Tsugawa Jun, Ouma Shinji, Fukae Jiro, Tsuboi Yoshio, Maki Yoshimitsu, Hokezu Youichi
Department of Neurology, Fukuoka University, School of Medicine.
Rinsho Shinkeigaku. 2014;54(6):515-7. doi: 10.5692/clinicalneurol.54.515.
Pure trigeminal motor neuropathy is a rare clinical manifestation, and its etiology remains obscure. Here, we report the case of a 67-year-old woman who presented with jaw deviation to the right. Neurological examination revealed atrophy of the right temporal and masseter muscles and jaw deviation to the right. Absence of other cranial nerve abnormalities, such as loss of sensation in the trigeminal nerve territory, suggested involvement of only the motor component of the right mandibular nerve. Results of laboratory tests, including hematologic, serologic, and biochemical analysis, were unremarkable, except for the finding of lymphocytic pleocytosis in the cerebrospinal fluid on symptom onset. Brain MRI revealed no abnormality in the brainstem or trigeminal nerve. Electromyography indicated chronic denervation in the right temporal muscle. A few days before the occurrence of the neurological signs, the patient had experienced flu-like symptoms; this suggests that post-infection neuropathy may be a possible cause of the right motor trigeminal neuropathy observed in our case.
纯三叉神经运动神经病是一种罕见的临床表现,其病因仍不清楚。在此,我们报告一例67岁女性患者,该患者出现右侧下颌偏斜。神经系统检查发现右侧颞肌和咬肌萎缩以及右侧下颌偏斜。未发现其他颅神经异常,如三叉神经区域感觉丧失,提示仅右侧下颌神经的运动成分受累。实验室检查结果,包括血液学、血清学和生化分析,均无异常,仅在症状出现时脑脊液中发现淋巴细胞增多。脑部MRI显示脑干或三叉神经无异常。肌电图显示右侧颞肌存在慢性失神经支配。在出现神经症状的几天前,患者曾有流感样症状;这表明感染后神经病可能是我们病例中观察到的右侧运动性三叉神经病变的一个可能原因。