电生理检测对面肌痉挛的诊断价值

Evaluation of Electrophysiologic Detection in the Diagnosis of Hemifacial Spasm

目的通过研究特发性半侧面肌痉挛(HFS)患者电生理表现,探讨其可能发病机制。方法将符合纳入标准的30例HFS患者作为病例组,将年龄、性别与之匹配且接受A型肉毒毒素局部注射不超过2周的20例HFS患者作为治疗组,记录患者面部F波和异常肌反应(AMR)。结果①病例组:与健侧比较,患侧面部F波波幅增高,时限增宽,出现率增加,均P<0.01;在患侧,F/Mme波幅比率与AMR/Moo波幅比率、F波时限与AMR时限均呈正相关。②治疗组:患侧与病例组患侧相比,波幅降低,时限增宽,出现率降低,均P<0.01;在患侧,F/Mme波幅比率与AMR/Moo波幅比率、F波时限与AMR时限均无明显相关性。结论F波可为HFS的病因诊断提供一种新的电生理指标;F波与AMR具有良好的相关性。

Objective To investigate the possible pathogenesis of hemifacial spasm （HFS） through a prospective study of the findings of electrodiagnosis. Methods There were 30 patients with HFS involved （patient group）, and 20 age- and gendermatched patients, who had been treated with botulinum toxin type A injection no more than two weeks served as treatment group. Facial F-waves and abnormal muscle responses （AMRs） were recorded. Results ① In the patient group, the duration （t= 2.641）, amplitude （t= 2. 650） and persistence （t= 2. 460） of F-waves were increased significantly on the symptomatic side as compared with the asymptomatic side （P〈0.01）; there was a significantly positive correlation between the amplitude ratio of F/Mme with AMR/Moo, and the duration of F waves with AMR. ② In the treatment group, the duration was increased （t= 2.513）, the amplitude （t = 2. 643） and persistence （t = 2. 458） of F-waves decreased significantly on the symptomatic side, as compared with those in the patient group （P〈0.01） ; There was no significant correlation between the amplitude ratio of F/M ruewith AMR/Moo, and the duration of F waves with AMR. Conclusion F wave may be used as a new index for etiological diagnosis of hemifacial spasm; F wave is of good correlation with AMR.