The Late Blink Reflex Response in Patients with Thalamic Hemorrhage

J Korean Neurol Assoc > Volume 17(5); 1999 > Article

Journal of the Korean Neurological Association 1999;17(5): 661-667.

시상출혈 환자의 지연 순목반사

박종무, 김호진 ·윤창호 ·이용석*·노재규 ·이광우

서울대학교 의과대학 신경과학교실,서울시립 보라매병원 신경과*,

The Late Blink Reflex Response in Patients with Thalamic Hemorrhage

Jong-Moo Park, M.D., Ho Jin Kim, M.D., Chang-Ho Yun, M.D., Yong-Seok Lee, M.D.*, Jae-Kyu Roh, M.D., Kwang-Woo Lee, M.D.

Department of Neurology, College of Medicine, Seoul National University, Seoul, Korea Department of Neurology, Boramae City Hospital, Seoul, Korea*

Abstract

Background : This study was designed to understand the possible pathways of R2 responses by testing the blink reflex in patients with a thalamic hemorrhage. Methods : Blink reflexes were obtained in 11 patients with a thalamic hemorrhage. The mean interval of the first test of the thalamic hemorrhage was 21.7(24.4days, and follow-up tests were performed in 5 patients about 10 months later. Results : All subjects showed normal R1 responses on affected or nor-mal sides. However, R2 responses were abnormal in 9 patients (81.8%). R2 responses were not recorded in 4, and pro-longed in 3. Two patients showed both absent and prolonged R2 responses. The abnormal R2 responses were grouped as follows. First, R2 was abnormal bilaterally by the stimulation on the affected side (afferent type, N=4). Second, R2 was abnormal bilaterally by the stimulation on the affected side and abnormal contralaterally by the stimulation on the normal side (mixed type, N=2). Third, R2 was abnormal contralaterally by the stimulation on the affected side (unde-termined type, N=2). One showed abnormal R2 bilaterally by the stimulation on the affected and normal side (coma type). On follow-up tests, all showed normalized R2 responses. Conclusions : Thalamic hemorrhages caused various abnormal R2 responses in blink reflexes, which were normalized in several months. It is suggested that the abnormal R2 responses of thalamic hemorrhage result from the removal of crossed cortical facilitation on brainstem interneurons rather than an interrupted central pathway of the R2 response. J Kor Neurol Ass 17(5):661~667, 1999 Key Words : Blink reflex, Thalamic hemorrhage, R2 Response, Crossed cortical acilitation *Address for correspondence