Department of Neurological Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Gerontology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Neurol Res. 2021 Jul;43(7):591-594. doi: 10.1080/01616412.2021.1900705. Epub 2021 Apr 15.
: To determine the value of the blink reflex in evaluating trigeminal sensory function during microvascular decompression for trigeminal neuralgia.: The blink reflex (BR) in 103 patients with primary typical trigeminal neuralgia treated by microvascular decompression (MVD) was tested pre- and intraoperatively. The changes in BR were recorded. All patients underwent general anesthesia with intravenous propofol and fentanyl. Surgical efficacy and complications were evaluated after surgery. The relationship between intraoperative changes in the BR and postoperative trigeminal sensory function was analyzed.: The BR was elicited in all patients before surgery, and no significant difference was found between the affected side and the contralateral side. In 93 of the 103 cases, the BR was successfully elicited during MVD surgery. Therefore, the recordability of the BR was 90.29%. R1 latency on the affected side and the contralateral side were 11.62 ± 4.96 ms and 11.66 ± 4.37 ms, respectively. During MVD surgery, R1 of the BR disappeared on the affected side in 7 cases and remained in 86 cases. After the operation, 98 of the 103 patients had immediate and complete remission of trigeminal neuralgia symptoms, and 5 cases had partial remission. The 7 patients whose R1 disappeared during the surgery all experienced facial numbness postoperatively. Of the 86 patients whose R1 remained, only 2 patients had postoperative facial numbness. Of the 10 patients whose R1 was not recordable during the operation, one complained of postoperative facial numbness. No patients had complications such as facial paralysis, cerebrospinal fluid leakage, and death.: Conclusion: The blink reflex may allow monitoring of trigeminal sensory function during microvascular decompression under general anesthesia.
：评估微血管减压术治疗原发性三叉神经痛时三叉神经感觉功能的眨眼反射价值：对 103 例原发性典型三叉神经痛患者在微血管减压术（MVD）治疗前和手术期间进行眨眼反射（BR）测试。记录 BR 的变化。所有患者均接受异丙酚和芬太尼静脉全身麻醉。术后评估手术疗效和并发症。分析术中 BR 变化与术后三叉神经感觉功能的关系。：所有患者术前均引出 BR，患侧与对侧无明显差异。在 103 例病例中，93 例在 MVD 手术中成功引出 BR，因此 BR 的记录率为 90.29%。患侧和对侧 R1 潜伏期分别为 11.62±4.96ms 和 11.66±4.37ms。在 MVD 手术过程中，BR 的 R1 在 7 例患者的患侧消失，86 例患者保留。术后，103 例患者中有 98 例立即完全缓解三叉神经痛症状，5 例部分缓解。手术过程中 R1 消失的 7 例患者术后均出现面部麻木。R1 保留的 86 例患者中，仅 2 例术后出现面部麻木。在手术过程中 R1 不可记录的 10 例患者中，有 1 例术后出现面部麻木。无患者出现面瘫、脑脊液漏、死亡等并发症。：结论：在全身麻醉下进行微血管减压术时，眨眼反射可能有助于监测三叉神经感觉功能。
