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Histochemical characteristics of human mimic muscles.

Eight different mimic muscles of 13 human cadavers (7 male, 6 female) were studied by histochemical techniques. In sections stained for myosin ATPase the composition of fibre types was quantitatively evaluated by computer-assisted image analysis. The data were compared to those of 2 muscles in the lower limb of the same individuals. According to the percentage of the type I muscle fibres 3 groups of mimic muscles were distinguished: (1) the orbicularis oculi muscle (15%), (2) the major zygomatic, levator labii superioris, levator anguli oris, depressor anguli oris muscles and platysma (27-38%), and (3) the occipitofrontal and buccinator muscles (57-77%). For comparison, the gracilis and rectus femoris muscles were built up by 36% and 48% of type I fibres. The average diameters of fibres in mimic muscles were significantly less than in the 2 limb muscles. Differences in muscle fibre size between male and female specimens were not significant. The relevance of morphological characteristics of mimic muscles for facial expression and reconstructive surgery is discussed.

Adenosine Triphosphatases↗

Myokymia in the course of Bell's palsy. An electromyographic study.

Facial myokymia has been described in association with many morbid conditions, most frequently multiple sclerosis (MS) and brainstem tumors (BST). Very few reports deal with myokymia in the course of Bell's palsy, despite high frequency of the disease. A series of 88 consecutive patients with Bell's palsy is presented, in which serial EMG controls were performed in the initial phases of facial palsy. Twenty three showed myokymic activity detected by EMG, while clinically evident myokymia could be observed only in 8. EMG features did not reveal any peculiarity as compared with myokymic discharges reported in other pathological situations. Considering the high incidence of myokymic activity reported in the course of Bell's palsy, it is the authors' opinion that an occasional finding of myokymia, both clinically evident or detected by EMG, should not necessarily lead one to suspect serious aetiologies.

Electromyography↗

Emotional facial paresis with striatocapsular infarction.

Emotional facial paresis (EFP) refers to hemifacial paresis of emotionally evoked or spontaneous smiling or weeping with preserved volitional movements of the face. The anatomical location for this phenomenon has been controversial. We report a 15-year-old boy with EFP. Follow-up MRI demonstrated infarction limited to the head of the caudate, putamen and anterior limb of the internal capsule on the contralateral side. This case lends support for selective damage at a striatal or capsular site in the production of EFP.

Adolescent↗

Increased release of cyclic adenosine monophosphate into jugular vein in response to isoproterenol administration.

Catecholamine administration elevates plasma cyclic AMP (cAMP) levels but the source of the cAMP is unknown. To determine possible sources, plasma cAMP levels were determined in blood vessels across the head, liver, kidney and lung in anesthetized dogs infused with the beta-adrenergic agonist, isoproterenol. Only the head showed an increased release of cAMP into the blood. The kidneys removed cAMP from the blood while liver and lung showed no change. This in vivo demonstration of release of cAMP from the head represents contributions from brain and facial muscles and may be a useful approach to study brain involvement in the action of various hormones and drugs.

Animals↗

NGC-evoked nociceptive behaviors: I. Effect of nucleus gigantocellularis stimulation.

The role of the nucleus gigantocellularis (NGC) in nociception was examined by investigating behavioral responses that are supported by NGC stimulation in rats. Analyses indicated that NGC stimulation will support escape, active avoidance, and increases in behaviors that are thought to reflect fear in rats. A variety of behavior patterns were elicited by NGC stimulation, including gross peripheral motor movements such as walking, circling and rearing, and specific orofacial movements such as eye closure, ear movement, jaw opening and facial muscle contractions. No major differences in avoidance, affect, or escape behaviors were revealed between the various electrode placements, suggesting functional homogeneity within this neural region. The results of this study suggest that NGC stimulation generates several components of nociception, including behavioral arousal, autonomic nervous system-mediated responses, aversive affect, and motor responses.

Affect↗

Paroxysmal tinnitus and nystagmus accompanied by facial spasm.

A case of paroxysmal tinnitus and nystagmus, accompanied by facial spasm, in which neurovascular decompression was performed, is reported. The paroxysmal tinnitus and nystagmus were synchronous with each other. Horizontal nystagmus with a rotary component was found to be counterclockwise during the brief attack of tinnitus, whereas its direction became clockwise while free of tinnitus. The patient has been postoperatively relieved not only of the facial spasm, but also of the tinnitus and nystagmus. The mechanism of the occurrence of the syndrome and the significance of the neurootologic examination are discussed.

Arteries↗

Arteries in contact with the cisternal portion of the facial nerve in autopsy cases: microsurgical anatomy for neurovascular decompression surgery of hemifacial spasm.

