Mitani Kotoe, Toyooka Keiko, Kaido Misako, Yuasa Ryoichi, Hamada Suguru, Tachimura Takashi
Department of Neurology, Sakai Municipal Hospital.
Rinsho Shinkeigaku. 2002 Jun;42(6):540-3.
We report a patient with syringobulbia extending to the pons, who could not open his mouth widely. He had been involved in the traffic accident at 16 years of age. Since them he had suffered numbness in the left neck and arm. At age 30, he became unable to open the mouth widely with pain in the left jaw joint. He also noted dysphagia and tinnitus. Neurologically, there were vocal cord paresis, dysesthesia of the face, ageusia and cerebellar ataxia all on the left side. Brain MRI revealed syringobulbia which extended to the pons. Spinal MRI revealed syringomyelia through the entire spinal cord. The syrinx of the spinal cord seemed to connect with the brainstem lesion. EMG of the masticatory muscles revealed paradoxical activity in the left masticatory muscles. We concluded that disturbance of jaw-opening in this case was caused by syringobulbia, the lesion of which could involve masticatory central pattern generator in the brainstem.
我们报告一例延髓空洞症累及脑桥的患者，该患者无法张大嘴巴。他16岁时遭遇交通事故。自那以后，他左侧颈部和手臂一直感到麻木。30岁时，他因左侧下颌关节疼痛而无法张大嘴巴。他还出现吞咽困难和耳鸣症状。神经系统检查发现，左侧存在声带麻痹、面部感觉障碍、味觉丧失和小脑共济失调。脑部磁共振成像（MRI）显示延髓空洞症累及脑桥。脊髓MRI显示整个脊髓存在脊髓空洞症。脊髓空洞似乎与脑干病变相连。咀嚼肌肌电图显示左侧咀嚼肌出现反常活动。我们得出结论，该病例中张口障碍是由延髓空洞症引起的，其病变可能累及脑干中的咀嚼中枢模式发生器。
