Department of Neurology, North Medical Center, Kyoto Prefectural University of Medicine.
Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine.
Rinsho Shinkeigaku. 2024 Jul 27;64(7):486-489. doi: 10.5692/clinicalneurol.cn-001965. Epub 2024 Jun 20.
An 82-year-old woman developed a droopy right eyelid with ipsilateral hemiparesis. Her ocular symptom was caused by weakness of the right frontalis, which is usually seen in patients with peripheral facial nerve palsy. However, head MRI showed acute cerebral infarction of the left lenticulostriate artery, and electroneurography did not detect damage to the right facial nerve. To explain the pathophysiology in this patient, asymmetrical bilateral cortex innervation to the right upper face was hypothesized. This case suggested that patients with some hemispheric strokes could develop upper facial weakness mimicking facial nerve palsy, and clinicians should pay attention to this potential pitfall in the differential diagnosis of facial nerve palsy.
一位 82 岁女性出现右侧眼睑下垂伴同侧偏瘫。其眼部症状是由右侧额肌无力引起的，通常见于周围性面神经麻痹患者。然而，头部 MRI 显示左侧纹状体动脉急性脑梗死，神经电图未检测到右侧面神经损伤。为了解释该患者的病理生理学，假设右侧上脸存在双侧皮质不对称支配。该病例提示，一些半球性脑卒中患者可能出现类似面神经麻痹的上脸肌无力，临床医生在面神经麻痹的鉴别诊断中应注意这一潜在陷阱。
