Jelasic F, Freitag V
J Neurol. 1975 Aug 1;209(4):287-96. doi: 10.1007/BF00314368.
Paradox activity of masticatory muscles was observed clinically and electromyographically in 4 patients with brain steem lesions who had trismus. There was no activity in the elevators of the jaw on the side affected during voluntary biting, as if the muscles were paralyzed. There was strong activity of the elevators on the side of the trismus on opening the mouth, inactivity on the unaffected side, or inverse activity appeared on both sides. In view of the trigeminal anesthesia on the side of paradox activation, and the absence of pyramidal signs, a stretch reflex mechanism and abolition of inhibition can not be the only basis for these phenomena; so, a disturbance of bilateral synergism, in the sense of an internuclear lesion, is postulated. In one case of motor and sensory paralysis after the extirpation of a meningioma of the cerebellopontine angle, intensive paradox activity was observed, without trismus.
临床上和通过肌电图观察到，4例患有牙关紧闭症的脑干病变患者咀嚼肌出现了反常活动。在患侧进行自主咬合力时，升颌肌没有活动，就好像肌肉瘫痪了一样。在张口时，患侧升颌肌有强烈活动，未患侧无活动，或者双侧出现反向活动。鉴于反常激活侧存在三叉神经麻醉，且无锥体束征，牵张反射机制和抑制解除不可能是这些现象的唯一基础；因此，推测存在核间病变意义上的双侧协同失调。在1例桥小脑角脑膜瘤切除术后出现运动和感觉麻痹的病例中，观察到了强烈的反常活动，但没有牙关紧闭症。
