Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “REFLEX”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,225 records · Page 68Linked to original sources
PubMed2005

Effect of experimental posterior temporalis muscle pain on human brainstem reflexes.

OBJECTIVE: To study the modulation of jaw-stretch and blink reflexes by experimental posterior temporalis muscle pain. METHODS: Thirty healthy volunteers (15 males, 25.5+/-0.6 years and 15 females, 27.4 +/- 1.2 years) were included. Short-latency stretch reflex responses were evoked in the masseter and temporalis muscles by fast stretches (1 mm displacement, 10 ms ramp time) and the blink reflexes were evoked by painful electrical pulses (0.5 ms duration), delivered by a concentric electrode placed on the left lower forehead close to the supraorbital foramen before, during and 15 min after a period with experimentally induced muscle pain. RESULTS: The normalized peak-to-peak amplitude of the stretch reflex in the painful temporalis was significantly higher during pain in both males and females compared with pre- and post-pain conditions (P < 0.004). The R2 root mean square (RMS) of the blink reflex decreased significantly during muscle pain as compared to the pre-pain (P < 0.03) in both males and females. CONCLUSIONS: The present results indicated that experimental posterior temporalis muscle pain facilitates the jaw-stretch reflex, whereas the nociceptive specific blink reflex is inhibited. SIGNIFICANCE: Present study suggested that these reflexes are suitable models for probing pontine and medullary pain processing.

Adult↗
PubMed1997

Effects of a new centrally acting muscle relaxant, NK433 (lanperisone hydrochloride) on spinal reflexes.

(-)-(R)-2-methyl-3-(1-pyrrolidinyl)-4'-trifluoromethylpropiophenone++ + monohydrochloride, lanperisone hydrochloride (NK433) administered intravenously or orally depressed the mono- and polysynaptic reflex potential, dorsal root reflex potential, flexor reflex mediated by group II afferent fibers, patellar and flexor reflexes. These effects were reduced by spinal transection. NK433 inhibited the facilitation of the flexor reflex mediated by group II afferent fibers that was induced by intrathecal administration of noradrenaline-HCl. (+)-(1R,2R)-2-methyl-3-(1-pyrrolidinyl)-1-(4-trifluoromethylphenyl)-1-pr opanol (LPS-9)-HCl, a metabolite of NK433, also inhibited the spinal reflexes. Given orally, NK433 had effects more than three times stronger and tending to be longer-lasting than those of eperisone-HCl. These results suggest that NK433 exerts a non-selective inhibition on spinal reflexes and that inhibition of the descending noradrenergic tonic facilitation within the spinal cord is involved in the mechanism of spinal reflex depression by NK433. LPS-9 could contribute to the potent activity of NK433 after oral administration.

Administration, Oral↗
PubMed2005

Reflex reciprocal facilitation of antagonist muscles in spinal cord injury.

STUDY DESIGN: Electromyographic study in complete and incomplete spinal cord injury (SCI). OBJECTIVE: To examine the changes in the pattern of reciprocal inhibition between agonist and antagonist muscles in SCI. SETTINGS: Sensory Motor Performance Program, Rehabilitation Institute of Chicago, IL, USA. METHODS: Tendon taps were delivered manually with an instrumented hammer to the tendons of the tibialis anterior and soleus muscle in positions of full-ankle dorsiflexion and plantarflexion in eight subjects with complete SCI and eight subjects with incomplete SCI. Electromyographic activity (EMG) was recorded from ankle dorsiflexor and plantarflexor muscles. Tapping force was also recorded by a force sensor mounted to the tendon hammer, indicating the stimulus onset. Measures of reflex EMG magnitude and reflex latency were obtained for both agonist and antagonist muscles. The ratio of antagonist to agonist EMG was computed based on normalized EMG. RESULTS: Substantial reflex responses occurred in both the stretched muscle and in its antagonist. The reflex in antagonist, which we term 'reciprocal facilitation (RF)', was most evident in subjects with incomplete SCI. The magnitude of RF was consistently greater than reflex responses in agonist muscles under all test conditions. The latency of the RF was comparable to that of monosynaptic reflex response. CONCLUSIONS: Following SCI, reciprocal organization of segmental reflexes at the ankle is often partially or completely suppressed, allowing reflex activation in antagonist muscles to be manifested. Possible mechanisms underlying these changes in neural organization are discussed. SPONSORSHIP: This study was supported by Spinal Cord Research Foundation, the Paralyzed Veterans of America.

