Tankéré F, Maisonobe T, Lamas G, Soudant J, Bouche P, Fournier E, Willer J C
Department of Otorhinolaringology, Hôpital Pitié-Salpêtrière, Paris, France.
Muscle Nerve. 1998 Aug;21(8):1013-8. doi: 10.1002/(sici)1097-4598(199808)21:8<1013::aid-mus5>3.0.co;2-b.
In patients with hemifacial spasm (HFS), abnormal muscle responses due to abnormal cross-transmission are observed in facial muscles. However, the site in the facial nerve responsible for the cross-transmission remains a matter of controversy. We have developed a model in which by considering the electrophysiological parameters involved in producing the abnormal muscle response, we can determine the site of the abnormal cross-transmission within the facial nerve. This model was applied to HFS patients with three different etiologies: idiopathic, post-Bell's palsy, and post-XII-VII anastomosis. Our data show that: in idiopathic HFS, the cross-transmission may occur in the facial nerve at the level of the pontocerebellar angle; in post-Bell's palsy, it is inside the petrous bone; and in XII-VII anastomosis, it must be in the extracranial part of the facial nerve. The possible mechanisms for this cross talk are discussed in terms of ephaptic transmission or of a central hyperexcitability in the facial motor nucleus.
在半面痉挛（HFS）患者中，面部肌肉会出现因异常交叉传导导致的异常肌肉反应。然而，面神经中负责交叉传导的部位仍存在争议。我们开发了一个模型，通过考虑产生异常肌肉反应所涉及的电生理参数，可以确定面神经内异常交叉传导的部位。该模型应用于患有三种不同病因的HFS患者：特发性、贝尔麻痹后和第十二对与第七对脑神经吻合术后。我们的数据表明：在特发性HFS中，交叉传导可能发生在脑桥小脑角水平的面神经处；在贝尔麻痹后，交叉传导发生在岩骨内；在第十二对与第七对脑神经吻合术后，交叉传导一定发生在面神经的颅外部分。本文从ephaptic传导或面部运动核的中枢性过度兴奋的角度讨论了这种串扰的可能机制。
