Urban P P, Forst T, Lenfers M, Koehler J, Connemann B J, Beyer J
Department of Neurology, Medical Hospital, University of Mainz, Germany.
Electromyogr Clin Neurophysiol. 1999 Jul-Aug;39(5):267-72.
We investigated the frequency of subclinical trigeminal and facial nerve involvement in 40 patients with diabetes mellitus and without clinical signs of cranial nerve lesions. 60% of the patients had distal symmetric sensory polyneuropathy which was confirmed by nerve conduction studies. Trigeminal and facial nerve functions were evaluated electrophysiologically using the blink-reflex R1 component (BlinkR-R1), masseter reflex (MassR), the first exteroceptive suppression of the masseter muscle (Mass-ES1), and distal motor latency of the facial nerve (DML VII). Latencies were significantly prolonged for the BlinkR-R1 (p < 0.0001), the Mass-ES1 (p < 0.05), and DML VII (p < 0.005) in diabetics compared with controls. No significant difference was found for the MassR. Prolonged latencies (> mean + 2.5 SD of age-matched controls) were demonstrated for the Mass-ES1 in 12.5%, BlinkR-R1 in 10%, DML VII in 6.2%, and MassR in 5% in individual of patients. Our findings indicate that trigeminal and facial nerve involvement is not infrequent in diabetics, although it is significantly less frequent than limb nerve involvement.
我们对40例无颅神经病变临床体征的糖尿病患者亚临床三叉神经和面神经受累情况进行了调查。60%的患者患有远端对称性感觉性多发神经病，经神经传导研究得以证实。采用眨眼反射R1成分（BlinkR-R1）、咬肌反射（MassR）、咬肌首次外感受性抑制（Mass-ES1）以及面神经远端运动潜伏期（DML VII）对三叉神经和面神经功能进行电生理评估。与对照组相比，糖尿病患者的BlinkR-R1（p < 0.0001）、Mass-ES1（p < 0.05）和DML VII（p < 0.005）潜伏期显著延长。MassR未发现显著差异。在个别患者中，Mass-ES1、BlinkR-R1、DML VII和MassR潜伏期延长（>年龄匹配对照组均值 + 2.5标准差）的比例分别为12.5%、10%、6.2%和5%。我们的研究结果表明，糖尿病患者三叉神经和面神经受累并不少见，尽管其发生率明显低于肢体神经受累。