Adult↗
PubMed1984

Characteristics of the spino-bulbo-spinal reflex with evoked EMGs in human subjects.

Training in sports medicine and rehabilitation medicine requires the establishment of conditioned reflexes. Reinforcement of a conditioned reflex is more effective when it is part of a set of two or three reflexes. The late spinal reflexes appearing after conditioning were resolved into a stretch reflex and a spino-bulbo-spinal (SBS) reflex. H and M waves on the tibialis anterior muscle induced by tibial nerve stimulation were determined from the escape potential of the triceps sural muscle contraction. The tibial nerve and peroneal nerve were stimulated bilaterally, and H and M waves from the triceps sural muscle and tibialis anterior muscle were recorded bilaterally. The complete separation method of the late response and the time course of the stretch reflex and SBS reflex that composed the late response are described in this paper.

Animals↗
PubMed1990

A review of myotatic reflexes and the development of motor control and gait in infants and children: a special communication.

Although the mechanism of the phasic myotatic (or "stretch") reflex is well-known, the role of this reflex in adult gait remains speculative. The acquisition and development of locomotor skills with respect to the development of the myotatic reflex require further study in both healthy and neurologically impaired children. In this article, the well-documented properties of the healthy adult's myotatic reflex are compared with recent findings of the myotatic reflex in healthy infants and children and contrasted with reflex properties in patients with cerebral palsy. These data allow us to begin to characterize the emerging features of the stretch reflex in normal and pathological early development. From these data, we can begin to speculate about the relationship between changes in stretch reflexes and the acquisition of skillful movement and gait in early childhood.

Adult↗
PubMed1983

The acute effect of the GABA-agonist, THIP, on proprioceptive and flexor reflexes in spastic patients.

THIP (Lu 2-030) is pharmacologically a specific and potent GABA-receptor-agonist which in animal studies depresses monosynaptic and, to a smaller extent, polysynaptic spinal reflexes. 5 spastic patients were investigated by means of neurophysiological tests comparing the acute effect of a single oral dose of THIP (15-25 mg) to "the test situation without drug administration" with an interval of 2 days. The neurophysiological tests included quantitative studies of proprioceptive reflexes (T-reflex, vibratory inhibition of the T-reflex, resistance to passive movement of a spastic muscle and clonus) and of the flexor reflex (threshold and latency). The voluntary power was measured by a static technique. THIP clearly reduced the monosynaptic T-reflex and reinforced vibratory inhibition of the IA monosynaptic pathway. The flexor reflex threshold was slightly increased during THIP administration, but the changes were not significant. Flexor reflex latency, resistance to passive movement, clonus and voluntary power were unchanged.

Adult↗
PubMed1983

The afferent volleys responsible for spinal proprioceptive reflexes in man.

1. To define the neural volleys responsible for the Achilles tendon jerk and the H reflex, muscle afferent activity was recorded using micro-electrodes inserted percutaneously into appropriate fascicles of the tibial nerve in the popliteal fossa.2. The response of soleus muscle afferents to tendon percussion consisted of a dispersed volley, starting 3.5-7.0 ms after percussion, increasing to a peak over 6.5-11.0 ms, and lasting 25-30 ms, depending on the strength of percussion. Electrical stimuli to the sciatic nerve at a level adequate to evoke an H reflex but subthreshold for the M wave produced a more synchronized volley, the fastest fibres of which had conduction velocities of 62-67 m/s, and the slowest 36-45 m/s.3. The wave of acceleration produced by percussion subthreshold for the ankle jerk spread along the skin at over 150 m/s. Midway between the bellies of the gastrocnemii it consisted of a damped oscillation with four to five separate phases and maximum amplitude approximately one-twentieth of that recorded on the Achilles tendon.4. With ten primary spindle endings, tendon percussion subthreshold for the ankle jerk elicited two to five spike discharges per tap, the shortest interspike intervals being 4-7 ms. Tendon percussion elicited single discharges from two Golgi tendon organs, and altered the discharge pattern of a single secondary spindle ending. The degree of dispersion of the multi-unit muscle afferent volley can be explained by the pattern of discharge of primary spindle endings.5. Percussion on the Achilles tendon evoked crisp afferent volleys in recordings from nerve fascicles innervating flexor hallucis longus, tibialis posterior, the intrinsic muscles of the foot and the skin of the foot. Electrical stimuli delivered to the tibial nerve in the popliteal fossa at a level sufficient for the H reflex of soleus produced either a volley in muscle afferents from the intrinsic muscles of the foot or a volley in cutaneous afferents from the foot.6. For comparable stimuli in the two positions, the H reflex was inhibited but the Achilles tendon jerk enhanced when the ankle was dorsiflexed from 105 degrees to 90 degrees .7. The duration of the rise times of the excitatory post-synaptic potentials (e.p.s.p.s) produced in soleus motoneurones by electrical stimulation, and by tendon percussion subthreshold for the H reflex and the ankle jerk respectively, was estimated from post-stimulus time histograms of the discharge of voluntarily activated single motor units in soleus. The mean e.p.s.p. rise times were 1.9 ms for electrical stimulation and 6.6 ms for tendon percussion. There was evidence that the duration of the electrically evoked e.p.s.p. was curtailed by an inhibitory post-synaptic potential (i.p.s.p.) of only slightly longer latency than the e.p.s.p.8. The mechanically induced and electrically induced afferent volleys are not homogeneous volleys in group I a afferents from triceps surae. The afferent volleys differ in so many respects that it is probably invalid to compare the H reflex and tendon jerk as a measure of fusimotor activity. It is suggested that neither reflex can be considered a purely monosynaptic reflex.

