Thomas R J
Department of Internal Medicine, East Tennessee State University, Johnson City 37614.
J Am Geriatr Soc. 1994 Jun;42(6):609-13. doi: 10.1111/j.1532-5415.1994.tb06858.x.
To review the clinical utility of blinking and the release reflexes, palmomental, glabellar, grasp, and snout, as an important part of the bedside neurological examination.
Articles published from 1966 to 1993 that addressed blinking or the release reflexes were identified by searching the MEDLINE database. Thirty-seven references provided clinically useful and applicable information.
There is controversy regarding the optimal method of clinical elicitation of these reflexes. The release reflexes are frequently seen as an incidental abnormality in the elderly. A positive grasp reflex, especially if asymmetrical, is sensitive but not specific for abnormal brain function. Lack of habituation is more important than the mere presence or absence of a reflex. The brainstem circuits involved in the regulation of blinking and the release reflexes are discussed, as are their abnormalities in a variety of clinical settings.
Blinking and the release reflexes have clinical utility in the diagnosis and bedside clinical assessment of diseases as diverse as frontal lobe lesions, hydrocephalus, multiple sclerosis, Parkinson's disease, Alzheimer's disease and other dementias, falls in the elderly, ageing, HIV-encephalopathy, schizophrenia, tumors in the region of the sylvian aqueduct and recovery from head trauma.
回顾瞬目反射和释放反射（掌颏反射、眉间反射、抓握反射和噘嘴反射）作为床边神经学检查重要组成部分的临床应用价值。
通过检索MEDLINE数据库，找出1966年至1993年发表的涉及瞬目反射或释放反射的文章。37篇参考文献提供了临床有用且适用的信息。
关于这些反射临床诱发的最佳方法存在争议。释放反射在老年人中常被视为偶然出现的异常。阳性抓握反射，尤其是不对称时，对脑功能异常敏感但不具特异性。缺乏习惯化比单纯反射的存在或缺失更重要。文中讨论了参与调节瞬目反射和释放反射的脑干回路，以及它们在各种临床情况下的异常表现。
瞬目反射和释放反射在诊断以及床边临床评估多种疾病时具有临床应用价值，这些疾病包括额叶病变、脑积水、多发性硬化症、帕金森病、阿尔茨海默病及其他痴呆症、老年人跌倒、衰老、HIV脑病、精神分裂症、中脑导水管区域肿瘤以及头部外伤后的恢复情况。
