• Annals of Clinical Neurophysiology
• /
• v.7 no.2
• /
• pp.88-92
• /
• 2005

Blink reflex could be a useful tool to differentiate facial synkinesis as one of complications of facial neuropathy, from volitional associated movements. We had performed applied blink reflex test for 23 patients with objective evidence of hemifacial weakness in which orbicularis oculi muscle(zygomatic branch) and mentalis muscle(mandibular branch) are electrophysiologically evaluated in response to supraorbital stimulation of trigeminal nerve. For an unaffected side of face there is no evidence of positive blink reflex from the mentalis muscle. We concluded that a positive blink reflex from mentalis muscle is almost always suggestive of chronic facial neuropathy even in clinical silence of facial synkinesis, or an aberrant reinnervation after peripheral facial neuropathy, and does not electrophysiologically correlate with the severity of facial palsy.

• Annals of Clinical Neurophysiology
• /
• v.14 no.1
• /
• pp.25-28
• /
• 2012

Background: Bell's palsy is the most common disease of cranial nerve. While most electrodiagnostic tests can detect the abnormality of facial nerve several days later in Bell's palsy, blink reflex usually reveals the abnormality earlier than other tests. Therefore, we investigated the diagnostic usefulness of blink reflex in the early stage of Bell's palsy. Methods: We performed a prospective investigation in patients with facial palsy. We enrolled patients with Bell's palsy who were evaluated within 7 days of symptom onset and excluded patients with secondary causes of facial palsy. We analyzed the findings of blink reflex according to age, sex, evaluation time, and severity of facial palsy. Results: Of 320 consecutive patients with facial palsy, a total of 204 patients were enrolled. Blink reflex was normal for 10 patients and abnormal for 194 patients. The time interval between the symptom onset and the evaluation time was not associated with the result of blink reflex, but House-Brackmann grade was significantly related to the result of blink reflex (P<0.001). Patients with mild Bell's palsy often showed normal blink reflex. Conclusions: Our study shows that blink reflex is useful diagnostic test regardless of evaluation timing in the early stage of Bell's palsy, although it could be normal in patients with mild Bell's palsy.

• Archives of Plastic Surgery
• /
• v.47 no.6
• /
• pp.559-566
• /
• 2020

Background Infraorbital nerve dysfunction is commonly reported after zygomaticomaxillary complex fractures. We evaluated sensory changes in four designated areas (eyelid, nose, zygoma, and lip) innervated by the infraorbital nerve. This evaluation was conducted using the static two-point discrimination test and the vibration threshold test. We assessed the diagnostic significance of the blink reflex in patients with infraorbital nerve dysfunction. Methods This study included 18 patients, all of whom complained of some degree of infraorbital nerve dysfunction preoperatively. A visual analog scale, the infraorbital blink reflex, static two-point discrimination, and the vibration threshold were assessed preoperatively, at 1 month postoperatively (T1), and at a final follow-up that took place at least 4 months postoperatively (T4). The results were analyzed using a multilevel generalized linear mixed model. Results Scores on the visual analog scale significantly improved at T1 and T4. The infraorbital blink reflex significantly improved at T4. Visual analog scale scores improved more rapidly than the infraorbital blink reflex. Two-point discrimination significantly improved in all areas at T4, and the vibration perception threshold significantly improved in the eyelid at T4. Conclusions Recovery of the infraorbital blink reflex reflected the recovery of infraorbital nerve dysfunction. We also determined that the lip tended to recover later than the other areas innervated by the infraorbital nerve.

