engleski

The value of Blink-reflex as a predictor of outcome of idiopathic peripheral partial facioparesis

The study has been done on 30 subjects diagnosed according to the ICD-X criteria. The symptomatic disease had been ruled out by means of laboratory and radiologic tests. We have stimulated the supraorbital foramen and recorded the evoked response from both mm. orbicularis oculi. We have measured the amplitudes and the latencies of the ipsilateral early phasic component (R1) and the bilateral late tonic component (R2, R2, ). The measurements have been made in the acute phase of the illness, and again 1 week and 6 months after the onset of symptoms. All patients have been treated with prednisone 80 mg/day orally beginning right after the onset and given for one week, then gradually decreased during the second week. In the group of subjects suffering from the idopathic facioparesis, in the acute phase, the Blink-reflex showed slightly prolonged latencies and reduced amplitudes of both R1and R2 on the afflicted side and the normal latencies and amplitudes at the contralateral side, proving the dysfunction in the efferent part of the reflex cycle. All subjects showed clinical symptoms and the neurogenic EMG changes, while 24 (80%) displayed the Blink-reflex abnormalities. One week after the onset, all patients were still symptomatic and showed the EMG changes, but the latency and amplitude changes of R1 and R2 remained in only 11 (33, 3%) of the patients. Six months after the onset of symptoms, 21 (70%) of the patients have become asymptomatic and showed no EMG changes, 7 (23, 3%) had no clinical symptoms, but the chronic neurogenic EMG changes could have been observed, while 2 (6, 66%) showed the residual weakness of the facial muscles and the signs of denervation in EMG. Blink-reflex abnormalities, especially the decrease of the R2 amplitude, could have been observed in 6 (20%) patients, 4 of them belonging to the group with the EMG changes and no clinical symptoms and 2 of them belonging to the group with both the EMG changes and the clinical symptoms. All of the patients showing residual clinical and EMG findings belonged to the 33, 3% who had still displayed the Blink-reflex abnormalities 1 week after the onset of symptoms. We believe that these results suggest that the Blink-reflex is a valuable tool for follow-up and the recovery prognosis for the partial idiopathic facioparesis, especially in the the early recovery phase.

blink-reflex; peripheral facioparesis

nije evidentirano