摘要
顏面麻痺不僅可以區分成週邊型或中樞型，還可區分成情緒性或自主性。一75歲男性，意外發現左側顏面肌群在開心微笑或是緊張皺眉時，總是比較無力，但刻意去做擠眉弄眼、噘嘴或表情模仿等動作卻又正常，因發作眩暈求診於本院。理學檢查顯示左側情緒性週邊型顏面麻痺、自發性向右水平性眼振、右側肢體及軀幹感覺減弱及左側肢體辨距不能。磁振造影證實是左側外延髓的急性梗塞。已有文獻報告外延髓梗塞會合併情緒性中樞型顏面麻痺，但合併情緒性週邊型顏面麻痺者尚無人報告過。根據神經定位，情緒性週邊型顏面麻痺為腦幹病變所致，須與貝爾氏麻痺（同時出現情緒性和自主性週邊型顏面麻痺）分別。
並列摘要
Facial palsy (FP) can be differentiated into peripheral- or central-type FP, and further differentiated into emotional or volitional FP. A 75-year-old man experienced weakness of the left facial muscles when smiling happily or frowning nervously, but no weakness when purposely winking, pouting or grimacing. He visited our emergency because of acute vertigo. The physical examination demonstrated left emotional peripheral-type FP, spontaneous rightward horizontal nystagmus, right side hemihypesthesia and left side dysmetria. Magnetic resonance imaging demonstrated an acute left lateral medullary infarction. Emotional central-type FP has been reported with lateral medullary infarction in the literature, but emotional peripheral-type FP has not. According to neurological localization, emotional peripheral-type FP can be attributable to a brainstem lesion. It is different from Bell's palsy, in which both emotional and volitional peripheral-type FP are present.
延伸閱讀
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