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PubMed2000

Continuous facial myokymia in multiple sclerosis: treatment with botulinum toxin.

Continuous facial myokymia (CFM) is an involuntary undulating, vermicular movement that spreads across facial muscles and is associated with a characteristic electromyographic pattern. It is an infrequent clinical sign that almost always occurs in intrinsic brainstem lesions, particularly in multiple sclerosis (MS). It is usually present for only a few weeks, but it may persist for long periods of time being very troublesome for patients. We report 2 cases with MS and continuous hemifacial myokymia persisting for up to 1 month which disappeared after injection of botulinum toxin. Botulinum toxin A (BTX-A) has been used successfully to treat a variety of focal dystonias and occasionally in orbicularis myokymia, but its use has not been reported in continuous hemifacial myokymia. BTX-A appears to be effective and safe for treating persistent facial myokymia in MS patients.

Adult↗
PubMed1981

Applications of biofeedback to the treatment of asthma: a critical review.

Both muscular and respiratory biofeedback procedures have been employed in attempts to reduce symptoms of bronchial asthma. Research relating to these approaches is reviewed in the present article. Biofeedback training both for facial muscle relaxation and for respiratory resistance decrease improves short-term pulmonary function in asthmatic individuals. These forms of training represent promising avenues for the management of asthma. However, unqualified endorsement of these procedures is premature, at the present time, since their influence on asthma-related variables other than pulmonary function has not been determined and since their long-term effects have not been investigated.

Airway Resistance↗
PubMed1999

The nasolabial fold: an attempt at synthesis.

There is now enough information on the nasolabial fold to try to synthesize it with other well-known structures, such as the dermal terminations of the facial muscles, the superficial musculoaponeurotic system, and the fat pad. Rest dynamic equilibrium is a good concept to use to understand the nasolabial fold, because the nasolabial fold is not a passive, definitive structure, but an evolutive border whose limits depend on the absence or presence of fibromuscular terminations crossing the superficial musculoaponeurotic system of the cheek. A simple photograph of two men will help illustrate the difference between the convex and the concave nasolabial fold.

Adipose Tissue↗
PubMed1996

Incidence of maxillofacial involvement in arthrogryposis multiplex congenita.

PURPOSE: This study determined the incidence of maxillofacial involvement in patients diagnosed with arthrogryposis multiplex congenita (AMC). PATIENTS AND METHODS: Twenty-three patients were evaluated by the pediatric physical medicine and rehabilitation, orthopedic surgery, and pediatric oral and maxillofacial surgery departments. Any patient in whom the diagnosis of AMC was in doubt was excluded from the study. All patients with limited mandibular function underwent computed tomography (CT) examination of their temporomandibular joints (TMJ). The results of physical therapy were followed. RESULTS: Five of the 23 patients diagnosed with AMC were found to have maxillofacial involvement, eg, presence of cleft palate, Robin-like sequence, high-arched palate, open-bite deformity, facial muscle weakness, esophageal dysfunction, and limited mandibular opening. No TMJ abnormalities were found by CT scan. Physical therapy was used for treatment of the limited opening, but relapse occurred quicky after therapy was discontinued. CONCLUSION: The incidence of maxillofacial findings is similar to that of most other reports. Treatment involves surgical correction of abnormal anatomy when possible (ie, cleft repair), symptomatic management (ie, esophageal dysfunction), and physical therapy.

Adolescent↗
PubMed1978

[Trigeminal-facial reflex of the orbicularis orbis muscle in patients with flaccid paralysis of the facial musculature].

With the aid of electric stimulation of the supraorbital nerve the authors studied the trigeminal facial reflex and evoked potentials of the facial nerve in patients with sluggish paresis of the facial muscles; 48 patients with neuritis of the facial nerve, 26 patients with polyradiculoneuritis, 5 patients with encephalitis and the syndrome of nucleus damage of the facial nerve (including 38 children) and 3 patients with myasthenia were studied. It is demonstrated that along with the equal extent of flaccidness of the facial muscles there are different characteristics of indices of the latent period and the amplitude of the trigeminal facial reflex, which are of diagnostic and prognostic significance.

