Gilhuis H J, Beurskens C H, Marres H A, de Vries J, Hartman E H, Zwarts M J
Department of Clinical Neurophysiology, University Medical Centre St Radboud, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Muscle Nerve. 2001 Dec;24(12):1703-5. doi: 10.1002/mus.1207.
We report on a patient with recovery of activity of the left orbicularis oris and nasalis muscles 3 months after a complete left facial palsy. Stimulation of the affected facial nerve evoked no responses, whereas contralateral facial nerve stimulation showed polyphasic responses with very long latencies in the nasalis and orbicularis oris muscles. Needle electromyography (EMG) revealed abnormal spontaneous activity in the left orbicularis oris muscle. The motor unit action potentials on the left side of the face could be recruited only during marked contraction of the corresponding muscles on the right and were of low voltage and polyphasic ("nascent potentials"). Contralateral reinnervation is probably due to sprouting of terminal branches crossing the midline of the face and innervating bundles of muscle fibers on the affected side. This phenomenon seems unfamiliar to most clinicians. Whether the activity is due to conduction along nerve fibers or muscle fibers crossing the midline is discussed.
我们报告了1例完全性左侧面神经麻痹3个月后左侧口轮匝肌和鼻肌活动恢复的患者。刺激患侧面神经未引出反应，而刺激对侧面神经时，鼻肌和口轮匝肌出现多相反应且潜伏期极长。针极肌电图（EMG）显示左侧口轮匝肌有异常自发电活动。面部左侧的运动单位动作电位仅在右侧相应肌肉明显收缩时才能引出，且电压低、多相（“新生电位”）。对侧神经再支配可能是由于终末分支越过面部中线并支配患侧肌纤维束的芽生所致。这种现象对大多数临床医生来说似乎并不熟悉。文中讨论了该活动是由于沿神经纤维传导还是越过中线的肌纤维传导所致。
