Ishikawa Mami, Takashima Koichi, Kamochi Haruna, Kusaka Gen, Shinoda Sohji, Watanabe Eiju
Department of Neurosurgery, Omiya Medical Center, Jichi Medical University, Saitama, Japan.
Neurol Res. 2010 Jul;32(6):656-60. doi: 10.1179/174313209X431129. Epub 2009 Aug 5.
Botulinum toxin type A (BTX) injection into the orbicularis oculi muscle is an effective treatment for patients with hemifacial spasm (HFS). The objectives of this study were to investigate the effect of this treatment on HFS, in particular the associated hyperexcitability of the facial motor nucleus, and to discuss the potential mechanism of HFS. F waves in the mentalis muscle were examined before, 2 and 6 weeks after the BTX treatment of only the orbicularis oculi muscle in ten patients with HFS. F/M ratio, duration of F waves and frequency of F waves decreased significantly after the BTX treatment compared with those before the BTX treatment. These findings demonstrate that the excitability of the facial motonucleus decreases after BTX treatment of the orbicularis oculi muscle. From these results, we hypothesize that the trigeminal afferent input and the cortical control contribute to the hyperexcitability of the facial motor nucleus in patients with HFS. This warrants further investigation into the pathophysiology of HFS.
向眼轮匝肌注射A型肉毒杆菌毒素（BTX）是治疗面肌痉挛（HFS）患者的有效方法。本研究的目的是探讨这种治疗方法对面肌痉挛的影响，特别是对面部运动核相关的过度兴奋的影响，并讨论面肌痉挛的潜在机制。在10例面肌痉挛患者仅对眼轮匝肌进行BTX治疗前、治疗后2周和6周，检测颏肌的F波。与BTX治疗前相比，BTX治疗后F/M比值、F波持续时间和F波频率均显著降低。这些结果表明，对眼轮匝肌进行BTX治疗后，面神经运动核的兴奋性降低。根据这些结果，我们推测三叉神经传入输入和皮质控制导致了面肌痉挛患者面部运动核的过度兴奋。这值得对面肌痉挛的病理生理学进行进一步研究。
