Intermittent muscle contractions

Introduction The clonic tendon is an intermittent rhythmic muscle contraction with muscle relaxation. The hemifacial spasm, also known as facial muscle twitching or hemifacial spasm, is a dysfunction syndrome caused by a side nerve stimulation. Most of them are on one side, and there are few patients with bilateral hernias, accounting for about 4%. Most of the patients were adults over 40 years old, and the ratio of male to female was 2:3. The incidence rate is about 64/100000 of the population. Stocks has reported that 13 out of four generations are sick but not hereditary. This disease was recorded in the Chinese medical book "Exploring Yao Letter" in the early 16th century. However, due to its pathological unknown pathology, it has long been recognized as an incurable disease. The disease is rarely discussed in the ear sciences, and it has not been studied extensively since the earliest decades of ear neurosurgery, making it an important disease in the ear science.

Cause

According to the cause, the disease can be divided into two types: special and secondary. Secondary symptoms are also called symptomatic hemifacial spasm, and any compression irritant lesion can induce this disease in the entire passage from the cerebral cortex to the peripheral branch of the facial nerve. Clinically common such as middle ear mastoid inflammation and tumors, space-occupying lesions of cerebellopontine angle (cholesteatoma and acoustic neuroma) and encephalitis, arachnoiditis, multiple sclerosis, Paget's disease and cranial depression. Those who can't find the inducement are collectively referred to as idiopathic sputum, accounting for about 2/3 of the total number of cases. In 1966, Jannetta proposed that the facial nerve is at the root of the brain (REZ) and is compressed by the small arteries that form the hemifacial spasm. The main cause, and the use of microvascular decompression treatment, achieved satisfactory results.

Jannetta suggested that the facial nerves (REZ) are compressed by the small arteries that are running, which are the main causes of hemifacial spasm. These blood vessels have anterior and posterior inferior cerebellum and varicose veins. After middle-aged people, these normal and nerve-cross-pressed blood vessels begin to harden, and blood pressure rises. Long-term compression of nerves can cause demyelinating degeneration, causing a string of electricity between the axons, and the excitement is transmitted from the passage to the afferent. There may be a large amount of abnormal potential accumulation and release, which may cause episodes of spasm. This argument can also be used to explain the causes of trigeminal neuralgia and glossopharyngeal neuralgia. However, in recent years, many scholars have held negative opinions because there are many facial nerves that are oppressed by blood vessels and no hemifacial spasm, and 20% to 30% of patients with hemifacial spasm cannot detect nerve compression. In recent years, the authors have measured serum and cerebrospinal fluid microtin in 30 patients, and found that all patients have significantly reduced serum calcium and magnesium ions, showing vascular compression nerve demyelination, which must be stimulated in the environment of reduced calcium and magnesium ions. Get rid of the disease.

an examination

Related inspection

Muscle tone examination electromyogram

an examination:

Typical convulsions, without other positive neurological signs, general diagnosis is not difficult. Electroencephalography and electromyography should be performed routinely. If necessary, mastoid, skull X-ray, head CT and MRI should be performed to exclude mastoid and skull diseases. It is characterized by electrical stimulation of the supraorbital nerve of the affected side, and the contraction of the muscles of the affected side of the orbicularis and other facial nerves. Normal or other diseases stimulate the unilateral supraorbital nerve, which only causes contraction of the orbicularis muscles that innervate the unilateral supraorbital nerve.

Clinical manifestations:

Beginning for one side of the eyelids, gradually extending from the top to the bottom to the hemifacial muscles, severely can affect the neck and shoulder muscles. This involuntary embarrassment, one can not control, emotional stress, excessive fatigue can induce or make the condition worse. According to the test, this facial muscle synchronous discharge is 350 times per second, which is characterized by tight eyelid closure, skewed mouth, a few seconds of convulsion time, several minutes of elders, intermittent length, and patients are upset during the attack. Unclear, occasional facial pain, stuffy nose and headache. Generally, no seizures occur during sleep, but 11% of patients still twitch as usual during sleep, which affects sleep. Attacks are more and more frequent, seriously affecting life and work. After a long time, the muscle strength gradually weakens, and in the late stage, it can develop to a half-sided side and end.

Differential diagnosis

Clinically, it should be differentiated from the following diseases:

1. Facial paralysis of facial paralysis: In the past, there was a significant history of facial paralysis. Due to the incomplete recovery of facial paralysis, the axonal regeneration was caused by confusion. The affected side left different degrees of facial muscle weakness and paralysis.

2. Idiopathic spasm: bilateral orbital tendon, often accompanied by mental disorders, EMG shows that the facial muscles are not synchronized discharge, the frequency is normal, may be caused by dysfunction of the pyramidal system.

3. Facial muscle twitch: for the facial muscles, the individual muscle bundles are slightly vibrating, often invading the surrounding orbital muscles, mostly limited to one side, can be relieved by themselves, may be caused by benign lesions of the brain stem and cranial nerve.

4. Habitual sputum: for small sputum, facial muscles have no purpose stereotypes or repeated beating, more common in one side, mostly in childhood.

5. The movement of the hand and foot caused by lesions in the midbrain and cone system.

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