Achilles Tendon↗
PubMed1984

Relation between the specific H reflex facilitation preceding a voluntary movement and movement parameters in man.

In a reaction-time situation, the monosynaptic spinal reflex (H reflex) is facilitated before the onset of an electromyographic (e.m.g.) response. The aim of the present investigation was to study aspects of this facilitation. Human subjects were required to perform isometric plantarflexions of the foot in response to a visual stimulus. The movement was always on the same side in the simple reaction-time situation, and randomly with the right or left foot in the choice reaction-time situation. Stimuli to evoke H reflexes were applied bilaterally 40-400 ms after the onset of the visual stimulus. Pre-motor time, i.e. the interval between the onset of the visual stimulus and the e.m.g. response, and reaction time, i.e. the interval between the onset of the visual stimulus and the response on the torque recording, were computed. In both reaction-time situations, there was a significant facilitation of the ipsilateral H reflex 100-160 ms before e.m.g. onset and, in some subjects, a small facilitation of the contralateral H reflex. The specific facilitation, i.e. the difference between the facilitation on the ipsi- and contralateral side relative to the movement, was not significantly different on the right and left side. Pre-motor time was divided into the interval from the light onset until the onset of the specific facilitation, and the interval from the onset of the facilitation until the onset of the voluntary response. Both intervals increased, and the slope and the amplitude of the facilitation decreased with increasing pre-motor time and reaction time. The specificity of the H reflex facilitation in a choice reaction-time situation implies that the interval from light onset until the onset of the facilitation includes stimulus identification and response selection, and the interval from the onset of the facilitation until the e.m.g. response preparation of the motor system for the required movement. The present results suggest that the specific facilitation of the H reflex before a movement is caused by removal of presynaptic inhibition at I a terminals or by activation of interneurones intercalated in polysynaptic components of the H reflex rather than by a subthreshold activation of motoneurones.

Action Potentials↗
PubMed2002

Reflex regulation during sustained and intermittent submaximal contractions in humans.

To investigate whether the intensity and duration of a sustained contraction influences reflex regulation, we compared sustained fatiguing contractions at 25 % and 50 % of maximal voluntary contraction (MVC) force in the human abductor pollicis brevis (APB) muscle. Because the activation of motoneurones during fatigue may be reflexively controlled by the metabolic status of the muscle, we also compared reflex activities during sustained and intermittent (6 s contraction, 4 s rest) contractions at 25 % MVC for an identical duration. The short-latency Hoffmann(H) reflex and the long-latency reflex (LLR) were recorded during voluntary contractions, before, during and after the fatigue tests, with each response normalised to the compound muscle action potential (M-wave). The results showed that fatigue during sustained contractions was inversely related to the intensity, and hence the duration, of the effort. The MVC force and associated surface electromyogram (EMG) declined by 26.2 % and 35.2 %, respectively, after the sustained contraction at 50 % MVC, and by 34.2 % and 44.2 % after the sustained contraction at 25 % MVC. Although the average EMG increased progressively with time during the two sustained fatiguing contractions, the amplitudes of the H and LLR reflexes decreased significantly. Combined with previous data (Duchateau & Hainaut, 1993), the results show that the effect on the H reflex is independent of the intensity of the sustained contraction, whereas the decline in the LLR is closely related to the duration of the contraction. Because there were no changes in the intermittent test at 25 % MVC, the results indicate that the net excitatory spinal and supraspinal reflex-mediated input to the motoneurone pool is reduced. This decline in excitation to the motoneurones, however, can be temporarily compensated by an enhancement of the central drive.

