颅神经英文对照cranialnerve

颅神经英文对照cranialnerve 颅神经英文对照cranialnerve;cranialnerves;cranialneural，颅神经又称“脑神经”。属周围神经，从脑内发出的左右成对的神经。人的12对脑神经是嗅神经、视神经、动眼神经、滑车神经、三叉神经、外展神经、面神经、听神经、舌咽神经、迷走神经、脊髓副神经和舌下神经。这些神经的分布限于头部和颈部,但迷走神经例外，其分布扩展至胸腔和腹腔的内脏器官。 编辑摘要 目录[隐藏 ] 1 组成 2 三叉神经定位 3 病变 4 症状 5 病因 6 嗅神经损害 7 视神经损害 8 动眼神经损害 9 三叉神经损害 10 面神经损害 颅神经 - 组成 十二对颅神经 人体共有十二对颅神经: 第一对叫做嗅神经，主要负责鼻子的嗅觉. 第二对叫做视神经，主管眼睛的视物功能. 第三对动眼神经，主管眼球向上、向下向内等方向的运动和上睑上提及瞳孔的缩小. 第四对滑车神经，主管眼球向外下方的运动. 第六对外展神经，主管眼球向外方向的运动。 第五对三叉神经， 此神经分为两部分，较大的一部分负责面部的痛、温、触等感觉;较小的一部分主管吃东西时的咀嚼动作。 大的感觉神经又分为三支: 第一支叫做眼支，主要负责眼裂以上之皮肤、粘膜的感觉，如额部皮肤、睑结膜、角膜等处的感觉。 第二支叫做上颌支、主管眼、口之间的皮肤、粘膜之感觉，如颊部、上颌部皮肤、鼻腔粘膜、口腔粘膜上部及上牙的感觉.。 第三支叫做下颌支，主管口以下的皮肤、粘膜之感觉，如下颌部皮肤、口腔粘膜下部及下牙的感觉。 第七对面神经，主管面部情肌的运动，此外还主管一部分唾液腺的分泌以及舌前三分之二的味觉感觉。 第八对颅神经，由两部分组成，一部分叫做听神经，主管耳对声音的感受.另一部分叫做前庭神经，其主要作用是保持人体的平衡。 第九对舌咽神经，主管咽喉部粘膜的感觉，一部分唾液腺的分泌和舌后三分之一的味觉，益与第十对迷走神经一起主管咽喉部肌肉的运动。 第十对迷走神经，除与第九对舌咽神经一起主管咽喉部肌肉的运动外，还负责心脏、血管、to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the 胃肠道平滑肌的运动。 第十一对副神经，主要负责转颈、耸肩等运动。 第十二对舌下神经，主管舌肌运动。 以上就是人体十二对颅神经的名称和它们的主要功能。当任何一个颅神经受到损伤时，就会表现出该神经支配区域的感觉或运动功能障碍，并表现出相应的临床症状。此外，还应强调一点，即十二对颅神经都是在人体最高司令部一一大脑的统一指挥下进行工作的，从而保证了它们的工作能各尽其能而又有条不紊。 颅神经 - 三叉神经定位 三叉神经 三叉神经为混合神经，也就是既含有运动神经又含有感觉神经。 感觉部分收集来自面部和头部的信息，运动部分则控制咀嚼肌。三叉神经是面部最粗大的神经，它的运动部分从脑桥与脑桥臂交界处出脑，再并入下颌神经，一同经卵圆孔穿出颅部。而它的感觉部分的胞体组成位于颞骨岩部尖端的三叉神经节，三叉神经节又分出三条分支(这也就是它叫三叉神经的原因)，第一分支为眼神经，第二分支为上颌神经，第三分支为下颌神经。 支配脸部、口腔、鼻腔的感觉和咀嚼肌的运动，并将头部的感觉讯息传送至大脑。 精细结构 第一分支眼神经 眼神经是三条分支中最小的一支，在三叉神经节处与上颌神经及下颌神经分开后，穿入海绵窦外侧壁，在动眼神经和滑车神经下方经眶上裂入进入眶部。眼神经又有三条分支:泪腺神经、额神经、鼻睫神经。 第二分支上颔神经 上颌神经从三叉神经节出发后同样进入海棉窦外侧，在圆孔处出颅后进入翼腭窝，经眶下裂进入入眶部，成为眶下神经。它的主要分支有眶下神经、回神经、翼腭神经、上牙槽神经。 第三分支下颔神经 下颌神经是三条分支中最粗大的分支，它还包括了三叉神经运动支。