The cisternal portion of the facial nerve and its contact arteries were examined anatomically in relation to neurovascular decompression surgery to treat hemifacial spasm. Thirty-five sides of brains from 20 autopsied adult patients were examined under a surgical microscope (x 5-x 25). One attaching point was found on 10 facial nerves, two points on 20 nerves, and three points on four nerves. More than two thirds of the facial nerves were attached at two points: the root exit zone and the distal cisternal portion. In a case of distal attachment, the contact artery formed an arterial-nerve complex with the distal portions of the facial and acoustic nerves. The arterial attachment at the root exit zone was evident on 24 of the 35 facial nerves (69%), and most of the contact arteries were the anterior inferior cerebellar artery and its branches. In five nerves, the root exit zone was attached at two points to arteries. The anatomy of autopsied brains without hemifacial spasm is not identical to that of actual clinical cases of hemifacial spasm; nevertheless, the results do aid in intraoperative anatomical orientations.

Adult↗

Hemifacial spasm: a review.

Hemifacial spasm can be diagnosed by observation and clinical history. It is thought to arise primarily from compression of the facial nerve at the pons, usually by an adjacent artery. Although many approaches to treatment have been tried, the most effective is microvascular decompression of the facial nerve at the pons. That operation has well-recognized risks, including ipsilateral deafness. The latter complication ordinarily can be avoided by the use of intraoperative monitoring of auditory evoked potentials.

Animals↗

Painful tic convulsif: case report.

A case with painful tic convulsif is presented. A 77-year-old woman had developed trigeminal neuralgia 12 years before admission and ipsilateral facial spasm 2 years before admission. Upon operation, the superior cerebellar artery was found to impinge upon the entry zone of the fifth nerve. In addition, the anterior inferior and posterior inferior cerebellar arteries were found to bend along the seventh nerve. Teflon sheets were placed between the nerves and offending arteries. She has been pain-free and spasm-free for the past 18 months. Pathomechanism of the association of the multiple compression syndromes and the treatment are discussed.

Aged↗

EEG coherence and power changes during a continuous movement task.

EEG coherence (COH) is a mathematically derived measure of the time- and frequency-related similarities between a pair of EEG channels. In this report, COH was measured during an externally verified motor task in which the areas of cortical involvement are known, with special consideration given to procedural and artifactual issues. Fourteen right-handed women (ages 18-39, means = 26.7 years) were instructed to alternate continuously between fist-clenching and finger extension of the right hand, left hand, both hands, or neither hand (rest condition) in a counter-balanced sequence (4 one-minute trials for each condition; 16 total minutes). One minute each of intentional eye-movement (EOG) and intentional facial muscle tension (EMG) was recorded for artifact assessment. Eight channels of eyes-closed EEG were recorded from Fp1, Fp2, F3, F4, C3, C4, P3 and P4, each referenced to the ipsilateral earlobe. FFT spectral power analyses were conducted on 8 EEG channels and COH analyses (percentage of seconds/minute in which COH greater than or equal to 0.80) were performed on 16 pairs of leads: 4 interhemispheric, 6 intrahemispheric (left) and 6 intrahemispheric (right). COH measures increased during hand movement conditions, especially in the 9-12 Hz range, and were most apparent from prefrontal, premotor and motor areas. Parietal sources were essentially unchanged. Power measures were unchanged for virtually all leads and conditions. Increases in COH were not due to EOG or EMG artifact contamination. Evidence for lateralized increases was equivocal; significant bilateral increases were observed more often regardless of the hand clenched. Implications and suggested areas for future research are discussed.

Adolescent↗

Transient expression of estrogen-receptor-like immunoreactivity (ER-LI) in the facial nucleus of the neonatal rat.

Estrogen receptor-like immunoreactivity (ER-LI) was detected in the medial subnucleus of the facial nucleus by immunocytochemistry in both male and female neonatal rats, but not in the adult rat. Identity of the motoneurons in this subnucleus projecting to the corresponding facial muscles and the cells with ER-LI positive signals was examined by retrograde tracing. The majority of the cells marked with the tracer did not carry ER-LI signals.

Animals↗

Early evoked potentials detected from the scalp of man following infraorbital nerve stimulation.

Stimulation of the infraorbital nerve evoked a short latency scalp response characterized by a large amplitude triphasic potential (W1), followed by two smaller negative deflections (W2 and W3). All these waves were presynaptic in origin (as shown by double pulse stimulation), but appeared to be generated by separate dipoles. Short distance bipolar recording showed that W1 travelled from the zygoma to the mastoid. This wave was thought to be generated in a nearby neural structure, presumably the proximal part of the maxillary nerve, the gasserian ganglion and possibly even the trigeminal root. W2 and W3 components were probably generated by the trigeminal root fibres running through the brain-stem. Their origin from slowly conducting trigeminal fibres was ruled out by their absence in short distance bipolar records along the line from the zygomatic bone to the mastoid process, and by studies on their thresholds, which were shown to be identical to those of W1. Control experiments with concurrent facial muscle recording excluded any possible contamination of the scalp response to infraorbital nerve stimulation by electromyographic activity, and demonstrated gross muscular artefacts, picked up as far-field activity by scalp electrodes, following electrical stimulation of the upper lip.

