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PubMed1976

Jaw reflexes and masseter electromyograms in mesencephalic and pontine lesions: an electrodiagnostic study.

Jaw reflexes and masseter electromyograms were studied in five patients with mesencephalic and 11 patients with pontine lesions, vascular or tumorous in nature. In the former group jaw reflexes were abnormal, being delayed or absent, whereas masseter electromyograms were normal. In the latter group, both jaw reflexes and masseter EMG, showing denervation, were abnormal in six and both normal in five cases. It is suggested that the afferent limb of the human jaw reflex passes through the mesencephalic trigeminal nucleus. The methods proved to be valuable in the diagnosis of mesencephalic and pontine lesions involving the fifth cranial nerve.

Brain Diseases↗
PubMedDate not supplied

Afferent pupillary defects in amblyopia.

We detected mild afferent pupillary defects with the "swinging flashlight" test in 4 out of 45 amblyopic patients. Our study was designed to minimize the effect of observer bias and to control for the difficulty of testing the pupils in young children. We found afferent defects in both strabismic and anisometropic amblyopes. There was no apparent relationship between pupillary response and visual acuity: afferent defects were noted in association with better than 20/100 vision in three cases but were absent in a majority of patients with profound visual loss. Vision was improved by occlusion therapy in two amblyopes with pupillary abnormalities. We regard the occurrence of afferent pupillary defects as evidence for a physiological disturbance at the retinal level in at least some cases of amblyopia. Our findings suggest that the extent of retinal involvement in amblyopic eyes is independent of reduction in acuity, to which primary cortical abnormalities may contribute as well.

Adolescent↗
PubMed1993

Modification of reflexes in normal and abnormal movements.

The trajectories observed for the limb during human locomotion are determined by a mixture of influences, some arising from neural circuits entirely within the central nervous system and others arising from a variety of sensory receptors. Muscle reflexes are highly modulated during locomotion in an adaptive manner within each phase of the step cycle. Furthermore, the modulation can be modified quickly for different tasks such as standing, walking and running, probably by changes in presynaptic inhibition. This modulation is often lost or severely reduced in patients with spasticity after spinal cord or head injury. In normal subjects cutaneous reflexes can be completely reversed from exciting to inhibiting a muscle during each step cycle, particularly in muscles that normally show two bursts of activity per cycle (e.g., tibialis anterior). In some patients stimulation of a mixed nerve (e.g., common peroneal) can directly produce muscle contraction, generate a reflex response (flexor reflex) and transiently reduce spasticity in antagonist (extensor) muscles. Thus, simple systems employing stimulation can enhance gait to a certain extent in patients with incomplete injuries.

Electric Stimulation↗
PubMed1995

The influence of local skin heating and reactive hyperaemia on skin blood flow abnormalities in patients with reflex sympathetic dystrophy (RSD).

Skin blood flow in reflex sympathetic dystrophy (RSD) patients has been reported to develop from an increase at an early stage to a decrease at later stages. So far, it remains unclear whether these abnormalities are solely of microcirculatory origin, and result from functional vasospasm or structural vessel wall changes. Eighty-seven RSD patients were categorized as follows: stage I in case of a stationary warmth sensation; stage II in case of an intermittent warmth and cold sensation; and stage III in case of a stationary cold sensation. Laser Doppler flowmetry (LDF) was used as a measure of total skin blood flow and transcutaneous oximetry (TCPO2) as a measure of vascular reactivity in the more superficial skin layers. Local skin heating and reactive hyperaemia were used to study the relative reserve capacity of skin microvessels. Finapres was used to assess digital arterial pressures. As compared to healthy volunteers (n = 16), LDF under control conditions demonstrated an increase in skin blood flow at stage I (P < 0.01). A decrease in skin blood flow under control conditions was seen at stages II (P < 0.05) and III (P < 0.05), but the relative flow reserve capacity, as measured with LDF, was not impaired at these stages. Regression analysis did not show a relation between LDF parameters and duration of the syndrome. TCPO2 revealed no differences between patient groups and controls. Regression analysis did not demonstrate a relation between TCPO2 parameters and duration of the syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Startle syndromes.

Startle syndromes consist of three heterogeneous groups of disorders with abnormal responses to startling events. The first is hyperekplexia, which can be split up into the "major" or "minor" form. The major form of hyperekplexia is characterised by excessive startle reflexes, startle-induced falls, and continuous stiffness in the neonatal period. This form has a genetic basis: mutations in the alpha1 subunit of the glycine receptor gene, GLRA1, or related genes. The minor form, which is restricted to excessive startle reflexes with no stiffness, has no known genetic cause or underlying pathophysiological substrate. The second group of startle syndromes are neuropsychiatric, in which excessive startling and various additional behavioural features occur. The third group are disorders in which startling stimuli can induce responses other than startle reflexes, such as startle-induced epilepsy. Diagnosis of startle syndromes depends on clinical history, electromyographic studies, and genetic screening. Further study of these disorders may enable improved discrimination between the different groups.

Humans↗