Abstract
A patient with facial myokymia, suffering from an infiltrating grade II astrocytoma originating within the pons with vegetations invading the cerebellopontine angle, was studied clinically and electromyographically from 1973 to 1979. The myokymias started in the muscles of the right side of the face and later spread to the left side. The latter point is worth noting because the myokymias of the left side were detectable by EMG but not by inspection. They preceded clinical and instrumental evidence of a contralateral spread of tumoral damage to the brainstem. From the physiopathogenetic angle they point up the importance of a mechanism of hyperexcitability and release of the facial motoneuronal pool. The results of the EMG study suggest that the persistence of myokymia, its association with an ingravescent neurogenic impairment of the facial musculature and its polymorphism in the course of pontine tumors are more reliable features than their discontinuity and rhythmicity.
Sommario
Gli AA. riportano uno studio clinico ed elettromiografico, condotto dal 1973 al 1979, di un paziente con Miochimia facciale, affetto da astrocitoma di II grado infiltrante a partenza intraprotuberanziale con vegetazioni invadenti l'angolo ponto-cerebellare.
Le miochimie insorgono nei distretti muscolari dell'emifaccia destra. Successivamente vengono sorprese anche a carico dell'emifaccia sinistra. Questo ultimo fatto pare degno d'interesse in quanto le miochimie dell'emifaccia sinistra si rivelano elettromiograficamente ma non ispettivamente; anticipano le prove cliniche e strumentali di una diffusione controlaterale della sofferenza neoplastica del tronco encefalico; dal punto di vista fisiopatogenetico, indirizzano a dare importanza ad un meccanismo di ipereccitabilità e liberazione del pool motoneuronale facciale.
I risultati, inoltre, delle indagini EMG inducono a ritenere la persistenza, l'associazione con un'ingravescente sofferenza neurogena della muscolatura facciale ed il polimorfismo della miochimia in corso di tumori pontini, caratteri più attendibili della discontinuità e ritmicità.
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Juvarra, G., Calzetti, S., Formentini, E. et al. Facial myokymia in the course of a pontine tumor. Ital J Neuro Sci 2, 35–42 (1981). https://doi.org/10.1007/BF02351685
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DOI: https://doi.org/10.1007/BF02351685