离开三叉神经节并从卵圆孔出颅后，它在翼外肌的深面分为前、后两条主干。除三叉神经运动支外，它包括的神经还有耳颞神经、颊神经、舌神经、下牙槽神经。 颅神经 - 病变 12对颅神经中除嗅、舌下神经外，其余10对神经均可受损，其中最常累及者为视神经、动眼神经及外展神经，一般为双侧对称性，也有单侧性，表现为视力障碍、复视等症状。 眼底检查呈乳头炎或视神经乳头萎缩。当第?(动眼)神经累及时常影响交感神经而瞳孔调节失常，有痉挛性散瞳与对光反射消失，甚而发生阿罗瞳孔，上眼睑常下垂，眼球外斜。 颅神经 - 症状 颅神经症状:如视力下降、视物成双、眼睑下垂、眼球位置偏斜、面部麻木、口眼歪斜、口角流涎、听力下降、吞咽困难、饮水呛咳、发音异常等，为脑干、颅神经肿瘤及颅底邻近部位病变如动脉瘤、脑膜瘤、脊索瘤、颅咽管瘤、垂体瘤、神经鞘瘤等所致。 颅神经 - 病因 颅神经颅神经特发的病例常见，虽然有许多发生在老年人与糖尿病患者中的外展神经瘫痪可能是由小血管的病变所引起。在特发的病例中，不发生其他颅神经的障碍，而且应该在2个月出现病情的改善。有一个可以加以明确的病因，即外展神经在海绵窦内受到起源于鼻咽部的肿瘤的压迫。 典型地，还发生头部剧烈的疼痛以及三叉神经第一支分布区域内的感觉消失。任何可以引起to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the 脑移位的病变或因素都能引起对第6神经的牵引，因为它是以锐角的姿势进入Dorello管道的。 因此，远离外展神经的巨大脑瘤，颅内压的增高或腰穿都可能导致第6神经瘫痪。糖尿病性梗塞是较为常见的病因之一。其他的病因包括不足以引起颅底骨折的头部外伤，累及脑膜的感染或肿瘤，Wernicke脑病，动脉瘤以及多发性硬化。 在没有颅内压增高征象的儿童中，第6神经瘫痪可以由呼吸道感染引起，而且可以为复发性。完全性第6颅神经瘫痪的诊断很容易，但要确定其病因学则有一定的难度。 排除颅内高压与视乳头水肿(眼底检查时注意有无视网膜静脉搏动)很重要.MRI或CT有助于排除颅内占位性病变，脑积水以及眶内，海绵窦内以及颅底病变。腰穿可测定脑脊液的初压，可发现软脑膜炎症，感染，或癌肿浸润的线索。 对结缔组织血管病变的筛查有助于排除血管病变性过程。在许多病例中，一旦原发的疾病经过治疗以后第6神经的瘫痪亦缓解。 颅神经 - 嗅神经损害 嗅神经 真正的嗅神经很短，迄今尚无原发性嗅神经病的，常与其他颅神经疾病合并存在或继发于其他疾病，主要症状为嗅觉障碍。病因和机理 主要为传导嗅觉纤维被阻断所致。常见的致病原因为颅内血肿、前颅窝、鞍区与鞍旁肿瘤、外伤、颅内压增高症与脑积水、老年性嗅神经萎缩、各种中毒及感染等。某些颞叶癫痫及精神病医学教育网搜集整理。 嗅神经损害的主要表现为嗅觉减退、缺失、嗅幻觉与嗅觉过敏等。 鉴别诊断 一、嗅觉减退、缺失 (一)某些有关的病毒感染和慢性鼻炎 其所引起的嗅觉减退常有双侧鼻粘膜发炎和鼻腔阻塞，局部检查可有鼻粘膜充血、鼻甲肥大等。 (二)颅底肿瘤(tumorofthebastoftheskull) 以嗅沟脑膜瘤最为常见，病人常有慢性头痛与精神障碍。因嗅神经受压产生一侧或两侧嗅觉丧失。随着肿瘤的生长产生颅内高压症状，颅脑CT常能明确诊断。 (三)某些伴有痴呆的中枢神经病(早老性痴呆、柯萨可夫精神病、遗传性舞蹈病等) 可有嗅神经萎缩引起双侧嗅觉减退。此类病人常见于中老年病人，可有阳性家族史。颅脑CT、MRI常见脑萎缩等。 (四)颅脑损伤(craniocerebralinjury) 颅前窝骨折及额叶底面的脑挫裂伤及血肿，可引起嗅神经的撕裂与压迫而引起嗅觉丧失，根据明确的外伤史，头颅X光、CT等可明确诊断。 