Corticonuclear innervation to facial muscles in normal controls and in patients with central facial paresis.
Recently it has been proposed that corticobulbar innervation of the lower facial muscles is bilateral, that is from both right and left sides of the motor cortex. The objectives of this study were, i) to evaluate the corticonuclear descending fibers to the perioral muscles and, ii) to determine how central facial palsy (CFP) occurs and often recovers rapidly following a stroke. Eighteen healthy volunteers and 28 patients with a previous history of a stroke and CFP (mean ages: 51 and 61 years) were investigated by TMS (transcranial magnetic stimulation) with a figure of eight coil. Intracranial facial nerve and cortical motor evoked potentials (MEPs) were recorded from the perioral muscles. The periorbital MEPs were also studied. The absence of MEPs in both perioral muscles with TMS of the affected hemisphere was the most obvious abnormality. Also, central conduction time was significantly prolonged in the remaining patients. The mean amplitude of the affected hemisphere MEPs was diminished. The amplitudes of the unaffected hemisphere MEPs recorded from the intact side were enhanced especially in the first week following the stroke. During TMS, only the blink reflexes were elicited from the periorbital muscles due to stimulus spreading to trigeminal afferent nerve fibers. It is concluded that perioral muscles are innervated by the corticobulbar tract bilaterally. CFP caused by a stroke is generally incomplete and mild because of the ipsilateral cortical and multiple innervations out of the infarction area, and recovers fast through cortical reorganisation.
Yildiz
Nebil
N
Abant Izzet Baysal University, Medical School Hospital Dept. of Neurology Gölköy, Bolu, Turkey (Türkiye). nebily@hotmail.com
Ertekin
Cumhur
C
Ozdemirkiran
Tolga
T
Yildiz
Serpil Kuyucu
SK
Aydogdu
Ibrahim
I
Uludag
Burhanettin
B
Secil
Yaprak
Y
D000328:Adult; D000368:Aged; D004558:Electric Stimulation / Q000379:methods; D004576:Electromyography / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology / Q000528:radiation effects; D005152:Facial Muscles / Q000503:physiopathology*; D005158:Facial Paralysis / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D011930:Reaction Time / Q000502:physiology / Q000528:radiation effects; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D013997:Time Factors
Brain. 1958 Sep;81(3):364-88
13596471
Exp Brain Res. 1988;71(3):623-32
3416974
Electroencephalogr Clin Neurophysiol. 1988 Oct;70(4):350-4
2458243
Brain. 1989 Oct;112 ( Pt 5):1333-50
2804615
J Neurol Neurosurg Psychiatry. 1989 Oct;52(10):1149-56
2795040
J Neurol Neurosurg Psychiatry. 1988 Jan;51(1):60-6
3351531
Adv Neurol. 1988;49:15-23
3278538
J Neurophysiol. 1988 Mar;59(3):796-818
2835448
Exp Brain Res. 1994;101(3):465-72
7851513
Neurology. 1990 Feb;40(2):309-12
2300253
Electroencephalogr Clin Neurophysiol. 1997 Feb;105(1):8-14
9118843
Muscle Nerve. 1998 May;21(5):561-6
9572234
Neurosurgery. 1987 Jan;20(1):164-8
3543723
J Neurol Neurosurg Psychiatry. 1995 Dec;59(6):586-96
7500095
Muscle Nerve. 1993 Nov;16(11):1268-9
8413384
J Physiol. 1987 Jul;388:397-419
3079553
Ugeskr Laeger. 1992 Dec 7;154(50):3593-6
1471279
Neurosci Lett. 1987 Mar 20;75(1):101-6
3574763
Neurosci Lett. 1990 Sep 4;117(1-2):68-73
2290623
Brain. 2001 Jan;124(Pt 1):176-208
11133797
Neurology. 1987 Jun;37(6):930-9
3587643
J Neurol. 1989 Feb;236(2):102-7
2709050