Komori Masahiro, Yanagihara Naoaki, Kashiba Keiko
Department of Otolaryngology, Takanoko Hospital, Matsuyama, Ehime, Japan.
Otol Neurotol. 2009 Sep;30(6):847-50. doi: 10.1097/MAO.0b013e3181ab3362.
Bell's palsy rarely recurs or arises bilaterally. We describe unique oral motor sequelae that manifest with bilateral facial palsy.
Two rare patients with alternating bilateral Bell's palsy experienced compromised mouth movement, affecting eating, speaking, and air exchange, and reduced quality of life.
Rehabilitation programs.
Electromyography and electroneuronography.
On electromyography study, little activity of the orbicularis oris muscle was seen in any mouth or eye movement in Case 1. In Case 2, the electromyography activity of the depressor anguli oris and depressor labii inferioris muscles was stronger than that of the orbicularis oris muscle. The 2 cases demonstrated different patterns of recovery after the same subsequent treatment.
Different patterns of reinnervation occur in bilateral Bell's palsy. Mouth movement disturbances after bilateral Bell's palsy are most disabling when incomplete reinnervation (as suggested by electroneuronography) of the orbicularis oris muscle occurs. Misdirection of regenerating nerve fibers produces lesser levels of oral motor impairment.
贝尔麻痹很少复发或双侧发病。我们描述了双侧面瘫所表现出的独特口腔运动后遗症。
两名罕见的交替性双侧贝尔麻痹患者出现口部运动功能受损，影响进食、说话和换气，生活质量下降。
康复计划。
肌电图和神经电图。
在肌电图研究中，病例1在任何口部或眼部运动时，口轮匝肌几乎未见活动。病例2中，降口角肌和降下唇肌的肌电图活动强于口轮匝肌。这2例患者在后续相同治疗后表现出不同的恢复模式。
双侧贝尔麻痹存在不同的神经再支配模式。当口轮匝肌发生不完全神经再支配（如神经电图所示）时，双侧贝尔麻痹后的口部运动障碍最为致残。再生神经纤维的错向生长导致的口腔运动功能损害程度较轻。
Zotero 插件