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Midbrain vs. pontine medial longitudinal fasciculus lesions: The utilization of masseter and blink reflexes
Author(s) -
Hopf H. C.,
Thömke F.,
Gutmann L.
Publication year - 1991
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.880140406
Subject(s) - medial longitudinal fasciculus , internuclear ophthalmoplegia , midbrain , corneal reflex , anatomy , medicine , abnormality , fasciculus , reflex , pons , magnetic resonance imaging , multiple sclerosis , white matter , central nervous system , radiology , fractional anisotropy , psychiatry
Masseter (MR) and blink reflexes (BL) were investigated in 51 patients with internuclear ophthalmoplegia (INO) due to multiple sclerosis (28) and lacunar infarction (23). The MR was abnormal in 20 of 23 cases with bilateral INO and in 21 of 28 with unilateral INO. The R1 component of the BL (BL‐R1) was abnormal in 7 of 23 patients with bilateral INO and 10 of 28 with unilateral INO. Combined MR and BL‐R1 changes occurred in 8 of 28 cases with unilateral INO and 7 of 23 with bilateral INO. The findings provide evidence for a rostral/caudal localization of lesions within the medial longitudinal fasciculus causing INO on the basis of MR and BL‐R1 abnormalities. An abnormality limited to MR suggests a midbrain location in 58.8% of patients while abnormal BL‐R1 with or without an associated MR change suggests a rostral pontine location in 35.3%.