Inagaki M, Kaga M, Maegaki Y, Kinoshita H, Hirano S
Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Chiba, Japan.
J Child Neurol. 1996 May;11(3):205-9. doi: 10.1177/088307389601100308.
The electrically elicited blink reflex was examined and evaluated quantitatively in 60 controls and seven patients with cerebral palsy due to perinatal asphyxia who exhibited normal auditory brainstem responses. In the controls, the early component (R1) latency changed slightly from infancy to adulthood, and the late component (R2 and R2') latencies decreased to adult values by 4 to 6 years of age. The electromyographic activity of R2 and R2' increased later and became mature in the young adolescent period. Prolonged R2 latency and decreased R2 amplitude were observed more frequently than R1 abnormalities in the patients. The electromyographic activity of R2 in the patients was lower than that in control subjects more than 13 years old. Almost all patients showed bilateral cerebral atrophy and dilated lateral ventricles, but only one patient exhibited distinct pontine atrophy on cranial computed tomographic scan. These electrophysiologic abnormalities suggest that decreased excitability of interneurons of the reflex arc was present in the patients, particularly in older ones. The blink reflex test seems to be more sensitive than the auditory brainstem response for detecting brainstem dysfunction in patients with cerebral palsy due to neonatal asphyxia.
对60名对照者以及7名因围产期窒息导致脑瘫且听觉脑干反应正常的患者进行了电诱发眨眼反射检查并进行定量评估。在对照者中，早期成分（R1）潜伏期从婴儿期到成年期略有变化，晚期成分（R2和R2'）潜伏期在4至6岁时降至成人水平。R2和R2'的肌电活动稍后增加，并在青少年早期成熟。与R1异常相比，患者中R2潜伏期延长和R2波幅降低更为常见。患者中R2的肌电活动低于13岁以上对照者。几乎所有患者均表现为双侧脑萎缩和侧脑室扩大，但仅1例患者在头颅计算机断层扫描上显示明显的脑桥萎缩。这些电生理异常表明，患者尤其是年龄较大者存在反射弧中间神经元兴奋性降低的情况。眨眼反射测试在检测新生儿窒息所致脑瘫患者的脑干功能障碍方面似乎比听觉脑干反应更敏感。