Brain Diseases↗
PubMedDate not supplied

Affective and physiological responses to racism: the roles of afrocentrism and mode of presentation.

Recent experiments have examined the subjective and physiological responses of African Americans to racism using video-taped vignettes or emotional imagery. These studies reported changes in mood and increases in cardiovascular (CV) and electromyographic (EMG) activity when analogs of the stressful situations were encountered. In addition, individual differences in responses were found to be related to various personality measures. The present study examined the mood, CV and EMG responses of 60 African-American women as they encountered social situations that included blatant and more subtle forms of racism. Half of the sample viewed both vignettes while the remainder imagined them. The relationship between responses and Afrocentrism, a measure related to black identity, was examined. Significant changes in heart rate, digital blood flow and facial muscle activity in the corrugator regions resulted. The most pronounced changes occurred when blatantly racist material was encountered. Mood changes tended to be stronger when material was imagined versus viewed. In general, Afrocentricity was not related to physiological responses to the scripts, though mood responses and Afrocentricity were related in several instances. The findings indicate that CV, as well as EMG and mood responses, are sensitive to various forms of racism presented in imagery and video modes.

Adult↗
PubMed1985

Maximum voluntary closing forces in the upper and lower lips of humans.

Forces generated by facial muscles during speech production have previously been estimated to involve up to 20% of maximum voluntary closing force. The gross nature of this estimate is due, in part, to the complex relationship between muscle contraction and three-dimensional tissue conformation and to the lack of data concerning maximum force. The objective of the present study was to determine the maximum voluntary closing forces for the upper and lower lips in male and female adults. The results indicate the maximum force capabilities for the lower lip to be approximately three times greater than for the upper lip. Male subjects generated significantly greater lip closing forces than female subjects. The large difference between the upper and lower lips as force plants is discussed in relation to speech function and skilled motor behavior.

Adult↗
PubMed1994

Differences in myosin composition between human oro-facial, masticatory and limb muscles: enzyme-, immunohisto- and biochemical studies.

Immunohistochemistry was used to determine the myosin composition of defined fibre types of three embryologically different adult muscles, the oro-facial, masseter and limb muscles. In addition, the myosin composition in whole muscle specimens was analysed with biochemical methods. Both similarities and differences between muscles in the content of myosin heavy chains and myosin light chains were found. Nevertheless, each muscle had its own distinct identity. Our results indicated the presence of a previously undetected fast myosin heavy chain isoform in the oro-facial type II fibre population, tentatively termed 'fast F'. The masseter contained aberrant myosin isoforms, such as foetal myosin heavy chain and alpha-cardiac myosin heavy chain and unique combinations of myosin heavy chain isoforms which were not found in the limb or oro-facial muscles. The type IM and IIC fibres coexpressed slow and fast A myosin heavy chains in the oro-facial and limb muscles but slow and a fast B like myosin heavy chain in the masseter. While single oro-facial and limb muscle fibres contained one or two myosin heavy chain types, single masseter fibres coexpressed up to four different myosin heavy chain isoforms. Describing the fibres according to their expression of myosin heavy chain isozymes, up to five fibre types could be distinguished in the oro-facial and limb muscles and eight in the masseter. Oro-facial and limb muscles expressed five myosin light chains, MLC1S, MLC2S, MLC1F, MLC2F and MLC3F, and the masseter four, MLC1S, MLC2S, MLC1F, and, in addition, an embryonic myosin light chain, MLC1emb, which is usually not present in normal adult skeletal muscle. These results probably reflect the way the muscles have evolved to meet the specialized functional requirements imposed upon them and are in agreement with the previously proposed concept that jaw and limb muscles belong to two distinct allotypes.

