PubMed · 16022400
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C Peota. 2005. Blink.. https://pubmed.ncbi.nlm.nih.gov/16022400/
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Hemimasticatory spasm (HMS) is a condition characterized by paroxysmal involuntary contraction of masticatory muscles. We performed an electrophysiological investigation of a single patient with HMS to identify any pathophysiological changes associated with the condition. We identified a delayed M wave and jaw jerk on the affected side and an absent masseteric silent period during spasm. Botulinum toxin injections successfully treated the clinical symptoms and resulted in a significant reduction in the excitability of the blink reflex recovery cycle. These data suggest that HMS may be due to ectopic activity in the motor portion of the trigeminal nerve that is capable of inducing changes in the excitability of central reflex pathways. These changes can be altered by successful treatment with botulinum toxin.
PURPOSE: The HR (prism diopters [PD] per mm of corneal light reflection test [CLRT] asymmetry for strabometry) varies in humans from 14 to 24 PD/mm, but is totally unpredictable. Photo(grammetric) HR calibration in (of) each case facilitates acceptable strabometry precision and accuracy. METHOD: Take 3 flash photos of the patient with both the preferred eye and then the deviating eye fixating straight ahead and then again with the deviation eye fixing at (+/-5-10 PD) the strabismic angle on a metric rule (stick) one meter away from the camera lens (where 1 cm = 1 PD). RESULTS: On these 3 photos, make four precise measurements of the position of the CLR with reference to the limbus: In the deviating eye fixing straight ahead and fixating at the angle of deviation. Divide the mm difference in location into the change in the angle of fixation to determine the HR for this patient at this angle. Then determine the CLR position in both the deviating eye and the fixing eye in the straight ahead primary position picture. Apply the calculated calibrated HR to the asymmetry of the CLRs in primary position to determine the true strabismic deviation. CONCLUSIONS: This imaging method insures accurate Hirschberg CLRT strabometry in each case, determining the deviation in "free space", under conditions of normal binocular viewing, uncontaminated by the artifacts or inaccuracies of other conventional strabometric methods or devices. So performed, the Hirschberg CLRT is the gold standard of strabometry.
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