A Cinical and a fundamental study of the efficacy and the safety of Transcraniol Magnetic Stimmulation on facial movement disorders.

对于周围性面神经麻痹患者的早期预后诊断，磁刺激器用DantecMag 2型面神经刺激器直接刺激15例正常人和108例周围性面神经麻痹患者的面神经颅内段，复合肌肉动作电位将经颅磁刺激引起的口轮匝肌的CMAP与电刺激引起的口轮匝肌外周部位的CMAP进行比较。与神经电图（ENoG）相似，是我科常用的检查方法。正常人磁刺激诱发的CMAP潜伏期比电刺激诱发的CMAP潜伏期长（1.0ms，SD 0.39ms），而患者的ENoG值在发病后第7天开始下降，之后趋于稳定。然而，磁诱发的CMAPs在患侧与健侧之间的振幅比没有下降的趋势， 关于我们 l瘫痪发作后第七天。因此，磁诱发的CMAP能否被记录下来与面神经麻痹的预后有关，必须加以讨论。磁诱发的CMAP可以记录在发病后第七天内的患者被归类为一组中的最小ENoG值大于20%。这些患者恢复近2个月后的麻痹发作，并显着优于他们的恢复率的患者中的磁诱发的CMAP不能recorded.The网站的面神经磁刺激仍然存在争议。对周围性面神经麻痹患者，通过检测镫骨反射、瞬目反射和磁诱发的CMAP的恢复情况，探讨磁刺激的作用部位。从临床角度来看，面神经被认为是磁刺激附近的耳道孔，这被认为是在贝尔麻痹的损害部位。该刺激部位与正常对照组磁诱发CMAP和ENoG潜伏期差的平均值几乎一致，磁刺激试验中未见不良反应。因此，证明了该试验的有效性。少

For an early prognostic diagnosis of patients with peripheral facial palsy, a magnetic stimulator (Dantec Mag 2) was used to directly stimulate the intracranial portion of the facial nerve in 15 normal subjects and 108 patients with peripheral facial palsy.In normal subjects and patients with facial palsy, compound muscle action potentials (CMAPs) of the orbicularis oris muscle elicited by transcranial magnetic stimulation were compared with CMAPs elicited by electrical stimulation at the peripheral site of the stylomastoid foramen which is similar to electroneurography (ENoG) and regularly used in our department. In normal subjects, the latency of magnetically evoked CMAPs was longer (1.0 ms, SD 0.39 ms) than that of CMAPs evoked by electrical stimulation.In patients, ENoG Values declined until the seventh day after onset of palsy, and then plateaued. However, the amplitude ratio of maganetically evoked CMAPs between the affected side and normal side showed no tendency to decline unti … More l the seventh day after onset of palsy. So, whether magnetically evoked CMAPs could be recorded must be discussed in relation to the prognosis for facial palsy. The patients whom magnetically evoked CMAPs could be recorded within the seventh day after onset of palsy were classified in a group in which the minimal ENoG value was greater than 20%. Those patients recovered almost 2 months after the onset of palsy, and were significantly better than their recovery rates those of the patients in whom magnetically evoked CMAPs could not be recorded.The site at which the facial nerve is magnetically stimulated remains controversial. In patients whth peripheral facial palsy, recovery of stapedial reflex, blink reflex and magnetically evoked CMAPs were examined to investigate the site of magnetic stimulation. From the clinical perspective, the facial nerve is thought to be magnetically stimulated near the meatal foramen which is thought to be the damage site in Bell's palsy. This stimulation site was almost the same point as that calculated from the mean latency difference between magnetically evoked CMAPs and ENoG in normal controls.No harmful effects were seen during the magnetic stimulation test. Accordingly, the efficacy of this test was demonstrated. Less