肌电图在面肌痉挛病因诊断中的临床应用价值

The Clinical Application Value of Electromyography in The Diagnosis of Hemifacial Spasm

目的:探析面肌痉挛病因诊断应用肌电图的临床应用价值。方法:选取2017年1月~2019年1月本院收治的30例面肌痉挛患者为研究对象。对比于颅脑MR颅神经扫描3D-TOF静态成像,主要目标为评估面神经与血管的连带性、敏感性及特异性。EMG检查主要开展神经传导检查与面肌肌电图检测两项。其中,电极置于耳前方,即对面神经电刺激,检测记录神经或肌肉电活动;针极置于肌肉内,或表面电极贴于面部肌肉的皮肤上(主要在口轮匝肌上唇处、额肌、眼轮匝肌)检测记录电活动。对比分析两组患者放松与收缩下的眼轮匝肌表面肌电值。结果:患者在放松状态下,眼轮匝肌患位与健位的MF值、MDF值差异不明显,不具有统计学意义(P>0.05);而患位与健位的EMG值对比,患位显著高于健位,差异具有统计学意义(P<0.05);患者在收缩状态下,眼轮匝肌患位与健位的MF值、MDF值、EMG值对比,健位显著高于患位,差异具有统计学意义(P<0.05)。结论:应用肌电图动态监测面肌痉挛患者所对应的电生理信号,并加以颅神经3D-TOF-MR静态成像予以“动静”式的联合观察,对患者早期病因的诊断具有实质性的辅助作用,对早期治疗及预后的情况改善具有十分重要的临床意义。

Objective:To explore the clinical application value of electromyography in the diagnosis of hemifacial spasm.Methods:30 patients with hemifacial spasm admitted to our hospital from January 2017 to January 2019 were selected as the research objects.Compared with 3D-TOF static imaging of cranial MR cranial nerve scanning,the main goal is to assess the connection,sensitivity and specificity of the facial nerve and blood vessels.EMG examination mainly carries out nerve conduction examination and facial electromyography examination.Among them,the electrode is placed in front of the ear,that is,the facial nerve is electrically stimulated,and the electrical activity of the nerve or muscle is detected and recorded;the needle is placed in the muscle,or the surface electrode is attached to the skin of the facial muscle(mainly at the upper lip of the orbicularis muscle,forehead Muscle,orbicularis oculi muscle)to detect and record electrical activity.Comparative analysis of the two groups of patients under relaxation and contraction of the surface EMG of the orbicularis muscle.Results:When the patient was in a relaxed state,the difference in MF and MDF values between the affected and healthy positions of the orbicularis oculi muscle was not significant and not statistically significant(P>0.05);while the EMG values of the affected and healthy positions were compared,The position was significantly higher than the healthy position,and the difference was statistically significant(P<0.05);in the contracted state,the MF,MDF and EMG values of the orbicularis oculi muscle were compared with the healthy position.The healthy position was significantly higher than that of the healthy position.The difference was statistically significant(P<0.05).Conclusion:The application of electromyography to dynamically monitor the corresponding electrophysiological signals of patients with hemifacial spasm,and 3D-TOF-MR static imaging of cranial nerves for"dynamic and static"combined observation,which is a substantial aid to the diagnosis of the early cause of the patient It has very important clinical significance for early treatment and improvement of prognosis.