Clapham L, Thomas S, Allen D, Arunachalam R, Cole J
Department of Neurophysiotherapy, Southampton University Hospitals NHS Trust, UK.
J Laryngol Otol. 2011 Jul;125(7):732-7. doi: 10.1017/S0022215111000892.
Following the onset of facial palsy, physiotherapists routinely inspect the inside of the patient's mouth and cheek for complications such as ulceration or trauma. In several patients with complete facial nerve palsy, it was noticed that when the cheek was stretched there was subsequent spasm of the muscles of facial expression. This also occurred in patients whose facial nerve had been transected.
We present four patients in whom this response was demonstrated. We consider the mechanism of this response and its relevance in the management of patients with facial paralysis.
Following severe or complete denervation, contraction of the facial muscles following mechanical stretch provides evidence of preservation of activity in the facial muscle's excitation-contraction apparatus. Further research will investigate the clinical significance of this sign and whether it can be used as an early predicator of the development of synkinesis, as well as its relevance to facial nerve grafting and repair.
面瘫发作后，物理治疗师通常会检查患者口腔和脸颊内部是否有溃疡或创伤等并发症。在几名完全性面神经麻痹患者中，注意到当脸颊被拉伸时，面部表情肌随后会出现痉挛。面神经被横断的患者也会出现这种情况。
我们展示了四名出现这种反应的患者。我们思考了这种反应的机制及其在面瘫患者管理中的相关性。
在严重或完全去神经支配后，机械拉伸后面部肌肉的收缩证明了面部肌肉兴奋 - 收缩装置中仍保留活性。进一步的研究将调查该体征的临床意义，以及它是否可作为联带运动发展的早期预测指标，及其与面神经移植和修复的相关性。
