| 经皮异常肌反应在面肌痉挛病因中的鉴别意义 |
| 投稿时间：2015-12-16 修订日期：2016-01-07 点此下载全文 |
| 引用本文：张洁,马秀丽,邢岩.经皮异常肌反应在面肌痉挛病因中的鉴别意义[J].医学研究杂志,2016,45(6):150-152 |
| DOI：
10.11969/j.issn.1673-548X.2016.06.038 |
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| 中文摘要:目的 引起面肌痉挛的原因主要有面神经根部REz受血管压迫和面神经炎后。本研究探讨经皮异常肌反应（AMR）在面肌痉挛病因中的鉴别意义。方法 对2014年7月～2015年7月在航空总医院对21例原发面肌痉挛患者、25例面神经炎后面肌痉挛者进行经皮AMR检查。结果 21例原发性面肌痉挛患者中18例阳性，阳性率85.7%，25例面神经炎后面肌痉挛患者中0例阳性。18例患者下颌刺激的经皮眼轮匝肌AMR波平均潜伏期为10.8ms。经额肌记录的AMR波平均潜伏期11.7ms。AMR阳性患者全部进行微血管减压术，术后面肌痉挛消失。术中发现18例患者全部存在小脑前下动脉或小脑后下动脉压迫面神经根部。结论 存在面神经根部REz受血管压迫和面神经炎后面肌痉挛患者AMR波出现率差异有统计学意义（P=0.000）。此结论也间接证明了二者发生面肌痉挛的机制不同。所有发现AMR波的患者术中均发现存在血管压迫，证明术前经皮AMR波的存在与面神经存在血管压迫间具有高度的吻合性。这一结论为临床工作带来了很大的便利，采用无创、价廉的AMR电生理方法能准确判断面肌痉挛的原因，指导下一步治疗方案的制定，在临床中值得大力推广。 |
| 中文关键词:异常肌反应 面肌痉挛 |
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| Diagnostic Value of Percutaneous Abnormal Muscle Response in the Etiology of Hemifacial Spasm |
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| Abstract:Objective Discusses the significance of percutaneous abnormal muscle response (AMR) in the etiology of hemifacial spasm. Methods From July 2014-July 2015 in aviation general hospital,there were 21 cases of primary facial spasm patients, 25 cases of facial paralysis of the facial spasm were performed by percutaneous AMR check. Results In 21 cases of primary hemifacial spasm patients,there were 18 cases were positive, and the positive rate of 85.7%. None of 25 cases of facial paralysis patients cases was positive.In 18 cases of patients with mandibular stimulation, the average latency of AMR wave by frontal muscle records was 11.7ms. AMR wave average latency by orbicularis oculi muscle record was 10.8ms. All patients with AMR positive patients were performed microvascular decompression, and muscle spasm disappeared after operation. 18 patients were found to have the nerve root compression of the posterior inferior cerebellar artery and inferior cerebellar artery. Conclusion The presence rate with AMR wave of facial nerve root REz by vascular compression and facial neuritis of facial muscle spasm of patients had significant difference (P=0.000). This conclusion also indirectly proved that the mechanism of the occurrence of the two different facial spasm. There was vascular compression in all patients with AMR wave. It proved that there was a high degree of anastomosis between the presence of AMR wave and the presence of nerve root compression. This conclusion for clinical work bring great convenience, AMR electrophysiological method is noninvasive and inexpensive which can accurately judge the cause of hemifacial spasm, guide the formulation of a treatment plan, with the clinical worth promoting. |
| keywords:Abnormal muscle response (AMR) Hemifacial spasm |
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