Prognostic Significance of the Electrically Elicited Blink Reflex in Neonates

Abstract

The electrically elicited blink reflex was examined in ten normal neonates, 11 postasphyxial neonates, and 3 congenital hydrocephalus cases. The blink reflex was elicited in all cases. In normal neonates, the latencies and amplitudes were 10.9 ± 0.7 msec and 159 ± 62 μV at R₁, 34.3 ± 1.4 msec and 123 ± 30 μV at R₂, and 40.7 ± 2.3 msec and 84 ± 25 μV at R'₂ respectively. Ischemic-hypoxic brain damage during the neonatal period mainly influenced the late components of the blink reflex. The blink reflex of the postasphyxial neonates showed significantly prolonged latencies of R ₂ and R'₂. The amplitudes were increased in cases with a fair prognosis and decreased in cases with a poor prognosis. A case of congenital hydrocephalus with mental retardation also showed the prolonged latencies of R₂ and R'₂ in neonatal period. The blink reflex in neonates appears to be useful in predicting the outcome in cases of neonatal asphyxia and congenital hydrocephalus. (J Child Neurol 1987;2:287-292).

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References

Kugelberg E. : Facial reflex. Brain 1952;75:385-396.

Kimura J. : Electrodiagnosis in Disease of Nerve and Muscle: Principles and Practice . Philadelphia, FA Davis, 1983, pp 323-351.

Tokunaga AM , Kato HT , Hirata T. , et al: An experimental study of facial reflex by evoked electromyography Med J Osaka Univ 1958;9:397-411.

Kimura J. : The blink reflex as a test for brainstem and higher central nervous system function, in Desmedt JE (ed): New Developments in Electromyography and Clinical Neurophysiology . Basel, Karger, 1973, Vol 3, pp 682-691.

Kimura J. : Alteration of the orbicularis oculi reflex by pontine lesion. Arch Neurol 1970;22:156-161.

Kimura J. , Lyon LW : Alteration of orbicularis oculi reflex by posterior fossa tumors. J Neurosurg 1973;38:10-16.

Ongerboer de Visser BW , Kuypers Hgjm : Late blink reflex changes in lateral medullary lesions. An electrophysiological and neuroanatomical study of Wallenberg's syndrome. Brain 1978;101:285-294.

Hopf HC , Hufschmidt HJ , Stroder J. : Development of the trigemino-facial reflex in infants and children . Ann Pacdiatr 1965;204:52-64.

Kimura J. , Bodensteiner J. , Yamada T. : Electrically elicited blink reflex in normal neonates. Arch Neurol 1977;34:246-249.

10.

Vecchierini MF : Evolution de reflexe de clignement pendant les trois premieres anness de la vie cheleneant. Rev EEG Neurophysiol 1983;13:137-144.

11.

Clay SA , Ramseyer C. : The orbicularis oculi reflex in infancy and children. Establishment of the normal value. Neurology 1976;26:521-524.

12.

Blank A. , Ferber I. , Shapira Y. , et al: Electrically elicited blink reflex in children. Arch Phys Med Rehabil 1983;64:558-559.

13.

Sarnat HB , Sarnat MS : Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol 1976;33:696-701.

14.

Kimura J. , Lyon LW : Orbicularis oculi reflex in the Wallenberg syndrome: Alteration of the late reflex by lesion of the spinal tract and nucleus of the trigeminal nerve. J Neurol Neurosurg Psychiatr 1972;35:228-233.

15.

Kimura J. : Effect of hemispheral lesions on the contralateral blink reflex. A clinical study. Neurology 1974;24:168-174.

16.

Beradrelli A. , Accornero N. , Cruccu G. , et al: The orbicularis oculi response after hemispheral damage. J Neurol Neurosurg Psychiatr 1983;46:837-843.

17.

Settats AF , Parker SA , MeriuspCaras A. : The blink reflex in coma and after recovery from coma. Acta Neurochir 1976;34: 79-97.

18.

Lyon L. , Kimura J. , McCormick WF : Orbicularis oculi reflex in coma. Clinical electrophysiological and pathological correlation. J Neurol Neurosurg Psychiatr 1972;35:582-588.

19.

Hebek A. , Karlberg P. , Kjolmer I. , et al: Clinical application of evoked electroencephalographic response in newborn infants. Dev Med Child Neurol 1977 ;19:33-44.