半面痉挛患者面神经损伤的超微结构研究

Study no the ultrastructural injuries of facial nerves in patient with hemifacial spasm

目的 :进一步探讨半面痉挛患者面神经损伤的超微病理特征。方法 :随机选取10例半面痉挛患者面神经 (男6例,女4例 ) ,年龄28～67岁 ,病程6～30年。透射电镜下观察面神经的超微结构改变。结果:有髓神经髓鞘结构严重变性 ,板层分离形成透明空泡或网络状 ,并向轴索内膨出 ,神经微丝、微管溶解断裂 ,有大量不规则的溶解灶。髓鞘周的雪旺氏细胞及无髓神经也可见不同程度的溶解。间质中的微血管显著变化 ,胞饮泡增多 ,胞质水肿 ,基底板显著增厚或复层化 ,严重者可见基底板裸露或内皮细胞变性坏死脱落。结论 :有髓神经、无髓神经及微血管的严重损伤。

Objective:To study the ultrastructural pathological characteristics of the facial nerves in patients with hemifacial spasm.Methods: Facial nerves from 10 patients (6 males and 4 females)of 28 to 67 years old, With hemifacial spasm clinical for 6 to 30 years were randomly selected and each of their ultrastructural changes was observed by electron microscopy. Results: Myelin sheaths of myelinated nerve fibers were severely damaged. Myelin sheaths lamellas were splited, which formed clear vacuoles or network forms, and extend into the axons. Neurofilaments and microtubules were lysed even broken, formed abundant irregular lysis. The schwann cells and the unmyelinated nerve fibers were lysed in different degree. The capillaries in nerve interstitium were obviously damaged, with increased pinocytotic vesicles, swelled cytoplasm, and thickened, reduplicated or exposed basal laminas, and the endothelail cells with dysfunctions features, necrosis, or falldown were occasinally found in every severe cases. Conclusion: The ultrastructural lesion of the myelinated nerve fibers, unmyelinated nerve fibers and their capillaries were seriously damaged which might be the important ultrastructural characteristics of injured facial nerves in patients with hemifacial spasm.