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Contralateral reinnervation of midline muscles in facial paralysis
Author(s) -
Gilhuis H. Jacobus,
Beurskens Carien H.G.,
Marres Henri A.M.,
de Vries Joost,
Hartman Ed H.M.,
Zwarts Machiel J.
Publication year - 2001
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.1207
Subject(s) - reinnervation , facial muscles , anatomy , facial nerve , electromyography , orbicularis oris muscle , palsy , medicine , facial paralysis , electrophysiology , stimulation , physical medicine and rehabilitation , surgery , pathology , upper lip , alternative medicine
Abstract We report on a patient with recovery of activity of the left orbicularis oris and nasalis muscles 3 months after a complete left facial palsy. Stimulation of the affected facial nerve evoked no responses, whereas contralateral facial nerve stimulation showed polyphasic responses with very long latencies in the nasalis and orbicularis oris muscles. Needle electromyography (EMG) revealed abnormal spontaneous activity in the left orbicularis oris muscle. The motor unit action potentials on the left side of the face could be recruited only during marked contraction of the corresponding muscles on the right and were of low voltage and polyphasic (“nascent potentials”). Contralateral reinnervation is probably due to sprouting of terminal branches crossing the midline of the face and innervating bundles of muscle fibers on the affected side. This phenomenon seems unfamiliar to most clinicians. Whether the activity is due to conduction along nerve fibers or muscle fibers crossing the midline is discussed. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24:1703–1705