Electrically elicited blink reflex in horses with trigeminal and facial nerve blocks

OBJECTIVE: To reassess reference values for the components of the electrically induced blink reflex, document reference values for facial motor nerve conduction velocity, and demonstrate usefulness of the blink reflex as a diagnostic tool in peripheral facial and trigeminal nerve dysfunction in horses. ANIMALS: 10 healthy adult horses (8 males, 2 females) without neurologic abnormalities. PROCEDURE: Blink reflex tests were performed by electrical stimulation of the supraorbital nerve and facial (auriculopalpebral) nerve. Reflex and direct muscle-evoked potentials of the orbicularis oculi muscles were recorded from concentric needle electrodes inserted bilaterally in these muscles. Supraorbital and auriculopalpebral nerve blocks were performed by lidocaine hydrochloride injections. RESULTS: Supraorbital nerve stimulation elicited 2 or 3 ipsilateral and 1 contralateral reflex muscle potential in the orbicularis oculi muscles. Auriculopalpebral nerve stimulation elicited a direct and a reflex potential in the ipsilateral orbicularis oculi muscle. After left supraorbital nerve block, no responses could be elicited ipsilaterally or contralaterally upon stimulation of the blocked nerve, but bilateral responses were obtained upon stimulation of the right supraorbital nerve. After right auriculopalpebral nerve block, no responses were recorded from the right orbicularis oculi muscle upon stimulation of left or right supraorbital nerves. CONCLUSIONS AND CLINICAL RELEVANCE: Reference values for the components of the blink reflex and facial motor nerve conduction velocity will allow application of these tests to assist in the diagnosis of equine neurologic disorders involving the trigeminal and facial nerves, the brainstem, and the cranial end of the cervical segment of the spinal cord. This study reveals the usefulness of the blink reflex test in the diagnosis of peripheral trigeminal and facial nerve dysfunction in horses.     

Electrophysiologic studies of the facial reflexes of the dog

Reflexes associated with the trigeminal and facial nerves were investigated electromyographically in 14 barbiturate-anesthetized dogs. Using subcutaneous needle electrodes, electrical stimulation of the infraorbital, frontal, and zygomaticofacial branches of the trigeminal nerve produced reflex contractions of the ipsilateral orbicularis oculi muscle. Cutaneous and subcutaneous electrical stimulation of the internal auricular branches of the facial nerve also produced reflex contractions of the ipsilateral orbicularis oculi muscle. After sectioning of this branch between the vagus and facial nerves, electrical stimulation of the proximal portion of the auricular branch of the vagus nerve produced reflex contractions of the ipsilateral orbicularis oculi muscle. After sectioning of the auricular branch of the vagus nerve; electrical stimulation of the proximal portion of the caudal and middle internal auricular nerves did not produce reflex contractions of the ipsilateral orbicularis oculi muscle. Subcutaneous electrical stimulation of the palpebral nerve produced reflex contractions and direct-evoked muscle activity of the orbicularis oculi muscle. Subcutaneous electrical stimulation of the infraorbital and middle mental nerves produced reflex contractions of the rostral belly of the digastricus muscle.     

Nociceptive trigeminal reflexes in non-sedated horses

Electrically induced reflexes can be used to investigate the physiology and pathophysiology of the trigeminal system in humans. Similarly, the assessment of the trigemino-cervical (TCR) and blink reflexes (BR) may provide a new diagnostic tool in horses. The aim of this study was to evoke nociceptive trigeminal reflexes and describe the electrophysiological characteristics in non-sedated horses. The infraorbital (ION) and supraorbital nerves (SON) were stimulated transcutaneously in 10 adult Warmblood horses in separate sessions using train-of-five electrical pulses. The current was increased gradually until the TCR threshold was found. The stimulus-response curve of the TCR was evaluated. At the same time as TCR, the BR response was also assessed. Surface electromyographic (EMG) responses were recorded from the orbicularis oculi, splenius and cleidomastoideus muscles. Latency, duration, amplitude of the reflexes and behavioural responses were analysed. Noxious electrical stimulation of the ION or SON evoked reflex EMG responses, with similar features regardless of the nerve that had been stimulated. Stimulations of increasing intensity elicited reflexes of increasing amplitude and decreasing latency, accompanied by stronger behavioural reactions, therefore confirming the nociceptive nature of the TCR. These findings provide a reference for the assessment of dysfunction of the equine trigeminal system.     