Adult↗
PubMedDate not supplied

[Biopercular lesion with inverse dissociation].

Foix-Chavany-Marie Syndrome or anterior opercular syndrome constitutes the cortical form of pseudobulbar palsy. Its most common etiology is stroke in the region of either operculum. Clinically it can be characterized by severe dysarthria and facio-pharyngo-glosso-masticatory dysplasia with automatic-voluntary dissociation. An inversion of this classical dissociation can be seen in patients with emotional paralysis in the face, in whom asymmetry of emotional expression but conservation of voluntary movement can be seen. The lesional topography of this inverse dissociation corresponds to the supplementary motor area. both processes support the existence of an anatomical base which is different for emotional movements and voluntary types. We describe the clinical case of a 65 year old woman with a history of breast cancer who presented a subacute and progressive clinical picture of dysphagia and severe dysarthria. Upon neurological examination slight velo-palato-pharyngea was noticed; most relevant was paralysis of the facial muscles for either emotional or automatic movements while voluntary innervation was maintained. Neuroradiological studies show the presence of brain metastasis located in both Roland opercula. Although the neuroanatomic bases for automatic-voluntary dissociation remain unclear, our case lends weight to the evidence that impulses for voluntary and emotional movements originate in different cortical areas or else take a different route through the brain. We have been unable to find any cases of biopercular lesion with inverse dissociation described in the literature we reviewed.

Aged↗
PubMed1993

Botulinum toxin for the treatment of hyperfunctional lines of the face.

OBJECTIVE: To determine the effectiveness of botulinum toxin injections for the management of hyperfunctional facial lines in patients with dystonia. DESIGN: Twenty-six patients were included in the study: 24 patients had dystonic movement of the face as either a primary or secondary component, and two patients were treated for purely hyperfunctional lines. Botulinum toxin type A was injected via a monopolar hollow-bore Teflon-coated electromyography needle into the facial muscles associated with the hyperfunctional lines. Doses were divided into 1.25- to 10-U aliquots. Qualitative assessments by the patient and physician were made before injection and 2 to 3 weeks after injection. PATIENTS: Twenty-six patients (two male and 24 female) with hyperfunctional lines were included. The ages were from 32 to 84 years with an average age of 59 years. Twenty had dystonia, four had hemifacial spasm, and two had pure hyperfunction without neuromuscular disease. RESULTS: All of the patients had an effect of toxin within the first 24 to 72 hours. All of the patients experienced benefit from the toxin injections with partial or total resolution of painful contractions or unsightly hyperfunctional lines and spasms. The effects of the injection lasted 3 to 6 months. No systemic side effects were noted. Adverse effects included mild, temporary eyelid or lip weakness. CONCLUSION: Based on this initial pilot study, botulinum toxin may be an important new option for the treatment of patients with hyperfunctional facial lines.

Adult↗
PubMed1985

[Studies on the occupational maladjustment syndrome (Part 2). In reference to relationship between psychophysiological characters and clinical features].

In a previous report (Natsume et al., Jpn. J. Ind. Health, Vol. 24) on the occupational maladjustment syndrome (O.M.A.S.), on the basis of clinical data, we classified patients with O.M.A.S. into 5 subcategories; core, drop-out, transient reaction, special job maladjustment and other. The core and drop-out types are typical of O.M.A.S. In order to test our hypothesis regarding the clinical and psychophysiological character of patients with O.M.A.S., 39 subjects (25 core type and 14 drop-out type) were studied by polygraphic techniques such as EEG, EMG of facial muscles and electrooculogram, and the results were compared with those of 16 normal subjects. We were specifically interested in their behavior in mental arithmetic and at rest. The results are summarized as follows: At rest, less frequent irregular rapid eye movement (especially "r-type") and smaller amplitudes of the corrugator supercilii muscle characterized the patients compared to the normals. During mental arithmetic these two indicators showed a greater tendency to increase in the core type than in the normals, but they remained unchanged in the drop-out group. In the core type subjects, the increased levels in these indicators persisted briefly after the arithmetic sessions. We discuss the relationship between the clinical character of the two types and the above results. We consider that the psychophysiological character of the two types may play an important role in the pathogenetic mechanism of O.M.A.S.

