Acta Medica Medianae
ELECTROPHYSIOLOGICAL EVALUATION OF THE TRANSITORY DYSFUNCTION OF THE NERVUS TRIGEMINUS AND THE NERVUS FACIALIS IN THE PATIENTS SUFFERING FROM THE DIABETES NEUROPATHY BY EXAMINING THE BLINK REFLEX
Zoran PERIĆ, Slobodan ANTIĆ, Vojislav CVETKOVIĆ, Slađana JOVIĆ, Milica LAZOVIĆ and Irina STOJANOVIĆ
Clinic for the Protection of Mental Health, Neurology and Development Age Psychiatry of the Clinic Center, Niš
In 90 patients with clinically mild diabetes neuropathy (DN) with no clinic signs of any affection of the nervus trigeminus (NTR) and of the nervus facialis (NF) including 50 with the insulin-independent diabetes (IND) and 40 with the insulin-dependent diabetes (IZD) of average age between 44,23±12,56 years of average diabetes duration of 9,42±7,85 years, the latencies (in ms) Rl, R2 and R2' of the blink reflex response (BR) after the nervus supraorbital is electric stimulation are determined. Besides, in the given patients the values (in m/s) of the motor (MBP) and of the sensitive transmission rate (SBP) of the impulse along the nervus peroneus (NP) and the nervus tibialis (NT) are also determined. The control group consisted of 50 healthy persons of respective age.
On the same day when the electrophysiological examination was done, the following biochemic parameters were determined in the patients' serum, namely, the glycemia profile with calculation of the glycemia average value (MBG) as well as the values of the glycolized chemoglobine (HgAl), of the basal insulin level and of sodium (Na) and potassium (K). After that, the correlation between the given electrophysiological and the biochemic parameters was examined as well as that between the given parameters and the age of the examined and the diabetes duration.
A statistically significant correlation (p<0,00l) between the value of the latent R1 of the BR response and the value of the MBG and HgAl in the patients with the IND is registered, while the given correlation is not registered in the patients with the IZD. An important correlation (p<0,05) is determined between the value of the latencies of the Rl and R2 BR responses in the patients with the IZD as well as between the values of the latencies of the R1 and R2' BR responses in the examined persons with the IND while in all the patients there is an important correlation (p<0,01) between the values of the latencies of the R2 and R2' BR responses is registered. There is no important correlation (p>0,()5) between the values of the other examined parameters registered.
The obtained results show that hyperglycemia causes the emergence of the transitory dysfunction of the NTR and/or the NF in the patients with the IND and the clinically mild DN. The dysfunction of the NTR and/or the NF is approximately symmetrically present on the left and the right side in the patients with the IND and the clinically mild DN while in the persons with the IZD and the clinically mild DN there is asymmetry of the functional disturbance in the system of the NT-NF complex which is probably related to different effects of the right and left brain hemispheres structure upon the function of the BR reflex arc parts in the brain stem. In the given patients (with the IZD and the clinically mild DN) there are more prominent and lasting functional disturbances at the NTR and/or NF level since such persons suffer from diabetes for a considerably longer period of time. There is no important correlation between the transitory dysfunction of the NTR and/or NF and the dysfunction of the NP and the NT in the patients with the clinically mild DN.
Key words: Transitory dysfunction, nervus trigeminus, nervus facialis, blink reflex, diabetes neuropathy