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面瘫患者面部的感觉功能:一项使用定量感觉测试的前瞻性观察研究。

Sensory function in the faces of patients with facial palsy: A prospective observational study using quantitative sensory testing.

作者信息

Volk Gerd Fabian, Döhler Marianna, Klinger Carsten M, Weiss Thomas, Guntinas-Lichius Orlando

机构信息

Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.

Facial-Nerve-Center Jena, Jena University Hospital, Jena, Germany.

出版信息

Front Pain Res (Lausanne). 2022 Dec 19;3:1041905. doi: 10.3389/fpain.2022.1041905. eCollection 2022.

Abstract

OBJECTIVES/HYPOTHESIS: To determine the sensory function of both sides of the face in patients with acute or chronic facial palsy.

STUDY DESIGN

Prospective observational study.

METHODS

The standardized quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain (DFNS), including thermal or mechanical stimuli (touch, pain, vibration, and pressure), was used to investigate somatosensory function in the faces of patients. A patient-reported outcome measures for the assessment of disturbed facial comfort or facial pain, the facial Clinimetric Evaluation Scale (FaCE) Facial Comfort Subscale, and the 36-Item Short Form Survey (SF-36) pain subdomain were used.

RESULTS

A total of 29 patients (22 female, median age of 48 years; 7 acute palsy; 22 chronic palsy; House-Brackmann grade II-VI) were included. The median FaCE Facial Comfort Subscale score and the median SF-36 pain subdomain score were 50 and 100, respectively. Most patients had, at an individual level, a normal sensory function in all or most tests. On average, the frequencies for all parameters were not different between the paretic side and the contralateral side (all  > 0.05). Additionally, when -scores were used to compare our patient sample with healthy controls from the DFNS reference database, there was no difference between the paretic side and the contralateral side (all  > 0.05). Furthermore, there were no differences between patients with acute facial palsy and those with chronic facial palsy (all  > 0.05). The FaCE Facial Comfort Subscale score and the SF-36 pain subdomain score did not correlate with the QST parameters (all  > 0.05).

CONCLUSION

Patients with acute or chronic unilateral peripheral facial palsy had normal sensory function on the paretic and contralateral sides compared with the reference values of healthy controls, and there was no significant difference between the sides. The numbness frequently felt in the affected hemiface is not related to a peripheral sensory disorder and is most likely a manifestation of an unsolved cortical somatosensory-motor mismatch.

摘要

目的/假设:确定急性或慢性面瘫患者面部两侧的感觉功能。

研究设计

前瞻性观察研究。

方法

采用德国神经病理性疼痛研究网络(DFNS)的标准化定量感觉测试(QST)方案,包括热刺激或机械刺激(触摸、疼痛、振动和压力),来研究患者面部的躯体感觉功能。使用患者报告的评估面部舒适度或面部疼痛受干扰情况的结局指标、面部临床计量评估量表(FaCE)面部舒适度子量表以及36项简短健康调查(SF-36)疼痛子领域。

结果

共纳入29例患者(22例女性,中位年龄48岁;7例急性面瘫;22例慢性面瘫;House-Brackmann分级II - VI级)。FaCE面部舒适度子量表的中位得分和SF-36疼痛子领域的中位得分分别为50分和100分。大多数患者在个体层面上,在所有或大多数测试中感觉功能正常。平均而言,患侧与对侧所有参数的频率无差异(均P>0.05)。此外,当用z分数将我们的患者样本与DFNS参考数据库中的健康对照进行比较时,患侧与对侧无差异(均P>0.05)。此外,急性面瘫患者与慢性面瘫患者之间也无差异(均P>0.05)。FaCE面部舒适度子量表得分和SF-36疼痛子领域得分与QST参数无相关性(均P>0.05)。

结论

与健康对照的参考值相比,急性或慢性单侧周围性面瘫患者患侧和对侧的感觉功能正常,且两侧之间无显著差异。患侧半面部经常感觉到的麻木与周围感觉障碍无关,很可能是未解决的皮质躯体感觉 - 运动不匹配的表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0e2/9806347/56832a304a5e/fpain-03-1041905-g001.jpg

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