Ferguson J H
Ann Neurol. 1978 Aug;4(2):97-103. doi: 10.1002/ana.410040202.
Spontaneous and associated hyperkinetic facial movements and contracture which follow injury to the seventh cranial nerve (postparalytic hemifacial spasm) or arise without known previous injury (cryptogenic hemifacial spasm) are pathological motor phenomena not found in the distribution of other cranial or somatic motor nerves. The commonly expressed hypotheses of pathogenesis--aberrant regeneration and fiber excitation by false synapse formation (ephapses) at the site of injury--cannot account for all aspects of these phenomena or for the uniqueness of such movements to the distribution of the seventh nerve. The suggestion is made that the existing diversity of facial motor behavior, which encompasses voluntary, emotional, and especially automatic, associated, and reflexive movements, is based on a unique central organization that sets it apart from other motor groups. I hypothesize that because of this organization, the changes following axonal injury--which include selective deafferentation, glial response, axonal sprouting, functional reconnection, and hyperexcitability from dendritic spike generation--can unmask and augment automatic, associated, and reflexive movements already present in the facial neuronal network to result in facial hyperkinesia.
第七颅神经损伤后出现的自发性及相关的运动亢进性面部运动和挛缩（麻痹后偏侧面肌痉挛），或在无已知既往损伤的情况下出现（隐源性偏侧面肌痉挛），是在其他颅神经或躯体运动神经分布中未发现的病理性运动现象。常见的发病机制假说——损伤部位的异常再生以及通过假突触形成（突触外接触）导致纤维兴奋——无法解释这些现象的所有方面，也无法解释此类运动在第七神经分布中的独特性。有人提出，现有的面部运动行为多样性，包括随意运动、情感运动，尤其是自动、关联和反射性运动，是基于一种独特的中枢组织，使其有别于其他运动组群。我推测，由于这种组织，轴突损伤后的变化——包括选择性传入神经阻滞、胶质细胞反应、轴突发芽、功能重新连接以及树突棘产生导致的兴奋性增强——可以揭示并增强面部神经元网络中已存在的自动、关联和反射性运动，从而导致面部运动亢进。
