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Blink reflex in motor neuron disease.

E Szmidt-Sałkowska¹, K Rowińska-Marcińska

¹Department of Neurology, Medical University of Warsaw, Poland. ela.szmidt@wp.pl

Electromyography and Clinical Neurophysiology

|October 13, 2005

Summary

Blink reflex (BR) testing shows diagnostic value in motor neuron disease (MND). Abnormal R2 responses in amyotrophic lateral sclerosis (ALS) suggest brainstem neuron involvement, unlike in primary lateral sclerosis (PLS) or progressive muscular atrophy (PMA).

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Area of Science:

Neurology
Neurophysiology

Background:

Motor neuron disease (MND) encompasses several progressive neurodegenerative disorders.
Accurate early diagnosis is crucial for managing MND, including amyotrophic lateral sclerosis (ALS), primary lateral sclerosis (PLS), and progressive muscular atrophy (PMA).

Purpose of the Study:

To evaluate the diagnostic utility of the blink reflex (BR) in differentiating subtypes of motor neuron disease.
To investigate alterations in BR parameters in patients with ALS, PLS, and PMA compared to healthy controls.

Main Methods:

The study involved 25 patients diagnosed with MND (18 ALS, 4 PMA, 3 PLS) and 12 healthy volunteers.
Blink reflex (BR) was elicited using standard electrophysiological techniques.
Latency and amplitude of R2 responses were measured and compared between groups.

Main Results:

Patients with ALS exhibited significantly increased R2 response latency and decreased amplitude compared to controls (p < 0.05).
Blink reflex parameters in patients with PLS and PMA remained within normal limits.
Reduced R2 response amplitude in ALS may indicate trigeminal and facial system pathway dysfunction in the brainstem.

Conclusions:

Blink reflex testing is a valuable tool for diagnosing amyotrophic lateral sclerosis (ALS).
Abnormalities in BR, specifically reduced R2 response amplitude, suggest lower brainstem neuron involvement in ALS.
BR appears normal in primary lateral sclerosis (PLS) and progressive muscular atrophy (PMA), aiding in differential diagnosis.

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