Kazem Shakouri S, Behzad Davoudi
Department of Physical Medicine & Rehabilitation, Tabriz University of Medical Science, Shohada Hospital, Tabriz, Iran.
Am J Phys Med Rehabil. 2006 May;85(5):449-52. doi: 10.1097/01.phm.0000197590.10469.4b.
Peripheral neuropathy (PN) is one of the late complications of diabetes mellitus. Cranial nerves III, VII, and V are among the most commonly affected in diabetic patients. Traditional electrodiagnosis (Edx) studies are a useful method for diagnosis of PN and symptomatic cranial neuropathy, and may not be useful for detecting subclinical involvement of cranial nerves. The main objective of this study is to evaluate the role of blink reflex (BR) for early diagnosis of cranial neuropathy in diabetic patients with PN.
A prospective study was performed on NIDDM patients with PN. One hundred eighty-eight subjects were included in our study in which 142 acted as healthy subjects and 46 as diabetic patients. Patients were excluded with prior history of cranial nerve lesions, stroke, or any other disease with polyneuropathy or drug-induced neuropathy. Routine nerve conduction studies were performed, and only patients with PN were included in this study.
Abnormalities were found in 54.4% of patients. R1, IR2, and CR2 were prolonged relative to the healthy group. Statistically there was no significant difference in R/D ratio of patients (P=0.201). Also, there was a positive correlation between R1, IR2, and CR2 latencies with duration of diabetes and severity of polyneuropathy, but not for R/D. The greatest correlation was shown in R1 latency (69.9% abnormality).
BR is a noninvasive and very useful method for the evaluation and diagnosis of subclinical cranial nerve involvement in diabetic patients.
周围神经病变（PN）是糖尿病的晚期并发症之一。糖尿病患者中，第三、第七和第五颅神经是最常受影响的神经。传统的电诊断（Edx）研究是诊断PN和症状性颅神经病变的一种有用方法，但可能无法检测出颅神经的亚临床受累情况。本研究的主要目的是评估眨眼反射（BR）在糖尿病合并PN患者颅神经病变早期诊断中的作用。
对患有PN的非胰岛素依赖型糖尿病（NIDDM）患者进行了一项前瞻性研究。我们的研究纳入了188名受试者，其中142名作为健康受试者，46名作为糖尿病患者。排除有颅神经病变、中风或任何其他伴有多发性神经病变或药物性神经病变疾病既往史的患者。进行了常规神经传导研究，本研究仅纳入患有PN的患者。
54.4%的患者发现异常。与健康组相比，R1、IR2和CR2延长。从统计学上看，患者的R/D比值无显著差异（P = 0.201）。此外，R1、IR2和CR2潜伏期与糖尿病病程和多发性神经病变严重程度呈正相关，但与R/D无关。R1潜伏期的相关性最强（异常率为69.9%）。
BR是评估和诊断糖尿病患者亚临床颅神经受累的一种无创且非常有用的方法。
