脑卒中对瞬目反射的影响  

Effects of hemispheric cerebrovascular diseases on blink reflex

作　　者：卢祖能[1] 聂传云[1] 曾庆杏[1] 汤晓芙[2] 

机构地区：[1]湖北医科大学附属第一医院神经科,430060 [2]北京协和医院神经科

出　　处：《卒中与神经疾病》2000年第1期40-42,共3页Stroke and Nervous Diseases

摘　　要：目的 :探讨脑干以上节段的病变对瞬目反射 ( BR)的影响。方法 :共 3 0例脑卒中患者作了 BR检测。于眶上切迹处以方波脉冲电流刺激眶上神经。双侧下眼轮匝肌分别记录 ,刺激同侧所记录的两个波为 R1 、R2 ,刺激的对侧所记录到的一个波为 R'2 。结果 :( 1 ) BR2例正常、2 8例异常。 ( 2 )在这 2 8例 56侧中 BR各成分的异常率分别为 R1 :4 8.2 % ( 2 7/56)、R2 :69.6% ( 3 9/56)、R'2 :57.1 % ( 3 3 /56)。 ( 3 )两个或以上的 BR成分缺如者 9例 ,其中 5例有神志的改变、2例有失语、2例神志清楚。结论 :大脑半球病变对 BR总的影响是抑制性的。 BR的异常与病人的神志状况及有否失语密切相关 ,而与病变部位、是否有中枢性面瘫、偏瘫、面部感觉障碍以及检测的时间间隔均关系不大。s Objective:To investigate the effects of suprasegmental lesions on blink reflex (BR). Methods:Thirty patients with cerebral stroke were examined with BR. The electrical pulse current with the intensity 15~20 mA was used to stimulate the supraorbital nerve at the supraorbital foramen on one side, the responses of bilateral inferiororbicularis oculi were recorded respectively, in which the two components recorded on the side of stimulation (i.e. ipsilaterally) were named R 1 and R 2, whereas the contralateral one, R ' 2. Results: Two cases showed normal BR and 28 abnormal. In this 28 cases of 56 sides tested, the abnormality rate of different components of BR accounted for 48.2% (27/56) in R 1, 69.6% (39/56) in R 2; 57.1% (33/56) in R ' 2, respectively. In addition, among 9 cases with absent response of two or more BR components uni or bilaterally, there were 7 cases who showed involvement of consciousness or / and aphasia, only 2 had clear consciousness. Conclusion: Generally inhibitory effect of cerebral hemisphere on BR responses existed. The abnormalities of BR in the patients with suprasegmental lesion were well correlated with the status of consciousness and aphasia, whereas poor correlated with the following conditions: lesion site, time interval between onset and BR test, whether occurrence of hemiplegia, facial sensory impairment and facial paralysis of supranucleus, or not.

关 键 词：瞬目反射 电刺激 脑血管病 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]