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The blink reflex in chronic renal failure

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Summary

The components of the electrically elicited blink reflex were investigated in 15 patients who were admitted to a chronic dialysis program because of chronic renal insufficiency with serum creatinine concentrations from 6.0 to 14.2 mg/dl. In addition, the conduction time in the facial nerve, the motor conduction velocities, and the distal motor latencies of the median and peroneal nerves were measured.

In 13 of 15 patients (87%) there was at least one component of the blink reflex pathologically delayed. Bilateral prolongation of the latency of the component R1 was seen most frequently. In all pathological cases the distribution pattern of the responses revealed dysfunction in the brainstem. Correlating the values of blink reflex latencies, the period of dialysis, the values of serum creatinine and urea nitrogen, and the results of peripheral neurography, there was a significant relationship between the motor conduction velocity of the peroneal nerve and the latency of the early component R1. The value of these findings in reference to the known neurological symptomatology in chronic renal failure is discussed.

Zusammenfassung

Bei 15 Patienten, die wegen einer chronischen Niereninsuffizienz in einem Dauerdialyseprogramm standen und Serumkreatininwerte zwischen 6,0 und 14,2 mg/dl aufwiesen, wurden die Komponenten des elektrisch ausgelösten Blinkreflexes untersucht. Zusätzlich erfolgte die Bestimmung der Leitungszeit des N. facialis sowie der motorischen Nervenleitgeschwindigkeit und der distalen motorischen Latenz des N. medianus und N. peronaeus.

Bei 13 von 15 Patienten (87%) ließen eine oder mehrere Komponenten des Blinkreflexes eine pathologische Verzögerung erkennen. Am häufigsten zeigte sich eine beidseitige Latenzverlängerung der Komponente R1. In sämtlichen pathologischen Fällen konnte aufgrund des Verteilungsmusters der Reflexantworten eine Funktionsstörung im Bereich des Hirnstammes angenommen werden. Korrelationsberechnungen zwischen den Latenzwerten des Blinkreflexes, der bisherigen Dialysedauer, den Serumwerten von Kreatinin und Harnstoff sowie den Ergebnissen der peripheren Neurographie ergaben einen bedeutsamen Zusammenhang zwischen der motorischen Leitgeschwindigkeit des N. peronaeus und der Latenz der frühen Komponente R1. Die Wertigkeit dieser Befunde im Rahmen der bekannten neurologischen Symptomatik bei der chronischen Niereninsuffizienz wird diskutiert.

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  1. Department of Neurology, University of Kiel, Niemannsweg 147, D-2300, Kiel, Federal Republic of Germany

    H. Strenge

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Strenge, H. The blink reflex in chronic renal failure. J. Neurol. 222, 205–214 (1980). https://doi.org/10.1007/BF00313119

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  • DOI: https://doi.org/10.1007/BF00313119

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