特发性面神经麻痹及面肌痉挛患者面神经电图各分支差异  

Differences between facial nerve electroneurography and conduction of facial nerve branches in patients with facial nerve palsy and hemifacial spasm

作　　者：徐玺 展淑琴[1] 向莉[1] XU Xi;ZHAN Shuqin;XIANG Li(Department of Neurology,Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院神经内科,西安710004

出　　处：《山西医科大学学报》2021年第8期1074-1077,共4页Journal of Shanxi Medical University

基　　金：国家自然科学基金资助项目(81070999);陕西省社会发展科技攻关项目(2016SF-020);西安市科技计划项目(2019114613YX001SF039(2));西安交通大学第二附属医院新技术新疗法(2019-32,2018-16,2010-22);中央高校基本科研业务费专项基金资助(xjj2014153,2009-95);西安交通大学第二附属医院人才培养专项科研基金科技骨干项目[RC(GG)201109]。

摘　　要：目的比较特发性面神经麻痹及面肌痉挛患者的面神经颞支、颧支、颊支、下颌缘支神经电图(electroneurography,ENoG)神经传导差异,为面神经分支病损诊断提供参考依据。方法通过收集288例包括特发性面神经麻痹(Bell麻痹)恢复期患者40例、Bell麻痹早期患者86例、面肌痉挛(hemifacial spasm,HFS)患者110例及面神经功能正常者52例的面神经电图(ENoG)潜伏期及波幅结果,分析面神经颞支(Ⅰ)、颧支(Ⅱ)、颊支(Ⅲ)、下颌缘支(Ⅳ)各分支运动传导潜伏期和波幅组间的差异,评估各分支受损差异。结果Bell麻痹早期颧支潜伏期高于正常组(P<0.05),Bell麻痹恢复期四支波幅均低于正常组(P<0.05),第Ⅰ、Ⅱ、Ⅲ支波幅降低更显著(P<0.01);HFS组第Ⅱ、Ⅳ支潜伏期低于正常组(P<0.01),第Ⅰ支波幅高于正常组(P<0.05)。结论面神经各分支之间存在差异,不同疾病对面神经分支的影响不同,Bell麻痹早期可能出现第Ⅱ支潜伏期延长,发病2周以上1月以内的Bell麻痹恢复期患者神经变性程度高,四支波幅均降低,第Ⅰ、Ⅱ、Ⅲ支波幅降低更明显;面肌痉挛时可出现神经兴奋性增高,第Ⅱ、Ⅳ支潜伏期明显缩短或第Ⅰ支波幅增高的电生理改变。这些结果为临床面神经分支病损分析提供了参考依据。Objective To compare the differences of nerve conduction of temporal branches(Ⅰ),zygomatic branches(Ⅱ),buccal branches(Ⅲ),and marginal mandibular branches(Ⅳ)using facial electroneurography(ENoG)in patients with facial nerve palsy and hemifacial spasm,and provide a reference basis in the diagnosis of lesions of facial nerve.Methods Forty cases of facial nerve para-lysis for more than two weeks(Bell’s facial palsy),86 cases of facial nerve paralysis within two weeks,110 cases of hemifacial spasm(HFS),and 52 controls of normal facial nerve function were included in this study.The latency time and the amplitude of ENoG of ill side were collected.The difference in the latency and the amplitude of the branchesⅠ,Ⅱ,Ⅲ,andⅣof facial nerve were compared,and the difference of lesions of each branch was invetigated.Results The latency of zygomatic branch in the early stage of Bell’s palsy patients was higher than that of normal controls(P<0.05).The amplitudes of the four branches during the recovery period of Bell’s palsy patients were lower than that of normal controls(P<0.05),and the amplitudes of branchesⅠ,ⅡandⅢwere reduced more significantly(P<0.01).The latencies of the branchesⅡ,Ⅳof the HFS patients were lower than those of normal controls(P<0.01),and the amplitude of the branchⅠwas higher than that of normal controls(P<0.05).Conclusion There is difference among the four branches of the facial nerve.Moreover,the involvement of the facial nerve branches in different diseases is different.In the early stage of facial nerve palsy,the latency of the branchⅡmay be prolonged.When the onset of Bell’s palsy is more than two weeks and less than one month,the degree of neurodegeneration is high,and the amplitudes of the four branches are reduced,especially branchesⅠ,Ⅱ,andⅢ.In hemifacial spasm,the nerve excitability can be increased,the latencies of branchesⅡandⅣare significantly shortened,or the amplitude of the branchⅠis increased.These provide a new basis for the analysis of faci

关 键 词：面神经电图 面神经麻痹 面肌痉挛 

分 类 号：R714.04[医药卫生—妇产科学]