急性皮质核束缺血性卒中伴孤立性中枢性面瘫
Acute Corticonuclear Tract Ischemic Stroke with Isolated Central Facial Palsy.
作者信息
Wolf Marc E, Rausch Hans-Werner, Eisele Philipp, Habich Sonia, Platten Michael, Alonso Angelika
机构信息
Department of Neurology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Germany.
Department of Neuroradiology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Germany.
出版信息
J Stroke Cerebrovasc Dis. 2019 Feb;28(2):495-498. doi: 10.1016/j.jstrokecerebrovasdis.2018.10.030. Epub 2018 Nov 13.
OBJECTIVE
The clinical distinction between habitual facial asymmetry, early stage peripheral facial palsy, and isolated central facial palsy is sometimes difficult. The diagnosis of acute central facial palsy is of importance to identify patients for stroke work-up and appropriate treatment. We aimed to evaluate the prevalence and localization of acute ischemic lesions associated with isolated central facial palsy.
METHODS
We screened our stroke database for patients presenting with isolated central facial palsy related to ischemic stroke between 2012 and 2017. All identified patients were comprehensively characterized including magnetic resonance (MR) diffusion-weighted imaging (DWI).
RESULTS
We identified four out of 5169 patients (one male; 62-83 years) with isolated facial palsy as a result of acute ischemic stroke (NIHSS 1-2). All four had circumscribed DWI lesions in different regions of the corticonuclear tract in different areas with different etiologies.
CONCLUSION
Isolated central facial palsy is a rare manifestation of acute ischemic stroke and may be missed if clinical suspicion is not raised. MR-DWI identifies small ischemic lesions in the corticonuclear tract, which results in appropriate diagnostic work-up and secondary prophylaxis.
目的
习惯性面部不对称、早期周围性面神经麻痹和孤立性中枢性面神经麻痹之间的临床鉴别有时较为困难。急性中枢性面神经麻痹的诊断对于识别需进行卒中检查和接受适当治疗的患者至关重要。我们旨在评估与孤立性中枢性面神经麻痹相关的急性缺血性病变的患病率及定位。
方法
我们在卒中数据库中筛选了2012年至2017年间因缺血性卒中出现孤立性中枢性面神经麻痹的患者。所有确诊患者均进行了全面的特征分析，包括磁共振（MR）扩散加权成像（DWI）。
结果
我们在5169例患者中识别出4例（1例男性，年龄62 - 83岁）因急性缺血性卒中导致孤立性面神经麻痹（美国国立卫生研究院卒中量表评分1 - 2分）。这4例患者在不同区域的皮质核束均有边界清晰的DWI病变，病因各不相同。
结论
孤立性中枢性面神经麻痹是急性缺血性卒中的一种罕见表现，如果临床未引起怀疑可能会被漏诊。MR - DWI可识别皮质核束中的小缺血性病变，从而进行适当的诊断检查和二级预防。
Zotero 插件