Electromyographic evaluation of conduction time and velocity of the recurrent laryngeal nerves of clinically normal dogs

In 25 adult dogs of various breeds, recurrent laryngeal nerve fibers were electrically stimulated at 2 points along their extralaryngeal course. Evoked compound muscle action potentials were recorded in the ipsilateral intrinsic laryngeal muscles, using a percutaneous needle electrode. Latencies, amplitudes, and durations were measured. Latencies were correlated with neck length (r = 0.88 on left and 0.82 on right). Five of the dogs were euthanatized, and the nerve length between the 2 stimulating needle electrodes was measured; calculated conduction velocities (mean +/- SD) were 55 +/- 6 m/s (left) and 57 +/- 6 m/s (right). In 38 additional canine cadavers, the lengths of the exposed left and right recurrent laryngeal nerves were correlated with neck length (r = 0.44 on left and 0.56 on right). A linear regression model is proposed for predicting normal latencies, despite variations in neck length among different breeds of dogs.     

Idiopathic facial paralysis in the dog

Facial nerve paralysis of acute onset is reported in seven mature dogs, five of which were cocker spaniels. The clinical signs were characterised by ear drooping, lip commissural paralysis, sialosis, and collection of food on the paralysed side of the mouth. All dogs showed absent menace responses and trigeminofacial/acousticofacial reflexes. Horner's syndrome was not present in any dog. In four dogs, bilateral facial paralysis developed. The facial paralysis was unrelated to otitis media. Electrodiagnostic studies revealed denervation potentials and absent evoked muscle potentials. Facial nerve biopsies from two cases showed nerve fibre degeneration and apparent loss of larger diameter myelinated fibres. The condition has been termed idiopathic facial paralysis since the aetiopathogenesis is presently unknown.     

Measurement of the Lateral Thoracic Reflex Latency in Ponies

Lateral thoracic nerve reflex latencies values were measured in ponies using a simple, non-invasive technique. The reflex was elicited using an external triggering hammer attached to an electrodiagnostic unit. The resulting evoked, compound muscle action potentials were recorded with electrodes, which were placed over the 6th ribs or 11th rib level with the axilla. Two superimposed repeats of 4 signal-averaged sweeps of 50 or 100 milliseconds were recorded and the estimated reflex pathway was measured for each subject in order to calculate the reflex latencies and latency velocities. Mean left and right 6th rib peak latencies were not significantly different from each other ( P = .609), but left 6th rib latencies were shorter than those recorded from the 11th rib ( P < .0001), substantiating the existence of an indirect (central) pathway to the reflex. The calculated left and right 6th rib latency velocities were not significantly different from each other ( P = .58) but left 6th rib latency velocities were different from left 11th rib ( P = .009). The calculated latency velocities were within the broad range for corticospinal tract motor conduction velocities and comparable to magnetic motor evoked latency velocities. The use of lateral thoracic reflex latency measurements to objectively identify the site of spinal cord lesions is discussed.     

Conduction velocities and reflexes of the proximal and distal parts of the saphenous nerve of the dog

The maximal conduction velocities of compound-action potentials in the proximal and distal parts of the saphenous nerve were determined by averaging potentials evoked and recorded through needle electrodes. Antidromic, triphasic compound-action potentials unipolarly recorded from the distal part of the saphenous nerve were of the same minimal latency as potentials having 4 phases which were recorded bipolarly from the same site. However, the unipolarly recorded potentials were of greater amplitude. Monophasic compound-action potentials were recorded through bipolar chlorided silver electrodes from the surface of fascicles of the distal part of the saphenous nerve. The maximal conduction velocity of these potentials was in agreement with the conduction velocity of compound-action potentials of the distal part of the saphenous nerve which were evoked and recorded through subcutaneous needle electrodes. The specificities of the stimulating and recording sites were verified by recording before and after the saphenous nerve was cut between the stimulating and recording sites. Mean conduction velocities were 62.3 +/- 2.0 m/s for the distal part of the saphenous nerve and 66.3 +/- 2.2 m/s for the proximal part of the saphenous nerve. Reflex-evoked muscle activity was elicited in the ipsilateral tensor muscle of the fascia lata and semimembranous muscle after electrical stimulation of the saphenous nerve through subcutaneous needle electrodes. The effects of various stimulus intensities on the latency and duration of these reflex-evoked muscle potentials were determined.     

