Kawamura H, Amano K, Tanikawa T, Kawabatake H, Kubo O, Kitamura K, Ono Y
No Shinkei Geka. 1986 Aug;14(9):1113-9.
Recently, the brainstem pathways of bilateral late reflexes (R2) of electrically elicited blink reflex have been well established. An afferent delay or block of the late reflexes is closely related to a lesion of the lateral medullary portion. The chronological alteration of blink reflex (BR) was studied to compare with radiological abnormalities on MRI in a patient with lateral medullary infarction on the right side. A diagnosis of Wallenberg syndrome was made clinically and location of the lesion was identified in detail by MRI. The infarcted region which was well demonstrated as an increased intensity area on SE images obtained 52 days after the onset of symptoms was much smaller than that on SE as well as on IR image 21 days after the onset of symptoms. Therefore, it was concluded that more than half of the increased intensity area on the SE images obtained 21 days after the onset of symptoms recovered from the condition of being extremely damaged by ischemia on the right lateral medullary portion in this patient. On the other hand, in the initial BR 26 days after the onset of symptoms, the late reflexes (R2) were consistently absent bilaterally when the affected side (right) was stimulated and normal when the normal side (left) was stimulated. This type of BR abnormality is compatible with an afferent block of late reflexes (R2). The early reflex (R1) was normal on either side. Whereas in the second BR at 55 days after the onset of symptoms, the late reflexes turned to be normal in latency when the right side was stimulated.(ABSTRACT TRUNCATED AT 250 WORDS)
最近，电诱发眨眼反射的双侧迟发反射（R2）的脑干通路已得到充分证实。迟发反射的传入延迟或阻滞与延髓外侧部病变密切相关。对一名右侧延髓梗死患者的眨眼反射（BR）的时间变化进行了研究，以与MRI上的放射学异常进行比较。临床上诊断为瓦伦贝格综合征，并通过MRI详细确定了病变位置。症状出现52天后获得的SE图像上梗死区域显示为高强度区域，比症状出现21天后的SE图像以及IR图像上的梗死区域小得多。因此，可以得出结论，在该患者中，症状出现21天后获得的SE图像上超过一半的高强度区域从右侧延髓外侧部因缺血而极度受损的状态中恢复。另一方面，在症状出现26天后的初始BR中，当刺激患侧（右侧）时，双侧迟发反射（R2）始终缺失，而当刺激正常侧（左侧）时则正常。这种类型的BR异常与迟发反射（R2）的传入阻滞相符。两侧的早期反射（R1）均正常。而在症状出现55天后的第二次BR中，当刺激右侧时，迟发反射的潜伏期恢复正常。（摘要截短于250字）
