title: [Orbicular eye reflex (R3) and the valsalva manoeuvre].
abstract: BACKGROUND
  Different kinds of tests have been devised to evaluate the autonomic nervous system, including the changes in heart rate and arterial blood pressure after carrying out Valsalva s manoeuvre. However, to date, the behaviour of the three responses to the orbicular eye reflex during this manoeuvre was not known and this was the reason for carrying out our study.
  
  
  METHODS
  We evaluated 12 neurologically normal persons before and after doing a Valsalva manoeuvre by studying the orbicular eye reflex using the method of Kimura and recording the three responses: R1, R2 and R3.
  
  
  RESULTS
  The late results (R3) of this reflex, but not those of short (R1) or medium (R2) latency were significantly modified whilst the manoeuvre was carried out (p< 0.05).
  
  
  CONCLUSIONS
  Inhibition of the gamma motor neurones during this inspiratory manoeuvre, which are also related to activity of the facial muscles, seems to be the mechanism most likely to explain the findings during the practice of BREATH (Blink reflex autonomic testing in humans). Studies which evaluate only the first two responses to this reflex whilst the manoeuvre is carried out should not be taken too seriously since they may lead to dangerously erroneous conclusions.
authors.affiliation: Neurología Clínica Neurociencias Aplicada; Universidad Industrial de Santander MD, PhD, Bucaramanga, Colombia. neuronetco@yahoo.com
authors.forename: F E
authors.initials: FE
authors.lastname: León-Sarmiento
authors.forename: M D
authors.initials: MD
authors.lastname: Martín-Torres
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology*; D004558:Electric Stimulation; D004594:Electrophysiology; D005133:Eye Movements / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D012018:Reflex; D014636:Valsalva Maneuver / Q000502:physiology*