Ying Tingting, Zhong Wenxiang, Yuan Yan, Zhou Li, Li Shiting
Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai 200092, China.
Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai 200092, China.
Neurophysiol Clin. 2025 Apr;55(2):103019. doi: 10.1016/j.neucli.2024.103019. Epub 2024 Dec 21.
The aims of this study were to investigate the electrophysiological features of hemifacial spasm (HFS) and post-facial paralysis synkinesis (PFPS) that contribute to differential diagnosis.
This study was designed as a retrospective analysis, focusing on 132 patients diagnosed with HFS and 78 patients with PFPS between May and October 2023. Patient data were collected from existing medical records. The study aimed to analyze pre-existing electrophysiological data, including abnormal muscle response (AMR) and facial synkinesis, focusing on parameters such as AMR latency, amplitude, and duration.
In the HFS group, AMR could be induced in all patients, with synkinesis present in 31.8 %. In the PFPS group, AMR and synkinesis were induced in 79.5 % and 100 % of patients, respectively. Compared with the PFPS group, the HFS group had a shorter AMR latency and higher amplitude (P < 0.05). The duration of the AMR did not significantly differ between the two groups (P > 0.05). Synkinesis in the HFS group was typically accompanied or followed by an involuntary spasm episode, but not every eye closure or pouting led to synkinesis. In contrast, synkinesis in the PFPS group occurred with every voluntary movement and was synchronized with these movements.
Patients with HFS and PFPS may exhibit similar clinical symptoms. Neurophysiological tests, particularly electromyography, provide valuable information for the differential diagnosis of HFS and PFPS.
本研究旨在探讨有助于鉴别诊断的面肌痉挛（HFS）和面瘫后联动（PFPS）的电生理特征。
本研究设计为回顾性分析，聚焦于2023年5月至10月期间诊断为HFS的132例患者和PFPS的78例患者。患者数据从现有病历中收集。该研究旨在分析既往的电生理数据，包括异常肌肉反应（AMR）和面肌联动，重点关注AMR潜伏期、波幅和持续时间等参数。
在HFS组中，所有患者均可诱发出AMR，31.8%存在联动。在PFPS组中，分别有79.5%和100%的患者诱发出AMR和联动。与PFPS组相比，HFS组的AMR潜伏期更短，波幅更高（P<0.05）。两组间AMR的持续时间无显著差异（P>0.05）。HFS组的联动通常伴有或继发于一次不自主痉挛发作，但并非每次闭眼或撅嘴都会导致联动。相比之下，PFPS组的联动在每次自主运动时都会出现，并与这些运动同步。
HFS和PFPS患者可能表现出相似的临床症状。神经生理学检查，尤其是肌电图，为HFS和PFPS的鉴别诊断提供了有价值的信息。
