Neurology:见于舌下神经病变的肌纤维颤搐

2019-07-20 zxy 神经科病例撷英拾粹

50岁女性,表现为无痛性吞咽困难和构音障碍。没有放射暴露。查体发现舌头不自主运动,容积减小,伸舌右侧偏斜。余神经系统查体正常。脑/颅底MRI未见明显异常。

50岁女性,表现为无痛性吞咽困难和构音障碍。没有放射暴露。查体发现舌头不自主运动,容积减小,伸舌右侧偏斜。余神经系统查体正常。脑/颅底MRI未见明显异常。

肌电图之前的超声检查提示舌部异常运动并显示颏下肌和舌的超声解剖(视频)。超声检查可对舌部进行动态评估,而其他影像技术不可能实现。右侧颏舌肌肌电图证实肌纤维颤搐和稀疏肌束颤动,以及背景慢性神经源性运动单位重排和募集减少。

诊断为慢性特发性舌下神经病,临床缓解但随后由于神经过度兴奋出现而恶化。











(颏舌肌的超声检查提示右侧舌部回声异常伴舌肌纤维颤搐和肌束颤动,特点为小部分舌反复和持续的扭转运动,以右侧舌部更明显[屏幕左侧])

原始出处:Wee TC1, Markus R1, G Simon N2. Teaching Video NeuroImages: Tongue myokymia in hypoglossal neuropathy. Neurology. 2019 Jul 9;93(2):e214. 

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    2019-10-29 yinhl1978
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    2020-06-01 okhuali
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    2019-07-21 axin012
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