Somatosensory evoked blink response in hemifacial spasm and peripheral facial palsy

Somatosensory blink response (SBR) is produced by electrical stimulation of peripheral nerves or skin areas remote from the face. We investigated the presence of SBR in cases with hemifacial spasm (HFS) and peripheral facial palsy (PFP). Fifty-seven cases of HFS, 54 cases of PFP and 39 normal subjects were included in the study. A routine blink reflex study was performed in all subjects. Supramaximal stimulation of the median nerve was given ipsilateral to the either spasm or paralytic side for SBR. Recordings were made at the orbicularis oculi (o.oc) bilaterally and ipsilaterally at the orbicularis oris (o.or) muscles. SBR was elicited in 12 of 39 control subject. Twenty four of 48 HFS cases were SBR positive. Twelve of them had o.or response. An SBR was elicited at the ipsilateral o.oc in 35 of 46 patients with PFP with synkinesia. Twenty-six patients had an SBR at the ipsilateral o.or. In the 13 patients with PFP without synkinesia only 3 people had an SBR. SBR positivity was seen more often in PFP with synkinesia than in cases with HFS. SBR if positive spreads to the lower part of the face in most of cases with HFS and PFP with synkinesia.