The Masseter Inhibitory Reflex in Pontine Lesions

  • B. W. Ongerboer de Visser
  • G. Cruccu

Abstract

A variety of stimuli anywhere within the mouth or on the facial skin of the maxillary or mandibular trigeminal division evoke bilateral inhibitory reflex responses in jaw-closing muscles. One of these reflexes is the masseter inhibitory reflex (MIR) [1–3], which consists of early (SP1)and late (SP2) phases of an electrical silent period in masseter voluntary activity (Fig. 1A). Characteristics of the two reflex components are standardized by giving a reflex threshold electrical stimulus three times to the mental nerve at the chin during maximal clenching of the jaws (Fig. 2). It may be necessary to use a concentric needle electrode instead of surface electrodes, particularly if the signal is contaminated by facial muscle activity. Maximal contraction has to be maintained for not more than 3 s with the aid of audiovisual feedback by the EMG apparatus. After relaxation, contraction is repeated every 30s to avoid disappearance of EMG activity between the two silences.

Keywords

Neuropathy Neurol Dystonia Osteomyelitis Ophthalmoplegia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Godeaux E, Desmedt JE (1975) Exteroceptive suppression and motor control of the masseter and temporalis muscles in normal man. Brain Res 85:447–458CrossRefGoogle Scholar
  2. 2.
    Ongerboer de Visser BW, Goor C (1976) Cutaneous silent period in masseter muscles: a clinical and electrodiagnostic evaluation. J Neurol Neurosurg Psychiatry 39:674–679CrossRefGoogle Scholar
  3. 3.
    Ongerboer de Visser BW, Cruccu G, Manfredi M, Koelman JHTM (1990) Effects of brainstem lesions on the masseter inhibitory reflex: functional mechanisms of reflex pathways. Brain 113:781–792CrossRefGoogle Scholar
  4. 4.
    Cruccu G, Agostino R, Inghilleri M, Manfredi M, Ongerboer de Visser BW (1989) The masseter inhibitory reflex is evoked by innocuous stimuli and mediated by A beta afferent fibres. Exp Brain Res 77:447–450PubMedCrossRefGoogle Scholar
  5. 5.
    Cruccu G, Pauletti G, Agostino R, Berardelli A, Manfredi M (1991) Masseter inhibitory reflex in movement disorders, Huntington’s chorea, Parkinson’s disease, dystonia and unilateral masticatory spasms. Electroencephalogr Clin Neurophysiol 81:24–30PubMedCrossRefGoogle Scholar
  6. 6.
    Skiba TJ, Laskin DM (1981) Masticatory muscle silent periods in patients with MPD syndrome before and after treatment. J Dent Res 60:699–706PubMedCrossRefGoogle Scholar
  7. 7.
    Sharav Y, McGrath PA, Dubner R (1982) Masseter inhibitory periods and sensations evoked by electrical tooth pulp stimulation in patients with oral-facial pain and mandibular dysfunction. Arch Oral Biol 27:305–310PubMedCrossRefGoogle Scholar
  8. 8.
    Groot RH, Ongerboer de Visser BW, van Merkesteyn JPR, Speelman JD, Bras J (1992) Changes in masseter inhibitory reflex responses in patients with diffuse sclerosing osteomyelitis of the mandible. Oral Surg Oral Med Oral Pathol 74:727–732PubMedCrossRefGoogle Scholar
  9. 9.
    Ongerboer de Visser BW, Cruccu G (1993) Neurophysiological examination of the trigeminal, facial, hypoglossal, and spinal accessory nerves in cranial neuropathies and brainstem disorders. In: Brown WF, Bolton CF (eds) Clinical electromyography, 2nd edn. Butterworth BostonGoogle Scholar
  10. 10.
    Ongerboer de Visser BW, Kuypers HGJM (1978) Late blink reflex changes in lateral medullary lesions. An electrophysiological and neuroanatomical study of Wallenberg’s syndrome. Brain 101:285–294CrossRefGoogle Scholar
  11. 11.
    Ongerboer de Visser BW, Moffie D (1979) Effects of brain-stem and thalamic lesions on the corneal reflex. An electrophysiological and anatomical study. Brain 102: 595–608CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1993

Authors and Affiliations

  • B. W. Ongerboer de Visser
    • 1
  • G. Cruccu
    • 1
  1. 1.Departments of Clinical Neurophysiology and NeurologyUniversity of Amsterdam, Academicsh Mediisch CentrumAmsterdam-ZuidoostThe Netherlands

Personalised recommendations