The Techniques Of Expanded Studying In Normal Blink Reflex

Objective Blink Reflex is one of the brainstem reflexes that can be evoked by light,sound or touching to cornea.It is a defensive reflex which has an important effect to protect the eyeball and face.The detection of blink reflex can evaluate the functional status not only the peripheral nerves such as trigeminal nerve and facial nerve but also the central nervous system Now the technique commonly used in clinic is elicited electrically by delivering percutaneous stimulation over the supraorbital nerve at the supraorbital foramen.Responses are recorded from surface electrode positioned over the right and left orbicularis oculi.By the electrodiagnostic recording we get the early,simple R₁ and late,complex ipsilateral R₂ as well as contralateral R₂'.To research the different techniques and wave characteristic of applying non-invasive stimulation in Blink Reflex we selected thirty healthy volunteers and stimulated their supraorbital nerve and mental nerve then respectively recorded at orbicularis oculi and levator labli superioris.Through these different methods we can establish the laboratory data so as to offer basic physiological index for clinical using.Methods We selected 30(60 sides) healthy young volunteers.Male 14,Female 16,Age 22～28years old(average 24.1±1.5 years old).According to the following criteria:â‘ No medically contributory conditions select.â‘¡No neurologic conditions select.â‘¢facial muscular systems are within normal limits.â‘£No surgical or traumatic history on skull or maxillary and mandible.The machine is DISA-2000M oculomusclar electromyogram made by Danmark,the recording electrode is surface disk electrode withφ1cm.Using the electrodiagnostic techniques,orbital nerve and mental nerve were stimulated and the wave were respectively recorded at orbicularis oculi and levator labli superioris,then calculated the latency and amplitude of R₁,R₂,R₂'.All data were dealt with statistical software SPSS13.0 for windows.There was a statistical significance when P＜0.05 occurred.Results1.The 30 healthy cases(60 sides) all obtained satisfied wave when stimulating the supraorbital nerve then recording at orbicularis oculi and levator labli superioris.Three different components of blink reflex were observed.The early ipsilateral response(R₁) was single and sharpen.The late ipsilateral response(R₂) and late contralateral response(R₂') were constituted by several waves,the latency were long and the form were complicated.The images were consitantly and repeatable.2.The waves of stimulating mental nerve then recording at orbicularis oculi and levator labli superioris were unstable.Some were complete and others R₁ were absent.For these two kinds of method the present rate of R₁ were 67%and 60% respectively.But bilateral R₂ were all stable.3.The latencies of R₁,R₂,R₂' were Normal distribution by the four detected methods.In statistic analyse we adopted t-test and pair t-test that the sex had not significant difference between male and female,it was the same for the left and right sides (P＞0.05).So on the subsequently statistic analyse we did not consider the sides and sex.The variation between the four groups we adopted Analysis of Variance(ANOVA).The normal value of latency was expressed by(?)±s and top limit of normal value was expressed by(?)+3s.The wave amplitude varied obviously and it was not normal distribution by D-test.So we used median to describe it.Conclusion The techniques of stimulating orbital nerve then recording at orbicularis oculi and levator labli superioris are of the same value for clinical diagnosis.The techniques of stimulating mental nerve then recording at orbicularis oculi and levator labli superioris sometimes are unstable so they can be used as supplementary examination.These detected methods are non-invisive and easy that offer impersonality and quantitated criteria.They are reliable electrophysiological technique.