Evaluation of jitter by stimulated single-fiber electromyography in normal dogs

Single-fiber electromyography (SFEMG), a technique used to investigate neuromuscular transmission, has been described previously in the pelvic limb of dogs. Because preferential involvement of isolated muscle groups can occur in disorders of neuromuscular transmission, SFEMG was done in the peroneus longus (PL), extensor carpi radialis (ECR), and orbicularis oculi (OO) muscles of 10 adult, clinically normal dogs. Jitter was calculated as the mean absolute value of the consecutive differences in latency of 50 single muscle fiber action potentials after stimulation of intramuscular nerve bundles at the level of the motor point in at least 20 muscle fibers per muscle. Bilateral recordings were performed in 3 dogs. Mean jitter values were determined for each muscle, and differences among muscle groups and among dogs were compared. The upper limits of mean consecutive difference (mean plus 3 standard deviations) for the PL, ECR, and OO muscles were 21.94, 22.53, and 23.39 micros, respectively, and the upper limit of mean consecutive difference for individual muscle fibers in the respective fiber pools was 28.62, 36.39, and 35.68 micros. Jitter values for the ECR and OO were significantly higher than the jitter value for the PL muscle (P < .05). Significant differences among muscles or dogs or between sides were not observed for the ECR. Significant differences among dogs were observed for OO jitter values and were attributed to extremely low jitter values in 1 dog. Significant differences were demonstrated between sides for the PL and were attributed to small sample size. Results of this study provide normative data that can be used in the application of the stimulated SFEMG technique to dogs with suspected disorders of neuromuscular transmission.     

Resistance of the Peripheral Nervous System to the Effects of Chronic Canine Hypothyroidism

Background: Hypothyroidism has been implicated in the development of multiple peripheral mono‐ and polyneuropathies in dogs. The objectives of this study were to evaluate the clinical and electrophysiologic effects of experimentally induced hypothyroidism on the peripheral nervous system of dogs. Hypothesis: Chronic hypothyroidism will induce peripheral nerve sensorimotor dysfunction. Animals: Eighteen purpose‐bred, female dogs. Methods: Prospective, longitudinal study: Hypothyroidism was induced by radioactive iodine administration in 9 dogs, and the remaining 9 served as untreated controls. Neurological examinations were performed monthly. Electrophysiologic testing consisting of electromyography (EMG); motor nerve conduction studies of the sciatic‐tibial, radial, ulnar, and recurrent laryngeal nerves; sciatic‐tibial and ulnar F‐wave studies; sensory nerve conduction studies of the tibial, ulnar, and radial nerves; and evaluation of blink reflex and facial responses were performed before and 6, 12, and 18 months after induction of hypothyroidism and compared with controls. Results: Clinical evidence of peripheral nervous dysfunction did not occur in any dog. At 6 month and subsequent evaluations, all hypothyroid dogs had EMG and histologic evidence of hypothyroid myopathy. Hypothyroid dogs had significant (P≤ .04) decreases in ulnar and sciatic‐tibial compound muscle action potentials over time, which were attributed to the concurrent myopathy. No significant differences between control and hypothyroid dogs were detected in electrophysiologic tests of motor (P≥ .1) or sensory nerve conduction velocity (P≥ .24) or nerve roots (P≥ .16) throughout the study period, with values remaining within reference ranges in all dogs. Conclusion: Chronic hypothyroidism induced by thyroid irradiation does not result in clinical or electrophysiologic evidence of peripheral neuropathy, but does cause subclinical myopathy.     