Adjustment Disorders↗
PubMed1991

AAEM minimonograph #37: facial and limb myokymia.

Myokymia is a clinical phenomenon associated with characteristic electromyographic activity referred to as myokymic discharges. These are spontaneously generated bursts of individual motor unit potentials with each burst recurring rhythmically or semirhythmically, usually several times per second. It involves facial muscles more commonly than those of the extremities, and is most often seen in association with Guillain-Barré syndrome, multiple sclerosis, radiation plexopathy, pontine tumors, and timber rattlesnake envenomation. An alteration in the biochemical microenvironment of axon membranes at one of the various sites along the motor axon is the likely basis for the altered membrane excitability that underlies the myokymic discharges in most cases. The similarity of these discharges to those seen with hypocalcemic tetany, and the ability to manipulate myokymic discharges by altering serum-ionized Ca++, suggests that decrease in the ionized Ca++ in the microenvironment of the axon may play an important role.

Electromyography↗
PubMed2006

Muzzle of South American Pleistocene ground sloths (Xenarthra, Tardigrada).

Sloths are among the most characteristic elements of the Cainozoic of South America and are represented, during the Pleistocene, by approximately nine genera of gigantic ground sloths (Megatheriidae and Mylodontidae). A few contributions have described their masticatory apparatus, but almost no attention has been paid to the reconstruction of the muzzle, an important feature to consider in relation to food intake, and particularly relevant in sloths because of the edentulous nature of the muzzle and its varied morphology. The relationship between dietary habits and shape and width of the muzzle is well documented in living herbivores and has been considered an important feature for the inference of alimentary styles in fossils, providing an interesting methodological tool that deserves to be considered for xenarthrans. The goal of this study was to examine models of food intake by reconstructing the appearance and shape of the muzzle in five species of Pleistocene ground sloths (Megatherium americanum, Glossotherium robustum, Lestodon armatus, Mylodon darwini, and Scelidotherium leptocephalum) using reconstructions of the nasal cartilages and facial muscles involved in food intake. The preservation of the nasal septum, and the scars for muscular attachment in the rostral part of the skulls, allow making a conservative reconstruction of muzzle anatomy in fossil sloths. Wide-muzzled ground sloths (Glossotherium and Lestodon) had a square, nonprehensile upper lip and were mostly bulk-feeders. The lips, coupled with the tongue, were used to pull out grass and herbaceous plants. Narrow-muzzled sloths (Mylodon, Scelidotherium, and Megatherium) had a cone-shaped and prehensile lip and were mixed or selective feeders. The prehensile lip was used to select particular plants or plant parts.

Animals↗
PubMed1999

Diminished facial expression despite the existence of pleasant emotional experience in schizophrenia.

In order to investigate the relationship between pleasant emotional experience and facial expression (i.e., laughter), mood before and after watching comic film clips, self-rated pleasant emotional experience for each film clip and electromyographic activities of facial muscles involved in laughter while watching film clips were measured for 25 patients with schizophrenia and 20 normal controls. Patients with schizophrenia who showed a significant correlation between self-rated emotional experience and major zygomatic activity were equivalent to normal controls in self-rated emotional experience and in mood after film clips; they had a significant increase in mood scores related with pleasure. Although these patients were thought to have sufficient pleasant emotional experience, they showed significantly low major zygomatic activity as compared to normal controls. It is suggested that these patients have a disturbance in the process of emotional expression rather than emotional experience.

Adult↗
PubMedDate not supplied

[Motor representation of the facial musculature in the rabbit neocortex].

