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Migrainous facial palsy (MFP): the introduction of a new concept of neurovascular conflict and its preliminary clinical evidence.

偏头痛性面神经麻痹 (MFP): 神经血管冲突新概念的引入及其初步临床证据。

  • 影响因子:1.76
  • DOI:10.1007/s10072-020-04370-0
  • 作者列表:"Bhatjiwale M","Bhatjiwale M
  • 发表时间:2020-04-01
Abstract

BACKGROUND:Facial palsy and migraine have frequently been reported to occur in conjunction. We report a case series and propound a theory to explain the same. AIMS AND OBJECTIVES:To postulate an anatomico-pathophysiological association in the causative factor of lower motor neuron type of facial palsy in cases with migraine without aura. MATERIALS AND METHODS:Preliminary experiences and observations in 12 cases suffering from facial palsy following an attack of migraine without aura, mainly in the occipital and posterior auricular region, are elaborated. RESULTS:Facial palsy occurred on the ipsilateral side as the headaches in a majority of the cases (83.33%) and in rare cases of bilateral headaches (16.67%), it lateralised to the side the headaches were more severe. In most of these cases (75%), a complete clinical recovery was noted within 6 months. CONCLUSION:We concluded that neurogenic inflammation of the facial nerve trunk caused by its proximity to the dilated posterior auricular/stylomastoid/occipital and superficial temporal arteries during a migraine attack leads to a temporary lower motor neuron type of paresis of the muscles supplied by the facial nerve. SIGNIFICANCE:This pathophysiological understanding of the disease mechanism could open new avenues as to the treatment of this condition. This proposition indicates in clearer light than before, a possible mechanism to explain the higher incidence and risk of facial palsy in migraineurs.

摘要

背景: 面神经麻痹和偏头痛经常被报道合并发生。我们报告了一个病例系列,并提出了一个理论来解释同样的问题。 目的和目的: 在无先兆偏头痛的病例中,假设下运动神经元型面瘫的致病因素与解剖病理生理相关。 材料和方法: 对 12 例以枕部和耳后区为主的无先兆偏头痛发作后面瘫患者的初步经验和观察进行了阐述。 结果: 大部分病例 (83.33%) 的头痛发生在同侧面瘫,罕见的双侧头痛 (16.67%),它向侧面偏侧,头痛更严重。在大多数这些病例 (75%) 中,在 6 个月内观察到完全的临床恢复。 结论: 我们的结论是,偏头痛发作时面神经干靠近扩张的耳后/茎突肌/枕部和颞浅动脉引起的神经源性炎症导致暂时性下运动神经元型面神经供应的肌肉麻痹。 意义: 这种对疾病机制的病理生理学理解可以为这种疾病的治疗开辟新的途径。这一命题比以前更清晰地表明,这是解释偏头痛患者面瘫发病率和风险更高的可能机制。

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DOI:10.1007/s11011-020-00536-z
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影响因子:4.30
发表时间:2020-01-24
来源期刊:Experimental neurology
DOI:10.1016/j.expneurol.2020.113212
作者列表:["Bertrand SJ","Zhang Z","Patel R","O'Ferrell C","Punjabi NM","Kudchadkar SR","Kannan S"]

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影响因子:1.52
发表时间:2020-01-27
来源期刊:World neurosurgery
DOI:10.1016/j.wneu.2020.01.108
作者列表:["Middlebrooks EH","Lin C","Okromelidze L","Lu CQ","Tatum WO","Wharen RE Jr","Grewal SS"]

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