二、嗅幻觉 (一)颞叶癫痫(temporallobeepilepsy) 颞叶癫痫临床表现多种多样，钩回发作时表现嗅幻觉及梦样状态，病人可嗅到一种不愉快的难闻气味如腐烂食品、尸体、烧焦物品、化学品的气味，脑电图检查可见颞叶局灶性异常波。 (二)精神分裂症(schizophrenia) 在某些精神分裂症患者，嗅幻觉可作为一种症状或与其它幻觉和妄想结合在一起表现出来，精神检查多能明确诊断。 颅神经 - 视神经损害 视神经 视神经属于中枢性传导束，视神经损害系视神经传导通路内某种病因所致传导功能障碍的疾病。 to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the 病因和机理 引起视神经损害的病因甚多，常见的病因有外伤、缺血、中毒、脱髓鞘、肿瘤压迫、炎症、代谢、梅毒等。其共同的发病机理是引起视神经的传导功能障碍。 临床表现 1、视力障碍为最常见最主要的临床表现，初期常有眶后部疼痛与胀感、视物模糊，继之症状加重，表现视力明显降低或丧失。 2、视野缺损可分为两种:?双颞侧偏盲:如为肿瘤压迫所致两侧神经传导至鼻侧视网膜视觉的纤维受累时，不能接受双侧光刺激而出现双颞侧偏盲。肿瘤逐渐长大时，因一侧受压重而失去视觉功能则一侧全盲，另一侧为颞侧偏盲，最后两侧均呈全盲。?同向偏盲:视束或外侧膝状体以后通路的损害，可产生一侧鼻侧与另一侧颞侧视野缺损，称为同向偏盲。视束与中枢出现的偏盲不同，前者伴有对光反射消失，后者光反射存在;前者偏盲完整，而后者多不完整呈象限性偏盲;前者患者主观感觉症状较后者显著，后者多无自觉症状;后者视野中心视力保存在，呈黄斑回避现象。 鉴别诊断 一、视力减退或丧失 (一)颅脑损伤(craniocerebralinjury) 当颅底骨折经过蝶骨骨突或骨折片损伤颈内动脉时，可产生颈内动脉—海绵窦瘘，表现为头部或眶部连续性杂音，搏动性眼球突出，眼球运动受限和视力进行性减退等。根据有明确的外伤史，X光片有颅底骨折及脑血管造影检查临床诊断不难。 (二)视神经脊髓炎(opticnearomyelitis) 病前几天至两星期可有上呼吸道感染史。可首先从眼症状或脊髓症状开始，亦可两者同时发生，通常一眼首先受累，几小时至几星期后，另一眼亦发病。视力减退一般发展很快，有中心暗点，偶而发展为几乎完全失明。眼的病变可以是视神经乳头炎或球后视神经炎。如系前者即将出现视乳头水肿，如系后者则视乳头正常。 脊髓炎症状出现在眼部症状之后，首先症状多为背痛或肩痛，放射至上臂或胸部。随即出现下肢和腹部感觉异常，进行性下肢无力和尿潴留。最初虽然腱反射减弱，但跖反射仍为双侧伸性。感觉丧失异常上或至中胸段。周围血白细胞增多，血沉轻度增快。 (三)多发性硬化(multiplesclerosis) 多在20,40岁之间发病，临床表现形式多种多样，可以视力减退为首发，表现为单眼(有时双眼)视力减退。眼底检查可见视神经乳头炎改变。小脑征、锥体束征和后索功能损害都常见。深反射亢进、浅反射消失以及跖反射伸性。共济失调、构间障碍和意向性震颤三者同时出现时，即构成所谓夏科(charcot)三联征。本病病程典型者的缓解与复发交替发生。诱发电位、CT或MRI可发现一些尚无临床表现的脱髓鞘病灶，脑脊液免疫球蛋白增高，蛋白质定量正常上限或稍高。 (四)视神经炎(opticneuritis) 可分为视乳头炎与球后视神经炎两种。主要表现急速视力减退或失明，眼球疼痛，视野中出现中心暗点，生理盲点扩大，瞳孔扩大，直接光反应消失，交感光反应存在，多为单侧。视乳头炎具有视乳头改变，其边缘不清、色红、静脉充盈或纡曲，可有小片出血，视乳头高起显著。视乳头炎极似视乳头水肿，前者具有早期迅速视力减退、畏光、眼球疼痛、中心暗点及视乳头高起小于屈光度等特点，易与后者相鉴别。球后视神经炎与视乳头炎相似，但无视乳头改变。 (五)视神经萎缩(opticatrophy) 分为原发性与继发性两种。主要症状为视力减退，视乳头颜色变苍白与瞳孔对光反射消失。