Magnetic stimulation of the radial nerve in dogs and cats with brachial plexus trauma: a report of 53 cases

Brachial plexus trauma is a common clinical entity in small animal practice and prognostic indicators are essential early in the course of the disease. Magnetic stimulation of the radial nerve and consequent recording of the magnetic motor evoked potential (MMEP) was examined in 36 dogs and 17 cats with unilateral brachial plexus trauma.Absence of deep pain perception (DPP), ipsilateral loss of panniculus reflex, partial Horner’s syndrome and a poor response to MMEP were related to the clinical outcome in 29 of the dogs and 13 of the cats. For all animals, a significant difference was found in MMEP between the normal and the affected limb. Absence of DPP and unilateral loss of the panniculus reflex were indicative of an unsuccessful outcome in dogs. Additionally, the inability to evoke a MMEP was associated with an unsuccessful outcome in all animals. It was concluded that magnetic stimulation of the radial nerve in dogs and cats with brachial plexus trauma may provide an additional diagnostic and prognostic tool.     

Measurement of anal and genitoanal reflexes in cats

Noninvasive determination of anal and genitoanal reflexes was evaluated in clinically normal cats. Thirty adult mixed-breed cats (15 sexually intact or castrated males, 15 sexually intact or spayed females) were sedated by IV administration of ketamine, acetylpromazine, and atropine. Anal reflexes were recorded from the anal sphincter muscle after ipsilateral and contralateral electrical stimulation of the perineal skin. Genitoanal reflexes were recorded from the anal sphincter muscle after electrical stimulation of the penis or clitoris. An anal sphincter response to tibial nerve stimulation was attempted. Anal reflexes from ipsilateral and contralateral stimulations and a genitoanal reflex were detected in all cats. Anal sphincter responses to tibial nerve stimulation were inconsistent (4/30) and were not included in any analyses. Anal reflexes had response latencies of 7.5 to 12.0 ms (ipsilateral stimulation) and 6.5 to 13 ms (contralateral stimulation). Genitoanal reflexes had latencies of 9.0 to 13.0 ms (males) and 6.5 to 9.0 ms (females). Anal reflex latencies were significantly (P less than 0.05) longer for contralateral, opposed to ipsilateral, stimulation and were significantly (P less than 0.05) longer in males than in females. Genitoanal reflex latencies were also significantly (P less than 0.05) longer in males than in females, reflecting the more peripheral stimulation site in males. Anal reflex responses could be recorded in 2 feline clinic patients with such severe perineal trauma that pudendal nerve function could not be manually evaluated A potentially favorable prognosis was given in each instance on the basis of detection of the response. One cat eventually recovered.(ABSTRACT TRUNCATED AT 250 WORDS)     

Electrical stimulation of lumbar spinal nerve roots in dogs

The aim of this study was to test the applicability of electrical stimulation of lumbar spinal nerve roots and obtain normative electrical root stimulation (ERS) data for L7 nerve root and sciatic nerve in dogs. For that purpose ERS and sciatic nerve stimulations were performed consecutively, in totally 40 healthy dogs. ERS was applied in the L7/S1 intervertebral space via monopolar needle electrodes. Muscle responses were recorded from the gastrocnemius muscles on the left and right hind limbs. Sciatic nerve stimulation was performed at the greater trochanter level on the left hind limb, with records obtained from the left gastrocnemius muscle. Mean root latencies of the left and right side were 5.22?±?0.49 ms and 5.29?±?0.53 ms, respectively. There was no significant difference in root latency between the right and left sides. The mean terminal latency was 3.82?±?0.46 ms. The proximal motor nerve conduction velocity of the sciatic nerve was 63.15?±?3.43 m/s. The results of this study show that ERS provides objective data about the integrity of lumbar spinal nerve roots by evaluating the entire population of motor fibres and total length of the motor axon in dogs. ERS can be considered a useful diagnostic method for confirmation of diagnoses of lumbosacral diseases.     

