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[桥小脑角肿瘤的瞬目反射评估]

[Evaluation of blink reflexes in cerebellopontine angle tumors].

作者信息

Nagahiro S, Matsukado Y, Kaku M, Wada S, Urasaki E

出版信息

No To Shinkei. 1983 Nov;35(11):1117-24.

PMID:6607058
Abstract

Blink reflexes were analysed in 28 cases with cerebello-pontine angle tumors (22 cases of acoustic neurinoma and 6 cases of meningioma). In patients with acoustic neurinoma, delay or absence of R1 was found in all but two cases (91%) and abnormality of R2 was in 11 (50%). Estimating the mean latency difference of R1 on both sides it was found useful for establishing early diagnosis of small acoustic neurinomas, which had no apparent clinical signs of facial or trigeminal nerve involvement. In patient with obsolete hemorrhage (5 cases) or large cyst (6 cases) within the acoustic neurinomas, which were proven at operation, abnormality of blink reflexes was more prominent than in patient with solid tumors (11 cases). In patients with meningioma, although all were huge tumors, abnormality of R1 was less conspicuous in comparison with acoustic neurinoma. Bilateral delay of R2 was found in 3 of 6 patients. In 13 patients who underwent spinal accessory-facial anastomosis for facial palsy after removal of the tumors, R1-like response were recorded in all but one on the affected side and R2-like response was recorded in only one patient. Observing alteration of blink reflexes in patients with cerebello-pontine angle tumor was useful for establishing early diagnosis and evaluating function of trigeminal nerve, facial nerve and brainstem.

摘要

对28例桥小脑角肿瘤患者(22例听神经瘤和6例脑膜瘤)进行了瞬目反射分析。在听神经瘤患者中,除2例外,其余所有病例(91%)均发现R1延迟或缺失,11例(50%)R2异常。通过估计双侧R1的平均潜伏期差异,发现其有助于早期诊断无明显面或三叉神经受累临床体征的小型听神经瘤。在经手术证实的听神经瘤内有陈旧性出血(5例)或大囊肿(6例)的患者中,瞬目反射异常比实性肿瘤患者(11例)更明显。在脑膜瘤患者中,尽管均为巨大肿瘤,但与听神经瘤相比,R1异常不太明显。6例患者中有3例出现双侧R2延迟。在13例肿瘤切除后因面瘫接受副神经-面神经吻合术的患者中,除1例外,患侧均记录到类似R1的反应,仅1例患者记录到类似R2的反应。观察桥小脑角肿瘤患者瞬目反射的变化有助于早期诊断和评估三叉神经、面神经及脑干功能。

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