原发性视神经萎缩为视神经、视交叉或视束因肿瘤、炎症、损伤、中毒、血管疾病等原因而阻断视觉传导所致。继发性视神经萎缩为视乳头水肿，视乳头炎与球后视神经炎造成。 (六)急性缺血性视神经病(acuteischemicopticnearitis) 是指视神经梗塞所致的视力丧失，to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the 起病突然，视力减退常立即达到高峰。视力减退的程度决定于梗塞的分布。眼底检查可有视乳头水肿和视乳头周围线状出血。常继发于红细胞增多症、偏头痛、胃肠道大出血后，脑动脉炎及糖尿病，更多的是高血压和动脉硬化。根据原发疾病及急剧视力减退临床诊断较易。 (七)慢性酒精中毒(chronicalcoholism) 视力减退呈亚急性，同时伴有酒精中毒症状，如言语不清，行走不稳及共济运动障碍，严重时可出现酒精中毒性精神障碍。 (八)颅内肿瘤(见视野缺损) 二、视野缺损 (一)双颞侧偏盲 脑垂体瘤 1、脑垂体瘤(pituitaryadenoma) 早期垂体瘤常无视力视野障碍。如肿瘤长大，向上伸展压迫视交叉，则出现视野缺损，外上象限首先受影响，红视野最先表现出来。此时病人在路上行走时易碰撞路边行人或障碍物。以后病变增大、压迫较重，则白视野也受影响，渐至双颞侧偏盲。如果未及时治疗，视野缺损可再扩大，并且视力也有减退，以致全盲。垂体瘤除有视力视野改变外，最常见的为内分泌症状，如生长激素细胞发生腺瘤，临床表现为肢端肥大症，如果发生在青春期以前，可呈现巨人症。如催乳素细胞发生腺瘤，在女病人可出现闭经、泌乳、不育等。垂体瘤病人X光片多有蝶鞍扩大、鞍底破坏、头颅CT、MRI可见肿瘤生长，内分泌检查各种激素增高。 2、颅咽管瘤(craniopharyngioma)主要表现为儿童期生长发育迟缓、颅内压增高。当压迫视神经时出现视力视野障碍。由于肿瘤生长方向常不规律，压迫两侧视神经程度不同，故两侧视力减退程度多不相同。视野改变亦不一致，约半数表现为双颞侧偏盲，早期肿瘤向上压迫视交叉可表现为双颞上象限盲。肿瘤发生于鞍上向下压迫者可表现为双颞下象限盲。肿瘤偏一侧者可表现为单眼颞侧偏盲。颅骨平片有颅内钙化及CT、MRI检查和内分泌功能测定，临床多能明确诊断。 3、鞍结节脑膜瘤(tuberdeofsellaearachnoidfibroblastoma)临床表现以视力减退与头痛症状比较常见。视力障碍呈慢性进展。最先出现一侧视力下降或两侧不对称性的视力下降，同时出现一侧或两颞侧视野缺损，之后发展为双颞侧偏盲，最后可致失明。眼底有原发性视神经萎缩的征象。晚期病例引起颅内压增高症状。CT扫描，鞍结节脑膜瘤的典型征象是在鞍上区显示造影剂增强的团块影像。密度均匀一致。 (二)同向偏盲 视束及视放射的损害可引起两眼对侧视野的同向偏盲。多见于内囊区的梗塞及出血出现对侧同向偏盲、偏身感觉障碍和颞叶、顶叶肿瘤向内侧压迫视束及视放射而引起对侧同向偏盲。上述疾病多能根据临床表现及头颅CT检查明确诊断。 颅神经 - 动眼神经损害 动眼神经、滑车神经、外展神经损害 滑车神经 动眼、滑车和外展神经支配眼内外肌、和眼球运动，合称眼球运动神经，由于其解剖关系十分密切，并经常同时受累，故一并叙述。 病因和机理 常见的病因有动眼、滑车与外展神经本身炎症而致的麻痹，急性感染性多发性神经炎，继发于头面部急、慢性炎症而引起海绵窦血栓形成，眶上裂与眶尖综合征，颅内动脉瘤，颅内肿瘤，其它如结核、霉菌、梅毒与化脓性炎症引起的颅底脑膜炎等。由于病因不同，其发病机理亦各不相同，如肿瘤的直接压迫所致，原发性炎症时，动眼、滑车与外展神经纤维呈脱髓鞘改变等。 