Intraoperative Monitoring of Ischiatic Nerve Function with Sensory Evoked Potentials

Serial recordings of sensory evoked potentials (SEP) generated in response to stimulation of each tibial nerve were obtained from 23 anesthetized dogs. Five dogs were anesthetized for 3 hours to evaluate changes in serial SEP during general anesthesia. Nonsurgical and surgical manipulations were performed on one hind limb of five dogs to determine the effects of limb positioning and nerve retraction on SEP. In 13 dogs, the ischiatic nerve was exposed surgically and retracted until the SEP deteriorated and disappeared, to determine the relationship between amount of tension on the nerve and the time to complete deterioration of the SEP. Sensory evoked potential waveforms, which consisted of two to five peaks, were stable throughout the anesthetic period. The first two peaks were the most stable. Latency of the first two peaks was the easiest and most reliable parameter to evaluate. Although the peak latency in recordings from the superior hind limb was always slightly longer, SEP recordings from the inferior limb were good controls to monitor nerve function. There was considerable variation in sensitivity to nerve retraction. The technique proved to be a reliable way to monitor nerve function in normal anesthetized dogs.     

Paradoxical vestibular disease with trigeminal nerve-sheath tumor in a dog

A thirteen-year old spayed female poodle was referred because of atrophy of temporal and masseter muscles on the left and head tilt and episodical circling to the right side. Additionally, decreased facial sensation, absent menace reaction, palpebral and corneal reflexes on the left side, as well as ipsilateral hemiparesis and tongue palsy were noticed. Generalised vestibular ataxia and hypermetria in the front limbs were present. Based on the clinical signs, the presumptive anatomical localization of the lesion was the cerebellopontine angle including parts of the caudal brainstem with involvement of the trigeminal, facial and hypoglossal nerves. Involvement of either flocculonodular lobe or the caudal cerebellar peduncle on the left side causing paradoxical vestibular disease was suspected. On magnetic resonance imaging a large enhancing lesion in the area of the left cerebellopontine angle involving the trigeminal nerve and compressing cerebellum and brainstem was seen. Because of the poor prognosis the dog was euthanized on the owner's request. This space occupying lesion could be identified as a trigeminal neurofibrosarcoma/schwannoma on post mortem histopathological examination.     

Electrophysiological evidence of peripheral nerve dysfunction in six dogs with botulism type C

In six dogs with botulism type C electrophysiological examinations showed: fibrillation potentials and prolonged insertional activity; low amplitude of the evoked muscle action potential; decrease in amplitude of the compound muscle action potential with slow repetitive stimulation; slowing of motor and sensory velocities in the peripheral nerve; and restoration of velocity and amplitude corresponding to clinical improvement. These findings indicate peripheral nerve dysfunction which cannot be explained adequately by current knowledge of the action of botulinum toxin on cholinergic nerve endings. It is therefore suggested that botulinum toxin also interferes with peripheral nerve conduction.     

Contributions of the glossopharyngeal nerve and the pharyngeal branch of the vagus nerve to the swallowing process in dogs

The separate contributions of the glossopharyngeal nerve and the pharyngeal branch of the vagus nerve to the innervation of the pharyngeal muscles were studied first in 10 canine cadavers by dissection of the pharyngeal plexus and the pharyngeal muscles. In 10 other dogs, the parent trunks and 1st division of the glossopharyngeal nerve and the pharyngeal branch of the vagus nerve were electrically stimulated. The evoked stimulation potentials were recorded from the stylopharyngeal, hyopharyngeal, thyropharyngeal, and cricopharyngeal muscles. One of the parent trunks was then transected, and the effects on the swallowing process were observed clinically and by contrast videofluorography. Denervation potentials resulting from nerve transection were recorded in the soft palate, the hyopharyngeal, thyropharyngeal, and cricopharyngeal muscles. The pharyngeal plexus was composed of branches originating from the glossopharyngeal nerve and the pharyngeal branch of the vagus nerve. In most dogs, the pharyngeal muscles and the soft palate were innervated ipsilaterally by both nerves. The swallowing process was more severely disturbed after bilateral transection of the pharyngeal branch of the vagus nerve than after bilateral transection of the glossopharyngeal nerve.     

