الفهرس 
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Abstract
Summary
Idiopathic intracranial hypertension is characterized by an increase in ICP in absence of space occupying lesion or dilated ventricles and with normal CSF cellular and biochemical composition (Deborah I. Friedman and Jacobson, 2002). It is associated with single or multiple cranial nerve (CN) palsies, with 39–59% of the patients having some sort of cranial nerves deficit (Wall, 1991).
Blink reflex is a neural reflex analogous to the corneal reflex including the trigeminal (the sensory afferent), facial (the motor efferent) neurons and connected interneurons at the level of the pons and the lateral medulla (Blumenthal et al., 2005).It is useful in detecting abnormalities anywhere along the reflex arc including the peripheral and central pathways (Hartmann, 2013).
Air conducted Ocular Vestibular evoked myogenic potential (oVEMP) evaluates the ascending vestibular pathway as it is produced by superior vestibular nerve afferents. It represents the VOR pathway which begins with acoustic stimulation of the utricle and ends with activation of the contralateral inferior rectus muscle (Fife, 2017).
The aim of our research was to study the oVEMP and blink reflex in the BIH patients and healthy control groups and to evaluate the possible effect of the therapeutic lumber puncture (LP) on those tests parameters in the patient group.
The study included 40 adult females aging from 34.6± 9.7 years old; 20 BIH patients and 20 age and BMI matched healthy controls.
All subjects were underwent full history taking, general, neurological and cranial nerves examination and routine laboratory work up.
They were subjected to electrophysiological tests understudy, AC oVEMP and blink reflex, in Neuro-Diagnostic and Research Center, Beni-Suef University. The patient group had a therapeutic lumber puncture and repeated the tests two weeks after that.
In our study there was no significant effect of the lumbar puncture on N1, P1, R1 latencies and the R1 amplitude. However, there was a significant decrease of the ipsilateral R2 and contralateral R2 latencies and there was a significant increase of the N1-P1 amplitude.
Our study also revealed that there was a significant increase of the N1-P1 amplitude and a significant decrease of R1 amplitude, R2i and R2c latencies among controls than cases after the lumber puncture.
There was no significant relation between the studied parameters and disease recurrence or chronicity but, there was a significant negative correlation between P1 latency and amplitude and R1 amplitude with patient’s age.
We also found that there was a significant negative correlation between the opening pressure of CSF and R1 latency of the blink reflex.
It can be concluded that idiopathic intracranial hypertension impacts both AC ocular VEMPs and blink reflex in different ways.
The increased intracranial pressure reduced the amplitude of oVEMP which could be due to changes in intraotic pressure and increased the latencies of both R2I and R2c of the blink reflex which may predict subclinical affection of the facial nerve and/ or the central part of the reflex.
On the other hand the R1 component of the blink reflex showed en-hancement with increased pressure this may be explained by inflammatory pathology of the BIH and hyperxcitablity in those patients.