Analysis of Stapedial Reflex in Neuromuscular Diseases

Yamane, Masaaki; Nomura, Yasuya

doi:10.1159/000275691

Cited by 14 publications

(11 citation statements)

References 8 publications

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“…Smirne et al [25] and Zakrisson et al [29] found significantly prolonged relaxation time (D 50 ) in DM patients. Yamane et al [28], who studied three reflex measures (L, C 50 and D 50 ) in three DM patients, reported that L and D 50 were significantly longer than in the control subjects and that C 50 was longer but not statistically significantly so (500 Hz stimuli). In contrast, Huygen et al [9], who performed auditory function tests on 13 DM patients, found that D 50 was normal.…”

Section: Discussionmentioning

confidence: 95%

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Stapedial reflex in myotonic dystrophy type 1 and CTG repeat expansion

Osanai¹,

Kinoshita

Hirose³

2001

Journal of Neurology

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The severity of clinical symptoms of myotonic dystrophy type 1 (DM1) has been shown to be closely related to the size of a CTG triplet repeat in the gene encoding myotonin protein kinase. Neuro-otological examinations that include eye movement and stapedial reflex (SR) tests can contribute to the quantitative evaluation of muscular involvement in DM1. We previously found that saccadic eye movement velocity in DM1 patients was significantly lower than that in control subjects and that the saccadic velocity and size of the CTG triplet repeat in DM1 patients had a strong inverse correlation. We now report a case-control study that compared the SR wave form (latency: L, contraction time: C50, and relaxation time: D50) measured by the acoustic impedance method in 13 patients with DM1 and in 14 control subjects matched for age and sex. The correlation between the SR wave form and CTG repeat length in DM1 patients obtained by Southern blot analysis with EcoRI was also examined. We found (1) no significant difference between the pure tone audiometric threshold at 500 Hz in the DM1 patients and that in the control subjects; (2) or between the SR thresholds in the patients and controls (500 Hz stimuli); (3) C50 and D50 in DM1 patients to be significantly prolonged, whereas L was not; (4) C50 and D50 in DM1 patients to be significantly correlated with CTG repeat length, whereas L was not. Measurement of SR by the acoustic impedance method is completely non-invasive, causes no discomfort to the subject, and does not depend on the person's effort or cooperation. Our findings show that SR measurement can be used for a quantitative evaluation of muscle involvement in DM1. We believe that the prolongation of D50 in DM1 is caused by myotonia, which has to be confirmed by further clinical and pathological studies.

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Section: Discussionmentioning

confidence: 95%

“…The stapedial reflex therefore can be used to show muscle weakness and myotonia separately in the stapedial muscle. Several reports have been published on the stapedial reflex in patients with myotonic dystrophy (DM) [9,25,28,29]. Smirne et al [25] and Zakrisson et al [29] found significantly prolonged relaxation time (D 50 ) in DM patients.…”

Section: Discussionmentioning

confidence: 99%

Stapedial reflex in myotonic dystrophy type 1 and CTG repeat expansion

Osanai¹,

Kinoshita

Hirose³

2001

Journal of Neurology

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“…The decline in the reflex threshold in PD was slight and the significance of the decline is indefinite. A prolongation of C50 or a similar parameter was reported in spastic dysphonia [7] and multiple sclerosis [2,[10][11][12], and a prolon gation of D50 or a similar parameter was reported in mul tiple sclerosis [2 ], myotonic dystrophy [1], progressive muscular dystrophy [4], sensorineural hearing loss [ 13], and spasmodic dysphonia [14], But, these results are par tially controversial.…”

Section: Discussionmentioning

confidence: 95%

“…Stapedial reflex (SR) has been investigated in various neurological diseases using impedance audiometry [1][2][3][4][5][6][7], Parkinson's disease (PD) is a neurological disease charac terized by muscle rigidity, tremor, and akinesia. Abnor malities of the stretch reflex [8 ] and the blink reflex [9] in PD have been reported.…”

Section: Introductionmentioning

confidence: 99%

Stapedial Reflex in Parkinson’s Disease

Murofushi

Yamane

Osanai

1992

ORL

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In 27 patients with Parkinson’s disease (PD), stapedial reflexes were measured using impedance audiometry and compared with those of 11 age-matched control subjects. The reflex threshold of PD patients was lower than that of control subjects. A prolongation of contraction time (C₅₀) and relaxation time (D₅₀) was revealed. Between patients with and without L-dopa, there was no significant difference for any reflex parameter. But, the D₅₀ of patients without anticholinergic drugs was longer than that of patients with anticholinergic drugs. The authors could not find any relationship between the severity of PD and the reflex parameters. The authors assume that the prolongation of reflex parameters might be attributed to the hyperactivity of the indirect pathways of the stapedial reflex.

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“…If a diagnosis of MG is suspected, it can be confirmed using in unologic, pharmacological, and electrophysiologic testing [6,11,12]. Additional noninvasive testing, such as stapedius reflex testing, is advocated as a means to identify and further differentiate neuromuscular diseases such as MG [15][16][17].…”

Section: Discussionmentioning

confidence: 99%