面肌痉挛病人的电生理检查

①目的　探讨面肌痉挛 (HFS)病人发病的电生理机制。②方法　应用肌电图仪测定 2 8例原发性HFS病人、11例正常人眼轮匝肌和口轮匝肌瞬目反射各波的潜伏期、波幅和口 /眼轮匝肌波幅比值 ,并观察两组旁触传递的发生情况。③结果　HFS病人眼轮匝肌瞬目反射的波幅以及潜伏期与对照组比较 ,差异无显著性 (t =1.0 5 6～ 1.12 1,P >0 .0 5 ) ,健侧与患侧之间比较差异亦无显著意义 (t=0 .85 5～ 0 .96 7,P >0 .0 5 ) ;口轮匝肌瞬目反射HFS病人患侧R1或R2波的出现率高于健侧 (t=2 .0 5 8,P <0 .0 5 ) ,且同侧R1、R2、对侧R2的波幅、口 /眼轮匝肌波幅比值明显高于对照组 (t=2 .2 36～ 2 .4 95 ,P <0 .0 5 )。HFS病人出现旁触传递 ,对照组无旁触传递现象发生。④结论　面运动神经元受损后出现的突触修复、突触剥离 ,致使皮质对面神经抑制作用减低 ,面神经核兴奋性增高 ,从而产生了神经冲动的异常播散 ,是HFS形成的主要电生理机制。

AN OBSERVATION OF ELECTROPHYSIOLOGY IN PATIENTS WITH HEMIFACIAL SPASM

Objective Objective To explore the electrop hysiologic mechanism of patients with hemifacial spasm (HFS). Methods The latency, amplitude and the ratio of the amplitude of o rbicularis oris and orbicularis oculi of blink reflex were determined with EMG in 28 HFS patients and 11 normal controls. The ephaptic transmission of the two groups was observed. Results There was no significant difference of the amplitude and l atency of the orbicularis oculi of blink reflex between the two groups ( t=1.0 56-1.121, P >0.05); no significant difference between healthy and affected sid e ( t=0.855-0.967, P >0.05). Significant difference existed in the incidence of R1 or R2 between the two groups ( t=2.058, P <0.05), and in the ratio of the amplitude of orbicularis oris and orbicularis oculi ( t=2.236-2.495, P < 0.05).No ephaptic transmission existed in the controls. Conclusion The recovery and denudation of synapses after injury of the facial nerve decrease inhibition of the cortex to the facial nerves. The ac tivity of facial nucleus increases, and leads to the abnormal spread of impulse, which is the main electrophysiologic mechanism of HFS.