Action Potentials↗
PubMed2006

Temporal facilitation of spastic stretch reflexes following human spinal cord injury.

Recent evidence suggests that alterations in ionic conductances in spinal motoneurones, specifically the manifestation of persistent inward currents, may be partly responsible for the appearance of hyperexcitable reflexes following spinal cord injury (SCI). We hypothesized that such alterations would manifest as temporal facilitation of stretch reflexes in human SCI. Controlled, triangular wave, ankle joint rotations applied at variable velocities (30-120 deg s(-1)) and intervals between stretches (0.25-5.0 s) were performed on 14 SCI subjects with velocity-dependent, hyperexcitable plantarflexors. Repeated stretch elicited significant increases in plantarflexion torques and electromyographic (EMG) activity from the soleus (SOL) and medial gastrocnemius (MG). At higher velocities (> or = 90 deg s(-1)), reflex torques declined initially, but subsequently increased to levels exceeding the initial response, while mean EMG responses increased throughout the joint perturbations. At lower velocities (< or = 60 deg s(-1)), both joint torques and EMGs increased gradually. Throughout a range of angular velocities, reflex responses increased significantly only at intervals < or = 1 s between stretches and following at least four rotations. Ramp-and-hold perturbations used to elicit tonic stretch reflexes revealed significantly prolonged EMG responses following one or two triangular stretches, as compared to single ramp-and-hold excursions. Post hoc analyses revealed reduced reflex facilitation in subjects using baclofen to control spastic behaviours. Evidence of stretch reflex facilitation post-SCI may reflect changes in underlying neuronal properties and provide insight into the mechanisms underlying spastic reflexes.

Adult↗
PubMed1991

The effect of posture on the normal and pathological auditory startle reflex.

The effect of posture on the EMG pattern of the normal auditory startle reflex was investigated. The startle response to an unexpected auditory tone was studied in eleven normal subjects when standing, and in six normal subjects when sitting relaxed or tonically plantar flexing both feet. Reflex EMG activity was recorded in the tibialis anterior and soleus about twice as frequently when standing, than when sitting relaxed. In addition, the median latencies to onset of reflex EMG activity in the tibialis anterior and soleus were about 40 and 60 ms shorter during standing, than when sitting relaxed. No short latency EMG activity was recorded in the calf muscles during tonic plantar flexion of the feet, while sitting. The effect of posture on the EMG pattern of the pathological auditory startle reflex was studied in five patients with hyperekplexia. In three patients the latency to onset of reflex EMG activity in the tibialis anterior was shorter when standing, than when sitting relaxed. The EMG pattern of the reflex response to sound was studied in detail in two of these patients and consisted of up to three successive components. The expression of each EMG component depended on the postural set of the limbs. In particular, a distinct short latency component was found in posturally important muscles following auditory stimulation. This short latency component was not recorded when sitting relaxed. It is concluded that the EMG pattern of the physiological and pathological auditory startle response is not fixed, but may change with the postural stance of the body. This finding supports the theory that the normal startle reflex and the abnormal startle reflex in hyperekplexia have a common brainstem origin.

Adolescent↗
PubMed1988

Models of sensorimotor transformations and vestibular reflexes.

The vestibulo-ocular and vestibulo-collic reflexes are well-studied sensorimotor systems with dynamic properties that have been successfully modeled. Recently proposed matrix and tensorial models attempt to describe the spatial organization of these reflexes in three dimensions. Here we describe experiments that test these models. We show that a matrix model of the vestibulo-ocular reflex provides a satisfactory description of its spatial properties. The vestibulo-collic reflex is more complex, but a tensorial model makes close predictions of neck muscle excitation by the vestibulo-collic reflex. In addition, our preliminary data show that the cervico-collic or neck stretch reflex produces essentially the same spatial pattern of neck muscle excitation as the vestibulo-collic reflex, a finding predicted by the tensorial model. We conclude by showing electromyographic and single neuron responses that can be modeled only by combining models of dynamics with models of spatial organization. We believe that the development of such models is the next major challenge in the application of quantitative methods to analysis of reflex behavior.

