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K Nakashima, MD; J C. Rothwell, PhD; P D. Thompson, FRACP; B L. Day, DPhil; A Berardelli, MD; R Agostino, MD; J Artieda, MD; S M. Papas, MD; J A. Obeso, MD; C D. Marsden, FRS

Arch Neurol. 1990;47(4):413-416.

Abstract
• The blink reflex and its recovery cycle were examined in 57 patients with idiopathic dystonia affecting different parts of the body. The group comprised 9 patients with generalized and 15 with segmental forms, 19 with torticollis, and 14 with focal arm dystonia. None had blepharospasm. The duration and amplitude of the R₂ component of the blink reflex showed only minor changes. However, its recovery cycle to paired supraorbital nerve stimuli was abnormal in all groups of patients, except those with focal arm dystonia. These findings may be interpreted as showing abnormal control of the interneuronal networks mediating the blink reflex in patients with dystonia affecting sites other than the facial muscles. The fact that the principal changes were seen in patients with torticollis, and generalized or segmental dystonia, suggests that the extent of dystonia (rather than the severity) and, therefore, the close proximity to the cranial muscles was important in determining the extent of the abnormal interneuron function.

Author Affiliations
From the Medical Research Council Human Movement and Balance Unit, Institute of Neurology, London, England (Drs Nakashima, Rothwell, Thompson, Day, and Marsden), Quinta Clinica Neurologica, Dipartimento di Science Neurologiche, Universita di Roma (Italy) (Drs Berardelli and Agostino), Department of Neurology, Clinica Universitaria, Pamplona (Spain) (Drs Artieda, Papas, and Obeso). Dr Nakashima is presently with the Institute of Neurology, Tottori School of Medicine, Yonago, Japan.

Footnotes
Accepted for publication July 6, 1989.

Reprints not available.

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