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Tap-induced blink reflex and central nervous system dysfunction in diabetics with hyperosmolality
Y Tachibana1, A Yasuhara, M Ross
1Department of Internal Medicine, Mejiro 2nd Hospital, Tokyo, Japan.
European Neurology
|January 1, 1990
Summary
Hyperosmolality in diabetes disrupts the tap-induced blink reflex (TBR), with abnormalities correlating to serum osmolality more than blood glucose levels. The TBR may help monitor central nervous system dysfunction in diabetic patients.
Area of Science:
- Neurology
- Endocrinology
- Ophthalmology
Background:
- Diabetes mellitus is associated with various neurological complications.
- Hyperosmolality is a critical metabolic derangement in uncontrolled diabetes.
- The tap-induced blink reflex (TBR) is a neurological test assessing brainstem function.
Purpose of the Study:
- To investigate the impact of hyperosmolality on the tap-induced blink reflex (TBR) in patients with diabetes.
- To determine if TBR abnormalities correlate with serum osmolality or blood glucose levels.
- To evaluate the potential of TBR as a biomarker for central nervous system (CNS) dysfunction in diabetic hyperosmolality.
Main Methods:
- Assessed the tap-induced blink reflex (TBR), including its R1 and R2 components.
- Measured serum osmolality and blood glucose levels in diabetic patients.
- Compared TBR parameters in diabetic patients with and without hyperosmolality to controls.
- Correlated TBR abnormalities with the degree of hyperosmolality and blood glucose levels.
Main Results:
- The tap-induced blink reflex (TBR) was frequently absent or delayed in diabetic patients compared to controls.
- TBR abnormalities showed a stronger correlation with the degree of serum hyperosmolality than with blood glucose levels.
- TBR was typically absent in unconscious patients with significantly elevated serum osmolality.
- The R2' component of the TBR was sometimes absent even when consciousness was preserved in patients with high serum osmolality.
Conclusions:
- Hyperosmolality significantly affects the tap-induced blink reflex (TBR) in diabetic patients.
- Serum osmolality is a more critical factor than blood glucose in causing TBR abnormalities.
- The tap-induced blink reflex (TBR) shows promise as a non-invasive tool for monitoring CNS dysfunction in diabetic patients experiencing hyperosmolality.