Seijo-Martínez M, Varela-Freijanes A, Grandes J, Vázquez F
Neurology Service, Hospital do Salnés, Ande-Rubians, Villagarcia de Arosa, 36.619 Pontevedra, Spain.
J Neurol Neurosurg Psychiatry. 2006 Apr;77(4):559-61. doi: 10.1136/jnnp.2005.068601. Epub 2005 Dec 14.
Sneezing is a rarely explored symptom in neurological practice. In the cat, a sneeze evoking centre is located in the medulla. The existence of a sneezing centre has not been confirmed in humans. A case with abnormal sneezing secondary to a strategic infarct in the right latero-medullary region is presented. A 66 year old man suddenly presented paroxysmal sneezing followed by ataxia, right sided motor and sensory symptoms, and hoarseness. The application of stimuli to the right nasal fossa did not evoke sneezing nor the wish to sneeze. The same stimuli to the contralateral nasal fossa evoked normal sneezing. The preservation of the superficial sensitivity of the nasal fossa indicates that the lesion was localised in the hypothetical human sneezing centre, very close to the spinal trigeminal tract and nucleus. This centre appears to be bilateral and functionally independent on both sides.
打喷嚏是神经科临床中很少被探究的症状。在猫身上,喷嚏诱发中枢位于延髓。人类打喷嚏中枢的存在尚未得到证实。本文报告了一例因右侧延髓外侧区关键梗死继发异常打喷嚏的病例。一名66岁男性突然出现阵发性打喷嚏,随后出现共济失调、右侧运动和感觉症状以及声音嘶哑。刺激右侧鼻窝未诱发打喷嚏或打喷嚏的意愿。对侧鼻窝受到相同刺激时会诱发正常打喷嚏。鼻窝表面感觉的保留表明病变定位于假想的人类打喷嚏中枢,该中枢非常靠近脊髓三叉神经束和核。这个中枢似乎是双侧的,且两侧在功能上相互独立。