• Journal of Electrodiagnosis and Neuromuscular Diseases
• /
• v.20 no.2
• /
• pp.144-147
• /
• 2018

Although dysgeusia can occur as a consequence of stroke attacks, many physicians and patients tend to overlook it. A 50-year old woman complained of a 2-week history of abnormal sense of taste on the anterior two-thirds of right tongue. Blink reflex test demonstrated prolonged ipsilateral and contralateral R2 responses with the right supraorbital nerve stimulations, which suggest the lesion on the descending pathway. Brainstem magnetic resonance imaging (MRI) demonstrated abnormal findings in the right lower dorsal pons, anterior to 4th ventricle, lateral to inferior colliculus, and at the level of the pontomedullary junction, which was compatible with solitary tract nucleus and spinal trigeminal nucleus. Brainstem infarction should be considered in patients who have abnormal sense of taste. Additionally, blink reflex test may be helpful for the detection of central origin dysgeusia.

• Journal of Acupuncture Research
• /
• v.31 no.4
• /
• pp.121-131
• /
• 2014

Objectives : This study was performed to find the relation between prognosis of peripheral facial palsy and blink reflex. Methods : Data was collected from patients who were admitted and treated by East-West Collaborative Treatment of Facial Palsy Center in Kyung Hee University Hospital at Gangdong from January 2012 to June 2013. Patients were screened by inclusion/exclusion criteria and 163 patients' medical records were reviewed including blink reflex performed $14{\pm}2$ days after onset and House-Brackmann grade. Patients were divided into three groups, normal, delayed and absent group by blink reflex test. Trends of each recovery rate to House-Brackmann grade II and I depending on three group were analyzed at 1 month, 3 months and 6 months after onset using Linear by linear association. Results : At 1 month, 3 months and 6 months after onset, both recovery rate to House-Brackmann grade II and I had a tendency to be decreased statistically significantly in order of normal, delayed and absent group. Conclusions : We could find feasibility of blink reflex as a prognostic factor of peripheral facial palsy. Further study will be necessary.

• Journal of Korean Physical Therapy Science
• /
• v.4 no.3
• /
• pp.499-509
• /
• 1997

The facial nerve have a long pathway. Thus facial nerve fibers easily involved at any point along their course will lead to a facial palsy of lower motor neuron type and upper motor neuron type. The electrophysiologic examination can evaluate and anticipating that prognosis of facial nerve palsy. The electrophysiologic examination are Nerve Excitability Test(NET), Elecctroneurography(ENG), Electro-myography(EMG), Blink Reflex, and Electrogustometry et.al. The NET is very useful method for assessment of prognosis and distinguish between nerve degeneration and physiological block as early as 72 hour after onset of the facial palsy. And other examination also give objectively information of facial nerve for prognosis and treatment. Treatment goal of physiotherapy are prevent contracture and disuse atrophy of facial muscle with muscle reeducation and strengthening and maintain symmetry facial motion. The treatment better start as early as possible.

• Annals of Clinical Neurophysiology
• /
• v.7 no.1
• /
• pp.43-45
• /
• 2005

Trigeminal sensory neuropathy is a clinical diagnosis in which the main feature is facial numbness limited to territory of one or more sensory branches of the trigeminal nerve. We describe a 46-year-old woman who presented with left facial numbness in the territories of maxillary nerve and mandibular nerve. MRI disclosed a lesion in left trigeminal nerve root entry zone. In Blink test stimulating infraorbital foramen, ipsilateral R1 was delayed compared with contralateral R1. Lesion in pons or medulla can present as trigeminal sensory neuropathy.

• Annals of Clinical Neurophysiology
• /
• v.7 no.2
• /
• pp.117-120
• /
• 2005

Hemifacial spasm (HFS) may develop after Bell's palsy (BP). But it was not reported that contralateral HFS occurred simultaneously in acute BP. A 25-year-old woman admitted with left HFS occurred simultaneously in acute right BP for 6 days. Past, family, and social history were unremarkable. Nerve conduction studies (NCS) and blink reflex (BR) test showed bilateral facial neuropathies. Brain MRI and cerebral angiography were normal. The symptoms and signs of HFS and BP were improved slowly after acyclovir and prednisolone therapy. Follow-up serial NCS and BR also showed a rapid improvement.

• Archives of Craniofacial Surgery
• /
• v.18 no.1
• /
• pp.65-70
• /
• 2017

A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.