Motor responses (MRs) of single vibrissae and facial muscles in alert rabbits to intracortical microstimulation (ICMS) were observed visually and recorded by means of photodiodes. Moderate ICMS evoked only contralateral MRs of long caudal vibrissae; however motor responses of short rostral vibrissae, rostral part of the upper lip and lower jaw were often bilateral. Two levels of low-threshold ICMS were revealed in the cortical layers: at the depth of 0,6-1,0 mm and of 1,4-1,8 mm. Motor representation of vibrissae occupies a large territory within the frontal cortex, 1,5-3,5 mm laterally from the sagittal suture and 0-10 mm rostrally from bregma. Lip and jaw representations are located laterally from the vibrissal field, with some overlapping.

Animals↗
PubMed1992

Serum and erythrocyte magnesium concentrations and migraine.

Most people suffering from migraine present a hypersensitivity of the cervico-facial muscles, which may be linked to magnesium deficit. This paper describes a comparative study of serum and erythrocyte magnesium levels in 79 migraine patients and 55 controls. Serum magnesium did not differ significantly in either group, but some values were quite low. On the other hand, there was a significantly greater erythrocyte magnesium deficit in persons suffering from migraine than in controls (in both female and male subjects). This fact correlates with the improved state of migraine patients (already ascertained in earlier studies) following treatment consisting of the intake of magnesium-rich water. The findings support the hypothesis of a magnesium deficit in people suffering from migraine and raise the problem of the relationship between migraine and other pathologies, including chronic magnesium deficit, latent tetany due to magnesium deficit, mitral valve prolapse, and allergy.

Adolescent↗
PubMed2002

Pericranial muscular, respiratory, and heart rate components of the orienting response.

We have earlier found that voluntary attention to weak auditory stimuli induces inhibition of respiration, heart rate, and electromyographic (EMG) activity of masticatory and lower facial muscles and that these responses lower the auditory threshold for low-frequency sounds. In the current study, we examined whether this inhibitory response pattern also occurs during involuntary orienting to novel, nonsignal sounds. Environmental sounds of low intensity were presented unexpectedly during the performance of a reading task. Orienting responses (ORs) were elicited as indicated by heart rate deceleration and skin conductance responses. Inhibitory respiratory and pericranial EMG responses appeared to be intrinsic components of the OR. Together with the autonomic responses, they habituated when a nonsignal auditory stimulus was repeatedly presented. Our results also suggest that eye and pinna movements occurred toward the sound source. The results of the current study are consistent with the hypothesis of Sokolov (1963) that the primary function of the OR is enhancement of sensory sensitivity.

Acoustic Stimulation↗
PubMed2001

Intracortical inhibition and facilitation in human facial motor area: difference between upper and lower facial area.

OBJECTIVE: To investigate the intracortical inhibitory and excitatory systems in the motor cortical representation of upper and lower facial muscles. METHODS: Paired-pulse transcranial magnetic stimulation (TMS) was applied to 7 healthy volunteers, with the interstimulus interval (ISI) between the conditioning stimulus (CS) and test stimulus, varied from 1 to 20 ms. CS was set at 90% of motor threshold. Muscle evoked potentials (MEPs) were recorded from first dorsal interosseus (FDI), orbicularis oculi (o. oculi) and mentalis muscles. RESULT: TMS evoked MEPs in o. oculi on both ipsi- and contralateral sides in all subjects. In the paired-pulse study, MEP amplitude in the mentalis decreased at short ISIs of 1-3 ms, followed by increases at 12-20 ms. These effects were similar to those in the FDI. O. oculi did not show a distinct inhibitory period at short ISIs and facilitation at long ISIs was detected but was significantly less than in FDI and mentalis. In o. oculi, there was no significant difference between the effects of ipsilateral and contralateral CS on the MEPs. CONCLUSION: The bi-hemispheric control of volitional movement and the modulation from brainstem projections appear to markedly influence intracortical inhibitory and excitatory systems in the motor cortical representation of o. oculi.

Adult↗