Blink reflex: A practical test to evaluate the trigeminal nerve injury following percutaneous balloon compression for the treatment of trigeminal neuralgia

Objective To evaluate the blink reflex (BR) in estimating the potential injury of trigeminal nerve following percutaneous balloon compression (PBC) surgery, and to determine the association between BR alterations and early surgical outcomes. Methods In this single‐center, prospective before‐and‐after study, a total of 74 patients who had primary trigeminal neuralgia and scheduled for PBC between October 2020 and June 2021 were prospectively included. BR testing and facial sensory assessment were performed pre‐ and post‐PBC. The latency and the area under the curve (AUC) of pre‐ and postoperative R1 (R1pre/R1post) and R2 (R2pre/R2post) were measured. Results The BR components were noticeably delayed or diminished following PBC. R1post was elicited in only 26 patients, and absent in 48 patients. The residual R1post had markedly reduced AUC (median difference [Hodges–Lehmann]: −59.5, 95% confidence interval [CI]: −217.5 to −6.9, p = 0.023). Compared with R2pre, the latency of R2post was considerably delayed (mean difference: 4.3, 95% CI: 2.9 to 5.7, p