Animals↗
PubMed1991

Effects of tetanic stimulation on monosynaptic and dorsal root reflexes in kittens.

The effects of tetanic stimulation of peripheral afferents were examined on monosynaptic reflexes and dorsal root reflexes in kittens of various ages. Concomitantly recorded monosynaptic and dorsal root reflexes resulting from the stimulation of muscle nerves showed similar post-tetanic changes, namely, predominantly post-tetanic depression in neonates and post-tetanic potentiation in older kittens or adults. However, the changes in post-tetanic responses expressed as a percentage of control in dorsal root reflexes were much smaller than those in monosynaptic reflexes. When dorsal root reflexes originating from muscle and cutaneous afferents were compared, dorsal root reflexes from the latter behaved quite differently. For all ages, post-tetanic effects on dorsal root reflexes arising from cutaneous afferents were either insignificant or very small. The possible mechanisms underlying differences in post-tetanic effects from muscle and cutaneous afferents in adults and neonates are discussed.

Aging↗
PubMed1994

Mechanical actions of heterogenic reflexes linking long toe flexors with ankle and knee extensors of the cat hindlimb.

1. To study the means whereby ankle biomechanics are represented in the interneuronal circuitry of the spinal cord we examined stretch-evoked reflex interactions between the physiological extensors flexor hallucis longus (FHL) and flexor digitorum longus (FDL) as well as their interactions with gastrocnemius (G), soleus (S), and the quadriceps group (Q) in 34 unanesthetized decerebrate cats. To evoke stretch, DC motors provided ramp-hold-release length changes to tendons detached from their bony insertions. Semiconductor myographs measured resultant muscle force response. Reflexes were examined under both quiescent (no active force generation) and activated conditions; muscle activation was achieved through either crossed-extension or flexion reflexes. 2. FHL and FDL share mutual excitatory stretch-evoked interactions under most conditions examined. These interactions depended on muscle length, were asymmetric (with FHL contributing a larger magnitude of reflex excitation onto FDL), and occurred at a latency of 16 ms. Mutual Ia synergism previously described for these two muscles provides a basis for all of the above findings. Our data demonstrate that for this muscle pair, reflex connectivities revealed at the intracellular level can be extrapolated to cover the entire motoneuron pool; further, our data directly demonstrate the net mechanical result of ensemble synaptic events. 3. FHL was found to share strong, mutually inhibitory stretch-evoked interactions with G, S, and Q. Stepwise regression statistical analyses determined that these interactions depended on recipient muscle force and donor muscle force. These reflex interactions all occurred at a latency of 28 +/- 4 (SE) ms. Further, the heterogenic inhibition between FHL/G and FHL/S was attenuated by strychnine infusion (intravenous) but unaffected by either mecamylamine, picrotoxin, or baclofen infusion (intravenous, intrathecal). Disynaptic Ib inhibition previously described among hindlimb extensors provides a basis for the above findings; our data demonstrate that under certain conditions the ensemble activity of this system can cause a dramatic decline in whole muscle force output. 4. By contrast, FDL was found to share mutually inhibitory, stretch-evoked reflex interactions with G, S, and Q that were much weaker than those observed between FHL and these same muscles. The small magnitude of inhibition observed in these interactions made it difficult to assess reflex latency or to determine the factor(s) that best predicted the heterogenic inhibition. 5. This study provides further evidence of intrinsic differences in interneuronal organization between muscles whose activity occurs in a periodic manner during locomotion ("stereotypical") and a muscle whose locomotor activity is characterized by both periodic and nonperiodic components ("facultative").(ABSTRACT TRUNCATED AT 400 WORDS)

Afferent Pathways↗
PubMed2002

Postexercise facilitation of reflexes is not common in Lambert-Eaton myasthenic syndrome.

