原发性面肌痉挛和梅杰综合征患者侧方扩散反应及联带运动的对比分析  

Comparative analysis of lateral spread response and synkinesis in patients with primary hemifacial spasm or Meige's syndrome

作　　者：宋长栋 刘恒方[2] 冯淑艳[1] 李六一[1] SONG Changdong;LIU Hengfang;FENG Shuyan(Department of Electromyography,Henan Provincial People's Hospital,Zhengzhou(450003),Henan,China)

机构地区：[1]河南省人民医院神经电生理室,河南郑州450003 [2]郑州大学第五附属医院神经内科

出　　处：《癫痫与神经电生理学杂志》2023年第4期198-202,共5页Journal of Epileptology and Electroneurophysiology(China)

基　　金：河南省医学科技攻关计划省部共建项目(SB201901056)。

摘　　要：目的探讨面神经侧方扩散反应(LSR)及联带运动在原发性面肌痉挛(pHFS)和梅杰综合征(MS)患者中的应用价值。方法选取2021年6~12月在河南省人民医院诊断为pHFS的患者29例、MS患者15例,对两组患者进行LSR及联带运动检测,其中LSR包括3个分支:眼轮匝肌记录-下颌缘支刺激、额肌记录-下颌缘支刺激、下颏肌记录-颞支刺激。对两组患者的LSR及联带运动检测的阳性率进行比较,分析pHFS和MS患者3个分支LSR的潜伏期、波幅及时限指标。结果pHFS患者的LSR和联带运动的阳性率分别为96%和53%,而MS患者未见LSR和联带运动。pHFS患者分别在眼轮匝肌、额肌及下颏肌记录的LSR潜伏期和波幅结果比较差异无统计学意义,而眼轮匝肌记录的LSR时限较额肌和下颏肌短(P<0.05)。下颏肌记录的LSR阳性率为96%,较额肌的75%和眼轮匝肌的87%阳性率高(P<0.05)。结论LSR和联带运动检测对pHFS具有重要的诊断价值,有助于pHFS和MS的鉴别诊断。Objective To explore the appilication value of lateral spread response(LSR)and synkinesis in patients with primary hemifacial spasm(pHFS)or Meige's syndrome(MS).Methods Twenty-nine patients with pHFS and 15 patients with MS were selected at Henan Provincial People's Hospital from June 2021 to December 2021.LSR and synkinesis data were collected.LSR included three branches:orbicular oculi muscle and frontal muscle were recorded when marginal mandibular branch was stimulated,and submental muscle was recorded when temporal branch was stimulated.The positive rates of LSR and synkinesis were compared between two groups.Latency,amplitude,and duration indicators were analyzed in three LSR branches of pHFS patients and MS patients.Results The positive rates of LSR and synkinesis in pHFS patients were 96% and 53%,respectively,while both LSR and synkinesis were not found in MS patients.In orbicular oculi muscle,frontal muscle and submental muscle of LSR in pHFS patients,there were no significant differences in latency and amplitude.The duration of orbicularis oculi muscle was shorter than those of frontal muscle and submental muscle(P<0.05).LSR-positive rate in submental muscle was 96%,higher than 75% in frontal muslce and 87% in orbicular oculi muscle(P<0.05).Conclusion LSR and synkinesis are of important diagnostic values for pHFS,which helps to distinguish between pHFS and MS.

关 键 词：原发性面肌痉挛 梅杰综合征 侧方扩散反应 联带运动 面神经 潜伏期 

分 类 号：R741[医药卫生—神经病学与精神病学]