情緒性中樞型顏面麻痺－病例報告

Emotional Central-Type Facial Palsy: A Case Report

陳建志(Jiann-Jy Chen) ； 張馨丰(Hsin-Feng Chang) ； 陳登郎(Dem-Lion Chen) ； 馮紀新(Chi-Hsin Feng)

《北市醫學雜誌》 12卷3期 (2015/09) Pp. 56-61

https://doi.org/10.6200/TCMJ.2015.12.3.07

摘要

顏面麻痺不僅可以區分成中樞型或週邊型，還可區分成自主性或情緒性。一56歲男性，因發作眩暈求診於本院。理學檢查顯示左側顏面表情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，確認是左側情緒性中樞型顏面麻痺；不僅如此，右側軀幹及肢體感覺減弱。磁振造影證實是左側外延髓的急性梗塞。已有國外文獻報告外延髓梗塞會合併情緒性中樞型顏面麻痺，但國內文獻尚無人報告過。根據神經定位，外側腦幹病變會引起情緒性中樞型顏面麻痺，須與一般大腦中風所致中樞型顏面麻痹（同時合併自主性與情緒性）區別。

關鍵字

顏面麻痺 ； 眩暈 ； 外延髓梗塞 ； 皮質顏面神經核路徑

並列摘要

Facial palsy (FP) can be differentiated into central-or peripheral-type FP, and further, into volitional or emotional FP. A 56-year-old man visited our emergency department because of acute vertigo. The physical examination showed weakness of left facial mimetic muscles when smiling happily or frowning nervously, but no weakness was observed when purposely winking, pouting or grimacing. Thus, left emotional central-type FP was confirmed. Also, hemihypesthesia occurred at his right-side trunk and right limbs, and an acute left lateral medullary infarction was confirmed by magnetic resonance imaging. Emotional central-type FP with lateral medullary infarction has been reported in foreign literature but this has not been described in Taiwan literature yet. According to neurological localization, emotional central-type FP is attributable to lateral brainstem lesion, and should be differentiated from common central-type FP (both volitional and emotional) caused by cerebral infarction.

並列關鍵字

facial palsy ； vertigo ； lateral medullary infarction ； cortico-facial tract