Postexercise facilitation (PEF) with clinical reflexes, H-reflex, and T-reflexes at the ankle and knee was systematically studied in 16 patients with Lambert-Eaton myasthenic syndrome (LEMS). PEF was observed in ankle and knee deep tendon reflexes in five patients, in H-reflex in three patients, and in T-reflexes in six patients. When all reflex tests were combined, 7 (43.7%) of 16 patients showed PEF by at least one test. The authors conclude that the PEF of reflexes, the most helpful diagnostic clinical marker for LEMS, is not common.

Adult↗
PubMed2001

Effect of a reduced base of support in standing and balance training on the soleus H-reflex.

The present study provides evidence that a reflex at the segmental level can adapt over a two hour experiment in a functionally appropriate manner in response to a balance training task. Subjects (N=9) received soleus (S) H-reflexes in blocks of seven trials while free standing on a normal base-of-support (NBOS) and while standing on a plafform with a reduced base-of-support (RBOS) in the sagittal plane. During the RBOS condition, the H-reflex served as a postural perturbation. Subjects were instructed to suppress the H-reflex when it was evoked, as an attempt to maintain a balanced state. Background EMG from the S and tibialis anterior muscles, the S M-wave, and stimulus current were maintained at a constant level during the experiment. Subjects initially received a block of NBOS trials, followed by 4 RBOS blocks (training), a second NBOS block, four additional RBOS blocks, and a third NBOS block with the protocol repeated on three different days (D1, D2 and D3) within the same week. The S H/M ratio was depressed 9% upon standing on the RBOS. With training the S H/M ratio decreased by 22% on Dl, 18% on D2 and 6% on D3. The ratio between the H-reflex and background S EMG (H-reflex gain) decreased 10% on D1, 40% on D2 and 23% on D3 when the first NBOS and first RBOS blocks were compared. Due to a slight increase in the S EMG across blocks, the H-reflex gain decreased considerably more across blocks than the H/M ratio. Although the S H/M ratio underwent an 7% decrease from D1 to D3, the differences were not significant. Individually, however, six of the nine subjects decreased their H/M ratios from 12-42% across days. The results may reflect the inception of longer-term adaptations of the segmental stretch reflex system.

Adaptation, Physiological↗
PubMed1989

The H-reflex recovery curve from the wrist flexors: lateralization of motoneuronal excitability in relation to handedness in normal subjects.

Spinal motor asymmetry was studied in relation to handedness. Hand preference was assessed by Oldfield's Questionnaire and Geschwind scores. hand skill was evaluated by a peg moving task. The motoneuronal excitability was assessed by the size and recovery curve of the H-reflex elicited by stimulation of the right and left median nerves. H-reflex was recorded by cup electrodes placed over the wrist flexors. The mean reflex latencies from the right and left sides were 23.4 and 23.2 ms, respectively. The mean amplitude of the maximum H reflex was significantly higher on the right side than the left side in right-handers without familial sinistrality (FS). There were no significant side differences in the amplitudes of H-reflexes of the right-handers with FS. A genetic factor was suggested to involve this left shift of spinal motor lateralization in right-handers with FS. The recovery curve studies showed that the motoneuronal excitability was higher on the right than the left in right-handers without FS. There was no excitability difference between the right and left sides of the right-handers with FS. In left-handers, the motoneuronal excitability was significantly higher on the left than the right side. Voluntary flexions of the wrist increased the H-reflex especially on the right side of the right-handers. There was no relationship between this corticospinal facilitation and baseline EMG activity. The H-reflex amplitude was found to be inversely correlated with hand skill in right-handers. It was concluded that motoneuronal excitability is associated with handedness and also depends on FS. It was suggested that small reflexes are especially suitable in fine motor control of rapid aimed-movements, as the well-established relation between the size of motor units and fine motor control.

Adult↗
PubMed1986

Oculocardiac reflex and the anesthesiologist.

Oculocardiac reflex is one of the trigemino-vagal reflexes, and is frequently observed during anesthesia for pediatric strabismus surgery. The reflex is greatly exaggerated in the presence of hypoventilation, hypoxemia and acidosis. The reflex is important as a cause of cardiac arrest during eye surgery. Several related reflexes are known, such as blepharocardiac reflex, oculorespiratory reflex, and the sudden infant death syndrome. Although the reflex can be prevented by a retrobulbar block or the administration of parasympatholytic drugs, well conducted anesthesia and cooperation with the surgeon is much more important.

Anesthesia, General↗