不同部位脑干梗死的面瘫原因  

The causes of facial paresis in different topical brainstem infarction

作　　者：袁宝玉[1] 闫福岭[1] 郭怡菁[1] 徐海清[1] 

机构地区：[1]东南大学附属中大医院神经内科,南京市210009

出　　处：《江苏医药》2011年第4期421-423,共3页Jiangsu Medical Journal

摘　　要：目的分析不同部位脑干梗死导致面瘫的原因。方法根据脑干梗死灶的部位将患者分成脑桥上段腹侧组和背侧组、脑桥下段腹侧组和背侧组以及延髓腹侧组和背侧组,统计每组患者出现中枢性面瘫、周围性面瘫及其他常见脑干症状或体征的频次,比较各组中枢性面瘫的出现率。结果 74例脑干梗死患者中,有48例患者出现病灶对侧中枢性面瘫,其梗死病灶广泛分布在脑桥和延髓。脑桥上段梗死患者出现中枢性面瘫29例,出现率为74%;脑桥下段和延髓段共出现中枢性面瘫23例,出现率为68%。中枢性面瘫的出现率在两者之间无显著性差异。结论脑桥下段及延髓梗死出现中枢性面瘫的原因为脑桥下段和延髓内存在支配面神经核的皮质核束。Objective To analyze the causes of facial paresis in different local brainstem infarction.Methods According to the location of infarcted lesions as detected by MRI,74 patients were divided into six groups of ventral involvement of the upper pons,dorsal involvement of upper pons,ventral of the lower pons,dorsal involvement of lower pons,ventral involvement of medulla and dorsal involvement of medulla.The frequencies of occurrence of central（C-FP） or peripheral facial paresis（P-FP） were calculated and other brain stem signs were compared.Results Of 74 patients,48 cases had contralateral C-FP caused by brainstem infarct and the majority of infarcted lesions distributed in the ventral pons or medulla.There were 29 patients suffered from C-FP in the upper pons with an occurrence rate of 74%,23 patients suffered from C-FP in the lower pons and medulla with an occurrence rate of 68%（P0.05）.Conclusion The cause of C-FP in the lower pons and medulla infraction is where the corticobulbar tract suupering the facial nerve exists.

关 键 词：脑干梗死 面瘫 

分 类 号：R743[医药卫生—神经病学与精神病学]