Trigeminal nerve-evoked potentials in the dog

Brain stem and cerebrocortical potentials were evoked by electrical stimulation of the infraorbital nerve of dogs and recorded through needle electrodes placed adjacent to the contralateral parietal bone. Five individual, short latency peaks were recorded in each averaged trigeminal nerve-evoked potential and were identified as I, II (A and B), III (A and B), PI (A, B, and C), and NI. Mean peak latencies +/- 1 SD were as follows: I = 0.9 +/- 0.1 ms, IIA = 1.7 +/- 0.1 ms, IIB = 2.5 +/- 0.1 ms, IIIA = 3.6 +/- 0.15 ms, IIIB = 4.1 +/- 0.2 ms, PIA = 5.2 +/- 0.15 ms, PIB = 6.4 +/- 0.2 ms, PIC = 7.3 +/- 0.3 ms, and NI = 11.0 +/- 0.6 ms. Trigeminal nerve-evoked potentials recorded through needle electrodes were essentially the same as potentials evoked by direct stimulation of the infraorbital nerve and recorded directly from the dura mater overlying the contralateral rostral suprasylvian gyrus. The specificity of the stimulating site was verified by recording before and after the infraorbital nerve was cut proximal to the stimulating site.     

Effects of tenotomy of the tensor tympani muscle on the acoustic reflex in dogs

The acoustic reflex (AR) was recorded from 12 healthy mixed-breed dogs. Latency and amplitude were measured from ipsilateral and contralateral AR at stimulus frequencies of 1 and 2 kHz and intensities of 70 to 110 dB sound pressure level for ipsilateral AR and 70 to 120 dB hearing level for contralateral AR. Mean latencies for ipsilateral and contralateral AR were between 33.46 and 206.10 ms and between 45.26 and 180.89 ms, respectively, and amplitudes were between 0.14 and 1.79 cm3 and between 0.31 and 1.86 cm3 of air, respectively. Stimulus frequencies and intensities had significant effects (P less than 0.05) on ipsilateral and contralateral AR latencies and amplitudes. Ipsilateral and contralateral AR decays were determined by measuring compliance change during a 10-s pure-tone stimulation at frequencies of 1 and 2 kHz at an intensity of 10 dB above AR threshold. Reflex decays for 1 kHz and 2 kHz frequencies averaged 5.74% and 9.71%, respectively, for ipsilateral AR and 5.08% and 5.40%, respectively, for contralateral AR. Bilateral tympanograms and brain stem auditory-evoked responses were performed on each dog. Mean normal static compliance of the middle ear, as determined by tympanometry, was 0.15 cm3. Unilateral tenotomy of the tensor tympani muscle was done on 6 of the 12 dogs, and each of the preceding procedures were repeated within 1 week after surgical operation. Transection of the tensor tympani tendon did not alter (P greater than 0.05) the latencies or amplitudes of 1 kHz- or 2 kHz-evoked contralateral AR, the latency or amplitude of 1 kHz-evoked ipsilateral AR, or the amplitude of 2 kHz-evoked ipsilateral AR. However, the latency of 2 kHz-evoked ipsilateral AR was significantly (P less than 0.05) increased. Reflex decay increased significantly (P less than or equal to 0.001) for the contralateral reflex elicited by the 2 kHz stimulus. Neither compliance of the middle ear system nor amplitude and latency of the brain stem auditory-evoked response were affected (P greater than 0.05) by tenotomy. Since tenotomy eliminates participation of the tensor tympani in the AR, these data indicate that contraction of this muscle is not primarily responsible for the compliance changes recorded during an acoustic reflex in dogs.     

Electromyographic evaluation of adult Labrador retrievers with type-II muscle fiber deficiency

Labrador Retrievers with type-II muscle fiber deficiency were examined electrodiagnostically. Electromyographic changes consisted of positive sharp waves, fibrillation potentials, bizarre high-frequency discharges, and, rarely, myotonic-like discharges. Fasciculation potentials were recorded infrequently. Fibrillation potentials and bizarre high-frequency discharges were the most commonly observed electromyographic changes. Bizarre high-frequency discharges were prominent in muscles of the head and neck, proximal muscles of the thoracic limbs, and the thoracolumbar paraspinal musculature. Marked abnormalities were not observed in the motor nerve conduction velocity. Decremental responses of the evoked compound muscle action potential to repetitive nerve stimulation were not observed.