Cutaneous reflexes in patients with acute lacunar infarctions.
Cutaneous reflex (CR) was measured in 15 patients with acute lacunar stroke and in 15 age- and sex-matched normal subjects. EMG activities were recorded from the first dorsal interosseous muscle with surface electrodes, rectified and averaged. Intensity of the stimulation on the index finger was four times the sensory threshold. Aided by audio- and visual-feedback monitoring, the subjects abducted the index finger. Side-to-side comparison was made on all the subjects. CR abnormalities were found in all of our patients. The early inhibitory (I1) and second excitatory (E2) components were attenuated in 11 of 15 patients. The I1-E2 interpeak amplitude (A2) was significantly reduced in all the patients. Prolonged latency of I1-E2 components was found to be pronounced in six of eight patients with sensory symptoms. Eight patients were followed up 1 month later. By that time, the abnormal CR had reversed to some degree in all of them. CR alternation was still present in two fully recovered patients. Our results implied a thalamic relay in the afferent limb of the CR. CR could be a valuable adjunct for assessing long tract dysfunction and monitoring functional recovery.
Chen
C C
CC
Neurological Institute, Veterans General Hospital, Taipei, Taiwan.
Chen
J T
JT
Wu
Z A
ZA
Kao
K P
KP
Liao
K K
KK
D000368:Aged; D002544:Cerebral Infarction / Q000503:physiopathology*; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation; D009475:Neurons, Afferent / Q000502:physiology; D011930:Reaction Time; D012018:Reflex / Q000502:physiology*; D012867:Skin / Q000294:innervation*; D013997:Time Factors