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The menace reflex
Wouter J C van Ballegoij1, Peter J Koehler2, Bastiaan C Ter Meulen3
1Department of Neurology, St. Lucas Andreas Hospital, Amsterdam, The Netherlands.
Abstract:
The menace reflex (blink reflex to visual threat) tests visual processing at the bedside in patients who cannot participate in normal visual field testing. We reviewed a collection of recently discovered historical movies showing the experiments of the Dutch physiologist Gysbertus Rademaker (1887-1957), exploring the anatomy of this reflex by making cerebral lesions in dogs. The experiments show not only that the menace reflex is cortically mediated, but also that lesions outside the visual cortex can abolish the reflex. Therefore, although often erroneously used in this way, an absent menace does not always indicate a visual field deficit.
Insights
The menace reflex, a blink response to visual threats, is cortically controlled. Lesions outside the visual cortex can abolish this reflex, indicating it does not always signal a visual field deficit.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurophysiology
Background:
- The menace reflex (blink reflex to visual threat) is a bedside test for visual processing in non-cooperative patients.
- Understanding the neuroanatomical basis of the menace reflex is crucial for accurate clinical interpretation.
Observation:
- Historical films depicting Gysbertus Rademaker's experiments on dogs were reviewed.
- These experiments involved creating cerebral lesions to explore the menace reflex's anatomical pathways.
Findings:
- The menace reflex is mediated by the cerebral cortex.
- Lesions in areas beyond the visual cortex were found to abolish the menace reflex.
- An absent menace reflex does not exclusively indicate a visual field deficit.
Implications:
- Clinical assessment of visual processing using the menace reflex requires careful interpretation.
- The findings challenge the common assumption that an absent menace reflex directly equates to a visual field deficit.
- Further research into the complex neural circuitry of the menace reflex is warranted.
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