The Blink Reflex in Diabetic Patients

ABSTRACT

OBJECTIVE: To assess the facial and trigeminal nerve involvement in diabetic patients using blink reflex study and direct facial motor conduction study. METHOD: The subjects were 397 diabetic patients and 34 normal controls. Diabetic patients were subdivided into two groups based on the findings of nerve conduction studies of limb nerves. Group I, patients with diabetic polyneuropathy; Group II, patients without diabetic polyneuropathy. The blink reflexes and direct facial motor responses and R1 latency/direct response latency (R/D) ratio were obtained in all the subjects. R1 latency was correlated to the findings of nerve conduction studies of limb nerves. RESULTS: 1) R1 latencies or R2 latencies were abnormally prolonged in 22.4% of Group I, 3.3% of Group II, and direct facial responses were abnormal in 11.8% of Group I, 2% of Group II. 2) There were no significant differences in R/D ratio between the two groups. 3) These findings suggest that not only the facial nerve, but also the trigeminal nerve or brain stem could be affected in diabetic patients with polyneuropathy. CONCLUSION: In diabetic patients, blink reflex can provide useful information in determining the degree and distribution of cranial nerve and brain stem lesions.