Nudleman K L, Starr A
Neurology. 1983 Aug;33(8):1092-5. doi: 10.1212/wnl.33.8.1092.
An unusual case of focal facial spasm modified by factors affecting the peripheral facial nerve was investigated in a 32-year-old woman with involuntary contractions at the left mouth and nasal area. Voluntary facial movements were normal. The involuntary spasms ceased with digital pressure over the facial nerve in the left stylomastoid area. A difference between voluntary and these involuntary facial movements occurred both with local anesthetic blockade and with crushing of the facial nerve. Blink reflexes demonstrated unilateral left synkinesis, and facial EMG showed clonic discharges and individual motor units that discharged rapidly (200 Hz). Treatment with diphenylhydantoin, carbamazepine, and prednisone was ineffective. Neurolysis of the peripheral facial nerve resulted in temporary relief, whereas biofeedback controlled the spasms. Focal facial spasms may represent a disorder of the facial nucleus influenced by both peripheral and central mechanisms.
对一名32岁女性进行了调查，该患者左口角和鼻区出现不自主收缩，患有由影响周围面神经的因素所改变的特殊类型的局灶性面部痉挛。其随意性面部运动正常。在左侧茎乳孔区对面神经施加指压时，不自主痉挛停止。局部麻醉阻滞和压迫面神经时，随意性面部运动和这些不自主面部运动均出现差异。眨眼反射显示左侧单侧联带运动，面部肌电图显示阵挛性放电以及快速放电（200赫兹）的单个运动单位。苯妥英、卡马西平和泼尼松治疗无效。周围面神经松解术导致了暂时缓解，而生物反馈控制了痉挛。局灶性面部痉挛可能代表受外周和中枢机制影响的面神经核的一种疾病。