Adult↗

Normal conduction in pathways traversing an asymptomatic multiple sclerosis plaque.

A 31-year-old woman developed right facial myokymia as the initial manifestation of multiple sclerosis (MS). An MRI scan revealed a focal signal abnormality confined to the left dorsolateral pontomedullary region. Brain-stem auditory evoked potentials (BAEPs), somatosensory evoked potentials (SEPs), and blink reflex (BR) failed to show a conduction abnormality through the left brain-stem lesion. Instead, BAEP and BR indicated a conduction defect in the right pons and EMG showed myokymic discharges in right facial muscles. Our findings provide rare documentation of normal conduction through a presumably asymptomatic MS plaque. The abnormal MRI signal likely represents tissue edema, rather than demyelination. This case demonstrates that physical findings in MS patients may correlate better with electrophysiological abnormalities than with MRI abnormalities.

Adult↗

Origin of the facial long latency responses elicited by magnetic stimulation.

With magnetic stimulation (MS) it is possible to elicit bilateral long latency facial motor responses (LLRs). Due to a relatively wide magnetic field, the site of neural activation may take place in many different structures. The purpose of this study was to determine the site of origin of facial LLRs. The motor long latency responses were recorded bilaterally on the naso-labial folds (NLFs) with reference electrodes on the nose, and on some subjects also with reference electrodes on the chin. The stimulating coil was placed in the right parietal area. LLRs obtained with MS were compared to LLRs elicited electrically at the right stylomastoid foramen, supraorbital foramen, as well as cutaneous sensory area V1 of the trigeminal nerve. In addition, right sided high intensity electrical stimuli, paired magnetic stimulation and electrical stimulation with interstimulus intervals ranging from 0 to 80 msec were also applied for comparison. LLRs recorded with reference to the nose were always elicitable with MS as well as with the other stimulation procedures. The responses elicited with MS did not differ from those elicited electrically at various extracranial stimulation sites. With paired stimuli the second LLRs were inhibited by the preceding stimulation, whether given magnetically or electrically. In subjects with elicitable LLRs with chin references, the responses were always bilateral. Based on the similar characteristics with extracranial electrical stimuli, bilateral distribution of the responses, and inhibition of the second response with paired stimuli, it is concluded that the neural origin of LLRs to MS is in the extracranial trigeminal or facial nerve branches.

Adult↗

Infiltrating lipoma of the mental region: report of a case.

Lipoma is an uncommon tumour in the oral cavity. Infiltrating lipoma is extremely rare. An infiltrating lipoma of the mental region in a 48-year old woman is reported. Wide myectomy was performed, and follow-up showed excellent healing without recurrence.

Chin↗

Sublethal acute toxicity of carbosulfan [2,3-dihydro-2,2-dimethyl-7-benzofuranyl(d i-n-butylaminosulfenyl)(methyl)carbamate] in the rat after intravenous and oral exposures.

Sublethal toxicity of car-carbosulfan, 2,3-dihydro-2,2-dimethyl-benzofuranyl(di-n-butylaminosulfenyl++ +)(methyl)carbamate , was evaluated in female Sprague-Dawley rats. Erythrocyte acetylcholinesterase (AChE) activity was maximally inhibited 1 min after iv administration (38, 23, and 15% of pretreatment activity after 86, 250, and 690 micrograms/kg, respectively) and recovered by 4 hr. Maximum AChE inhibition (63% of pretreatment activity) was measured 45 min after oral dosing (690 micrograms/kg) and activity recovered after 5 hr. Signs included urination, defecation, facial muscle fasciculations, salivation, and tremors. Carbosulfan was less toxic when given orally. Metabolic activation of carbosulfan to carbofuran (2,3-dihydro-2,2-dimethyl-7-benzofuranol methylcarbamate) was investigated by measuring plasma concentrations 4, 30, and 240 min after iv (80-120 or 620-640 micrograms/kg) and oral (540-700 or 2030-2190 micrograms/kg) dosages of [carbonyl-14C]carbosulfan. Peak plasma concentrations were measured at 4 and 30 min after iv and oral exposure, respectively. Carbosulfan was rapidly activated to carbofuran. Reduction in AChE activity was better correlated (r = 0.97) with plasma concentration of [carbosulfan + carbofuran] and plasma carbofuran (r = 0.96) than with plasma carbosulfan (r = 0.73). Signs generally occurred when AChE activity was less than 65% of pretreatment levels, corresponding to 40 pmol/ml [carbosulfan + carbofuran] in plasma. Based on regression analysis and metabolic studies, both carbosulfan and carbofuran contributed to the observed AChE inhibition; however, carbofuran, a more potent in vitro inhibitor and the usual predominant inhibitor in plasma, was responsible for most of the erythrocyte AChE inhibition.

Acetylcholinesterase↗