面肌痉挛是一种罕见的神经肌肉疾病,主要特征是面部肌肉的不自主收缩或痉挛。这种痉挛通常会影响面部的一侧,导致面部抽搐、眼睑痉挛、嘴唇痉挛等症状。发病原因可能是由于面神经受到压迫,通常是由于血管的压迫导致,也可能由头部受伤、多发性硬化、中风或面神经附近的肿瘤引起。其他潜在因素包括遗传因素、环境因素以及神经传导问题。 面肌痉挛的诊断通常是通过医生的临床观察和患者的病史来进行的。医生可能会询问患者的症状、症状的持续时间以及可能的诱因。在进行体格检查时,医生可能会观察患者的面部肌肉的运动情况,以及是否存在痉挛的表现。 除了临床观察和病史询问外,医生还可能会建议进行以下检查来帮助诊断面肌痉挛:
诊断面肌痉挛的过程可能需要结合多种检查结果,以排除其他可能的病因并确定最佳的治疗方案。因此,建议患者在出现面肌痉挛症状时及时就医,接受专业医生的诊断和治疗。 面肌痉挛的发病率因地区和人群而异,但通常被认为是一种罕见的疾病。预防面肌痉挛的确切方法尚不清楚,但以下措施可能有助于减少症状的发作:
治疗面肌痉挛的方法包括药物治疗、肉毒杆菌注射、物理治疗、手术等。具体的治疗方案应根据个体情况和症状严重程度来制定,因此建议患者咨询医疗专业人员以获取个性化的治疗建议。 总的来说,早期诊断和有效治疗是管理面肌痉挛的关键。定期随访医生、遵循医嘱、保持积极的生活态度和健康的生活方式可能有助于减轻症状并提高生活质量。 参考文献:[1] Van der Geer, S., Kamstra, J., Roodenburg, J., Van Leeuwen, M., Reintsema, H., Langendijk, J., & Dijkstra, P. (2016). Predictors for trismus in patients receiving radiotherapy. Acta Oncologica., 55(11), 1318-1323. [2] Danisi, F., & Guidi, E. (2018). Characterization and Treatment of Unilateral Facial Muscle Spasm in Linear Scleroderma: A Case Report. Tremor and Other Hyperkinetic Movements., 8, 531. [3] Refaee, E., Rosenstengel, C., Baldauf, J., Pillich, D., Matthes, M., & Schroeder, H. (2018). Microvascular Decompression for Patients With Hemifacial Spasm Associated With Common Trunk Anomaly of the Cerebellar Arteries-Case Study and Review of Literature. Operative Neurosurgery., 14(2), 121-127. [4] Ram S, Kumar SK, Clark GT. Using oral medications, infusions and injections for differential diagnosis of orofacial pain. J Calif Dent Assoc. 2006 Aug;34(8):645-54. [5] Ward, A., Molenaers, G., Colosimo, C., & Berardelli, A. (2006). Clinical value of botulinum toxin in neurological indications. European Journal of Neurology., 13 Suppl 4, 20-26. [6] Hartl, D., Cohen, M., Juliéron, M., Marandas, P., Janot, F., & Bourhis, J. (2008). Botulinum toxin for radiation-induced facial pain and trismus. Otolaryngology and Head and Neck Surgery., 138(4), 459-463. [7] Winterholler MG, Heckmann JG, Hecht M, Erbguth FJ. Recurrent trismus and stridor in an ALS patient: successful treatment with botulinum toxin. Neurology. 2002 Feb 12;58(3):502-3. [8] Padilla, M., Utsman, R., Brenes, MJ. Hemifacial Spasm: A Case Report and Review of Literature. Journal of California Dental Association. July 2017. Vol 45(7):361-4. [9] Chaudhry, N., Srivastava, A., & Joshi, L. (2015). Hemifacial spasm: The past, present and future. Journal of the Neurological Sciences. 356(1-2), 27-31. [10] Abbruzzese, G., Berardelli, A., & Defazio. (2011). Hemifacial spasm. Handb Clin Neurol, 100, 675-680. [11] Kemp, L., & Reich, S. (2004). Hemifacial Spasm. Current Treatment Options in Neurology, 6(3), 175-179. [12] Liu, J., Zhang, Q., Lian, Z., Chen, H., Shi, X., Feng, M., Zhou, D. (2017). Painful tonic spasm in neuromyelitis optica spectrum disorders: Prevalence, clinical implications and treatment options. Multiple Sclerosis and Related Disorders, 17, 99-102. [13] Rosenstengel, C., Matthes, M., Baldauf, J., Fleck, S., & Schroeder, H. (2012). Hemifacial spasm: Conservative and surgical treatment options. Deutsches Ärzteblatt International.,109(41), 667-673. [14] Daniele O, Caravaglios G, Marchini C, Mucchiut L, Capus P, Natale E. Gabapentin in the treatment of hemifacial spasm. Acta Neurol Scand2001; 104:110–12. [15] Lu, A., Yeung, J., Gerrard, J., Michaelides, E., Sekula, R., & Bulsara, K. (2014). Hemifacial spasm and neurovascular compression. TheScientificWorld., 2014, 349319. [16] Jost WH, Kohl A. Botulinum toxin: evidence-based medicine criteria in blephraospasm and hemifacial spasm. J Neurol 2001; 248(Suppl.):21–4. [17] Ramirez-Castaneda J, Jankovic J. Long-term efficacy, safety, and side effect profile of botulinum toxin in dystonia: a 20-year follow-up. Toxicon: Off J Int Soc Toxinol. 2014;90:344–8 [18] Sindou, M., & Mercier, P. (2018). Microvascular decompression for hemifacial spasm: Outcome on spasm and complications. A review. Neurochirurgie, Neurochirurgie , 2018. [19] McLaughlin MR, Jannetta PJ, Clyde BL et al. Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg 1999;90(1):1-8. [20] Bigder, M., & Kaufmann, A. (2016). Failed microvascular decompression surgery for hemifacial spasm due to persistent neurovascular compression: An analysis of reoperations. Journal of Neurosurgery., 124(1), 90-95. |
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