特发性面神经麻痹病变部位与神经电生理检测关系探讨

Study of the relationship between lesion distribution of idiopathic facial palsy and electroneurophysiology

目的：探讨特发性面神经麻痹病变部位与电生理检测结果的关系。方法：对发病20d内的109例特发性面神经麻痹患者，根据临床表现进行面神经病变定位，分为4个组：膝状神经节病变组、面神经管镫骨神经以上病变组、面神经管镫骨神经以下病变组、茎乳孔以外病变组，并行面神经电生理检查，各组数据进行统计学处理。结果：109例患者中膝状神经节病变组15例，面神经管镫骨神经以上病变组21例，面神经管镫骨神经以下病变组38例，茎乳孔以外病变组35例；患侧瞬目反射、面神经复合肌肉动作电位（CMAP）潜伏期、波幅及患侧波幅下降比、F波消失率各组比较差异有统计学意义。结论：面神经麻痹电生理指标波幅下降比、瞬目反射、F波与其病变部位有关。

Objective：To reveal the relationship between electroneurophysiology and lesion distribution of idiopathic facial palsy. Methods： t09 patients with idiopathic facial palsy were selected within 20 days of onset,Those cases were divided into 4 qroups according to the lesion distribution： the geniculate ganglion lesion group, the facial nerve canal lesion group above nervus stapedius, the facial nerve canal lesion group below nervus stapedius, and the lesion group outside stylomastoid foramen. All patients underwent electrophysiological examinations. Results： Of 109 cases 15 cases were found in geniculate ganglion lesion,21 cases the facial nerve canal lesion above the nervus stapedius in,38 cases in the facial nerve canal below the nervus stapedius, 35 cases in lesion outside stylomastoid foramen. Their differences were significant in blink refiex（BR）,the latency of compound muscle action of facial nerves, amplitude,the decreased amplitude ratio and disappearance rate of F waves. Conclusion： Electrophysiological indexes,inclu ding blink refiex（BR）, the latency of compound muscle action of facial nerves, amplitude and the decreased amplitude ratio,and disappearance rate of F waves are associated with the lesion distribution of idiopathic facial palsy.