Takagishi T, Shukutani K, Sakuma Y, Sakuma F, Yoshikura N
No To Shinkei. 1976 May;28(5):479-85.
General review of the literature makes it apparent that there exist various combinations of associated movements between cranial nerves. Most of them involve four of nerves, the oculomotor, the abducens, the facial, and the motor potion of the trigeminal nerve. We report two patients in whom left upper eyelids produced peculior up and down movements in accompany with mastication. The one was a 9-year-old female who had shown left eye-lid retraction since 3 months; the other, a 4-year-old male, had produced the synkinesis one year since. Either children showed contraction of left palpebral levators associated with volitional mouth opening, deviation of the mandible toward the right, and sucking. Their pupils were normal and their upper eye-lids showed no ptosis on the affected side. The EEG showed high voltage rhythmic slow waves in parieto-occipital areas bilaterally. Head injuries or hereditary defects not being recorded in their histories, their synkinesis is assumed to be congenital in orgin. Abnormal neural connections have been presumed to be affected in the course of the development between the trigeminal and the oculomotor nuclei within the midbrain. In triggering the synkinesis, however, stretched muscle-spindles of the masseter muscle most play an important role. After all, synchronizing lid-jaw co-movements as observed in our two children represent an unusual pattern of the Marcus Gunn phenomenon.
对文献的综合回顾表明，颅神经之间存在各种联合运动组合。其中大多数涉及四条神经，即动眼神经、展神经、面神经和三叉神经的运动部分。我们报告了两名患者，他们在咀嚼时左上眼睑出现奇特的上下运动。一名是9岁女性，3个月来一直有左眼睑退缩；另一名是4岁男性，1年来一直出现联带运动。两名儿童在随意张口、下颌向右侧偏斜和吸吮时，左侧提上睑肌均出现收缩。他们的瞳孔正常，患侧上眼睑无下垂。脑电图显示双侧顶枕区有高电压节律性慢波。他们的病史中未记录头部受伤或遗传缺陷，因此推测他们的联带运动为先天性。据推测，中脑内三叉神经核与动眼神经核之间发育过程中的神经连接异常受到了影响。然而，在引发联带运动时，咬肌拉长的肌梭起着最重要的作用。毕竟，我们两名儿童中观察到的眼睑-下颌同步运动代表了一种不寻常的马库斯·冈恩现象。
