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Klinische Neurophysiologie 2008; 39(1): 25-38
DOI: 10.1055/s-2008-1046784
Originalia

© Georg Thieme Verlag KG Stuttgart · New York

Elektrophysiologische Diagnostik der Fazialisparesen und des Hemispasmus fazialis

Electrophysiological Diagnosis of Facial Nerve Palsy and Hemifacial SpasmP. Urban 1
  • 1Abteilung für Neurologie, Asklepios Klinik Barmbek, Hamburg
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Publication History

Publication Date:
27 March 2008 (online)

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Zusammenfassung

Im folgenden Beitrag werden die elektrophysiologischen Möglichkeiten der Diagnostik einer Läsion der zentralen kortiko-fazialen Projektionen und des N. fazialis dargestellt. Im Einzelnen handelt es sich dabei um die transkranielle Magnetstimulation des primären Motorkortex und des proximalen Abschnitts des N. fazialis, die direkte elektrische Stimulation des distalen N. fazialis, den Blinkreflex und die Elektromyographie. Besonders gehen wir auf die elektrophysiologischen Befunde bei peripherer Fazialisparese und dem Hemispasmus fazialis ein.

Abstract

We summarise the electrophysiolgical techniques used to investigate the central cortico-facial projections and the facial nerve. These include transcranial magnetic stimulation of the primary motor cortex and the proximal facial nerve, direct electrical stimulation of the distal facial nerve, blink reflex and electromyography. We also describe the lesion patterns in peripheral facial nerve palsy and hemifacial spasm.

