中枢传导通路生理功能的重要方法,有助于对ITN的定性及定量诊断.但因TSEP和BR的波型不稳定、干扰成分大、刺激与记录方法有待标准化、神经解剖与神经电生理基础还有待于进一步明确.     

Modulation of electrically elicited blink reflex components by visual and acoustic prestimuli in man

The effects of a prestimulus on the electrically elicited blink reflex components were investigated in 20 healthy subjects. In the first group of 10 subjects (warned group), electric shocks were delivered in isolation or preceded, at an interstimulus interval (ISI) of 0.1 s, 1 s, or 10 s, by a visual or acoustic warning stimulus. In the second group of 10 subjects (unwarned group), the electric shocks were delivered either in isolation or preceded, at the same ISI, by visual or acoustic stimuli having no warning value. The modulation of the three blink reflex components was then analysed. Compared to the baseline condition, the R1 oligosynaptic component was enhanced at 0.1 s and 1 s ISI, in the warned group with the visual prestimulus, but only at 0.1 s after a visual and acoustic prestimulus in the unwarned group. On the contrary, the polysynaptic responses showed a different course: R2 was significantly reduced at the 0.1 s interval in the warned group with both the prestimuli, and only with the visual prestimulus in the unwarned group. The R3 was inhibited at all three intervals with the visual prestimulus, and at the 0.1 s and 1 s with the acoustic one in the warned group, and only at 0.1 s in the unwarned group, both after visual and acoustic prestimuli. The decrement in R2 and R3 observed with the shortest interval was probably related to the prepulse inhibition of startle reflex. Furthermore, only R3 was still inhibited at longer intervals, when the sustained processes of attention may have influenced this component. Perhaps this combination of events represents, in the warned group, the best preparation for voluntary reflex reaction.     

Attentional blink reflex modulation in a continuous performance task is modality specific

Four experiments investigated the attentional modulation of acoustic blinks during continuous spatial tracking tasks. Experiment 1 found blink magnitude inhibition in a visual tracking task. Experiment 2 replicated this finding and also found blink latency slowing. Experiment 3 varied the difficulty of the task and found larger blink inhibition in the easy condition. Blink latency slowing did not differ and was significant at both difficulty levels. Experiment 4 employed less difficult visual and acoustic tracking tasks at two levels of task load. Blink magnitude inhibition during the visual and facilitation during the acoustic task was significant during high load in both modality groups. Blink latency was slowed in all visual task conditions and shortened in the difficult acoustic task. These results indicate that attentional blink modulation in a continuous spatial tracking task is modality specific.     

偏头痛患者发作期脑干听觉诱发电位和瞬目反射检测

目的：观察偏头痛患者发作期脑干听觉诱发电位(BAEP)和瞬目反射(BR)改变。方法：对45例偏头痛发作期患者进行BAEP、BR检测。结果：BR和BAEP联合检测提示脑干病变者31例，占69％；BAEP、BR检测提示听神经、三叉神经传入通路功能障碍和面神经传出通路功能障碍共26例，占58％，其中三叉神经传入通路障碍21例，占81％。结论：偏头痛发作期存在着以脑干和三叉神经为主的神经功能障碍．与血管舒缩功能障碍很可能互为因果、相互影响。