Schlüsselwörter

Neurolymphomatose - Polyneuropathie - B-Zell-Lymphom

Key words

neurolymphomatosis - polyneuropathy - B-cell-lymphoma

Literatur

  • 1 Morecraft RJ, Louie JL, Herrick JC, Stilwell-Morecraft KS. Cortical innervation of the facial nucleus in the non-human primates: a new interpretation of the effects of stroke and related subtotal brain trauma on the muscles of facial expression.  Brain. 2001;  124 176-208
    CrossrefPubMedGoogle Scholar
  • 2 Urban PP, Wicht S, Marx J, Mitrovic S, Fitzek C, Hopf HC. Isolated voluntary facial paresis due to pontine ischemia.  Neurology. 1998a;  50 1859-1864
    PubMedGoogle Scholar
  • 3 Sunada I, Akano Y, Yamamoto S, Tashiro T. Pontine haemorrhage causing disturbance of taste.  Neuroradiology. 1995;  37 659
    CrossrefPubMedGoogle Scholar
  • 4 Peitersen E. The natural history of Bell'y.  Am J Otol. 1982;  4 107-111
    PubMedGoogle Scholar
  • 5 Michaels L. Histopathological changes in the temporal bone in Bell's palsy.  Acta Otolaryngol. 1990;  470 114-118
    PubMedGoogle Scholar
  • 6 Fisch U, Esslen E. Total intratemporal exposure of the facial nerve: pathologic findings in Bell's palsy.  Arch Otolaryngol. 1972;  95 5-41
    PubMedGoogle Scholar
  • 7 Hellebrand MC, Friebe-Hoffmann, Bender HG, Kojda G, Hoffmann TK. Das Mona-Lisa-Syndrom - die periphere Fazialisparese in der Schwangerschaft.  Z Geburtsh Neonatol. 2006;  210 126-134
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Urban PP. Vergleichende Untersuchung elektrisch und magnetisch evozierter Potentiale aus unterschiedlichen Fazialis-innervierten Muskeln.  Klin Neurophysiol. 2002;  33 A27
    PubMedGoogle Scholar
  • 9 Gilhuis HJ, Beurskens CHG, Marres HAM, Vries J, Hartman AHM, Zwarts MJ. Contralateral reinnervation of midline muscles in facial paralysis.  Muscle Nerve. 2001;  24 1703-1705
    CrossrefPubMedGoogle Scholar
  • 10 Urban PP, Beer S, Hopf HC. Cortico-bulbar fibers to orofacial muscles: recordings with enoral surface electrodes.  Electroenceph Clin Neurophysiol. 1997;  105 8-14
    PubMedGoogle Scholar
  • 11 Esslen E. The acute facial palsies. Springer, Berlin 1977
  • 12 Glocker FX, Rösler KM, Linden D, Heinen F, Hess CW, Lucking CH. Facial nerve dysfunction in hereditary motor and sensory neuropathy type I and III.  Muscle Nerve. 1999;  22 1201-1208
    PubMedGoogle Scholar
  • 13 Vogel P, Bahlmann W. Zur Elektroneurographie des N.  facialis. Akt Neurol. 1990;  17 150-157
    PubMedGoogle Scholar
  • 14 Sittel C, Orlando G-L, Streppel M, Stennert E. Variability of repeated facial nerve electroneurography in healthy subjects.  Laryngoscope. 1998;  108 1177-1180
    CrossrefPubMedGoogle Scholar
  • 15 Zander Olsen P. Prediction of recovery in Bell's palsy.  Acta Neurol Scand. 1975;  61 52-90
    PubMedGoogle Scholar
  • 16 Mamoli B. Zur Prognosestellung peripherer Fazialisparesen unter besonderer Berücksichtigung der Elektroneurographie.  Wien Klin Wschr. 1976;  53 1-28
    PubMedGoogle Scholar
  • 17 Rösler KM, Hess CW, Schmid UD. Investigation of facial motor pathways by electrical and magnetic stimulation: sites and mechanisms of excitation.  J Neurol Neurosurg Psychiatry. 1989;  52 1149-1156
    PubMedGoogle Scholar
  • 18 Schmid UD, Moller AR, Schmid J. Transcranial magnetic stimulation of the facial nerve: intraoperative study on the effect of stimulus parameters on the excitation site in man.  Muscle Nerve. 1992;  15 829-836
    CrossrefPubMedGoogle Scholar
  • 19 Glocker FX, Magistris MR, Rösler KM, Hess CW. Magnetic transcranial and electrical stylomastoidal stimulation of the facial motor pathways in Bell's palsy: time course and relevance of electrophysiological parameters.  Electroenceph Clin Neurophysiol. 1994;  93 113-120
    PubMedGoogle Scholar
  • 20 Marx JJ. Die elektrophysiologische Untersuchung des Blinkreflexes.  Klin Neurophysiol. 2003;  34 8-14
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Thömke F, Urban PP, Marx JJ, Mika-Gruttner A, Hopf HC. Seventh nerve palsies may be the only clinical sign of small pontine infarctions in diabetic and hypertensive patients.  J Neurol. 2002;  249 1556-1562
    CrossrefPubMedGoogle Scholar
  • 22 Urban PP, Wicht S, Fitzek S, Marx J, Thömke F, Fitzek C, Hopf HC. Ipsilateral facial weakness in lateral medullary infarction-supranuclear or infranuclear origin?.  J Neurol. 1999;  246 798-802
    PubMedGoogle Scholar
  • 23 Urban PP, Wicht S, Vucurevic G, Fitzek S, Marx J, Thömke F, Mika-Grüttner A, Fitzek C, Stoeter P, Hopf HC. The course of cortico-facial projections in the human brainstem.  Brain. 2001;  124 1866-1876
    CrossrefPubMedGoogle Scholar
  • 24 Urban PP, Vogt T, Hopf HC. Cortico-bulbar tract involvement in amyotrophic lateral sclerosis (ALS).  Brain. 1998b;  121 1099-1108
    CrossrefPubMedGoogle Scholar
  • 25 Rösler KM, Magistris MR, Glocker FX. et al . Electrophysiological characteristics of lesions in facial palsies of different etiologies. A study using electrical and magnetic stimulation techniques.  Electroencephalogr Clin Neurophysiol. 1995;  97 355-368
    PubMedGoogle Scholar
  • 26 Nowak DA, Linder S, Topka H. Diagnostic relevance of transcranial magnetic and electrical stimulation of the facial nerve in the management of facial palsy.  Clin Neurophysiol. 2005;  116 2051-2057
    CrossrefPubMedGoogle Scholar
  • 27 Fisch U. Prognostic value of electrical tests in acute facial paralysis.  Am J Otolaryngol. 1984;  5 494-498
    PubMedGoogle Scholar
  • 28 House J, Brackmann DE. Facial nerve grading system.  Otolaryngol Head Neck Surg. 1985;  93 146-147
    Google Scholar
  • 29 Birkmann C, Rackl A, Haupt WF. Prognostische Aussagekraft des Orbicularis-oculi-Reflexes bei idiopathischer Fazialisparese.  Akt Neurol. 1998;  25 103-106
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Engström M, Jonsson L, Grindlund M, Stalberg E. Electroneurographic facial muscle pattern in Bell's palsy.  Otolaryngol Head Neck Surg. 2000;  122 290-297
    CrossrefPubMedGoogle Scholar
  • 31 Grosheva M, Guntinas-Lichius O. Significance of electromyography to predict and evaluate facial function outcome after acute peripheral facial palsy.  Eur Arch Otorhinolaryngol. 2007;  , ; epub
    PubMedGoogle Scholar
  • 32 Kimura J, Giron LT, Young SM. Electrophysiological study of bell palsy.  Arch Otolaryngol. 1976;  102 140-143
    PubMedGoogle Scholar
  • 33 Jannetta PJ, Abbacy M, Maroon JC, Morales-Ramos F. Aetiology and definitive microsurgical treatment of hemifacial spasm. Operative technique and results in fourty-seven patients.  J Neurosurg. 1977;  47 321-328
    CrossrefPubMedGoogle Scholar
  • 34 Montero J, Junyent J, Calopa M, Povedano M, Valls-Sole J. Electrophysiological study of ephaptic axono-axonal responses in hemifacial spasm.  Muscle Nerve. 2007;  35 184-188
    CrossrefPubMedGoogle Scholar
  • 35 Yamashita S, Kawaguchi T, Fukuda M. et al . Lateral spread response elicited by double stimulation in patients with hemifacial spasm.  Muscle Nerve. 2002;  25 845-849
    CrossrefPubMedGoogle Scholar
  • 36 Erdemir-Kiziltan M, Uzun N, Kiziltan G, Karaali-Savrun F. Somatosensory evoked blink response in hemifacial spasm and peripheral facial palsy.  Electromyogr Clin Neurophysiol. 2005;  45 203-207
    PubMedGoogle Scholar
  • 37 Kimura J, Rodnitzky RL, Okawara S-H. Electrophysiologic analysis of aberrant regeneration after facial nerve paralysis.  Neurology. 1975;  25 989-993
    CrossrefPubMedGoogle Scholar
  • 38 Jacobs L, Kaba S, Pullicino P. The lesion causing continuous facial myokymia in multiple sclerosis.  Arch Neurol. 1994;  51 1115-1119
    PubMedGoogle Scholar
  • 39 Hopf HC. Persistent tonic facial contraction: a local brain-stem sign. In: Caplan LR, Hopf HC (Ed). Brain-stem localization and function. Springer, Heidelberg 1993: 232-236
    Google Scholar

Korrespondenzadresse

Prof. Dr. P. UrbanMA 

Asklepios Klinik Barmbek

Abteilung für Neurologie

Rübenkamp 220

22291 Hamburg

Email: p.urban@asklepios.com

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