to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the 临床表现 1、动眼神经麻痹表现为上睑下垂，眼球外斜，向上外、上内、下内、同侧方向运动障碍，瞳孔散大，对光反应及调节反应消失，头向健侧歪斜。完全性瘫痪多为周围性，而不完全性多为核性。 2、滑车神经麻痹表现为眼球不能向下外方向运动，伴有复视，下楼时复视明显，致使下楼动作十分困难。头呈特殊位，呈下颏向下头面向健侧的姿势。 3、外展神经麻痹表现为眼内斜视，不能外展，并有复视。 鉴别诊断 一、动眼神经麻痹 (一)核性及束性麻痹 因动眼神经核在中脑占据的范围较大，故核性损害多引起不全麻痹，且多为两侧性，可见有神经梅毒，腊肠中毒及白喉等。束性损害多引起一侧动眼神经麻痹，表现为同侧瞳孔扩大，调节机能丧失及睑下垂，眼球被外直肌及上斜肌拉向外侧并稍向下方。 1、脑干肿瘤(tumorsofthebrainstem):特征的临床表现为出现交叉性麻痹，即病变节段同侧的核及核下性颅神经损害及节段下对侧的锥体束征。颅神经症状因病变节段水平和范围不同而异。如中脑病变多表现为病变侧动眼神经麻痹，桥脑病变可表现为病变侧眼球外展及面神经麻痹，同侧面部感觉障碍以及听觉障碍。延髓病变可出现病变侧舌肌麻痹、咽喉麻痹、舌后1/3味觉消失等。脑干诱发电位、CT、MRI可明确诊断。 2、脑干损伤(injuryofthebrainstem):多有明确的外伤史,伤后长时间的昏迷,且有眼球运动障碍等,诊断不难。 3、颅底骨折(fractureofthebaseoftheskull):颅脑外伤后可损伤颈内动脉，产生颈内动脉—海绵窦瘘出现眼球运动受限和视力减退，同时可有头部或眶部连续性杂音，搏动性眼球突出。 (二)周围性麻痹 1、颅底动脉瘤(aneurysmofthebaseoftheskull):动眼神经麻痹单独出现时，常见于颅底动脉瘤而罕见于其他肿瘤。本病多见于青壮年，多有慢性头痛及蛛网膜下腔出血病史，亦可以单独的动眼神经麻痹出现。脑血管造影多能明确诊断。 2、颅内占位性病变(intracranialspaceoccupyinglesion):在颅脑损伤颅内压增高及脑肿瘤晚期，一般皆表示已发生小脑幕切迹疝。表现为病侧瞳孔扩大及光反应消失，对侧肢体可出现瘫痪，继之对侧瞳孔也出现扩大，同时伴有意识障碍。根据病史及头颅CT检查多能明确诊断。 3、海绵窦血栓形成及窦内动脉瘤(carernoussinasthoomlosisandintercavernoussinasaneurysm):可表现为海绵窦综合征，除了动眼神经瘫痪外，还有三叉神经第一支损害，眶内软组织，上下眼睑、球结膜、额部头皮及鼻根部充血水肿，眼球突出或视乳头水肿，炎症所致者常伴有全身感染症状，结合眶部X线片及腰椎穿刺及血常规检查可明确诊断。 脑膜炎 4、眶上裂与眶尖综合征(superiororbitalfissureandorbitalapexsyndrome):前者具有动眼、滑车、外展神经与三叉神经第一支功能障碍，后者除此3对颅神经损害外，常伴有视力障碍，结合眶部视神经孔X线片，血液化验、眶部CT等多能明确诊断。 5、脑膜炎(cephalitismeningitis):脑膜炎引起的动眼神经损害多为双侧性，且多与滑车、外展神经同时受累。脑脊液检查细胞数、蛋白定量增高。 二、滑车神经麻痹 滑车神经麻痹很少单独出现，多与其他2对颅神经同时受累。滑车神经麻痹时，如不进行复视检查则不易识别。其鉴别诊断参见动眼神经麻痹。 三、外展神经麻痹 to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the (一)桥脑出血及肿瘤(pontinehaemonhageandtumour) 因与面神经在桥脑中关系密切，这两个神经的核性或束性麻痹常同时存在，表现为病侧外展及面神经的麻痹和对侧偏瘫，称为Millard-Gubler氏征群。起病常较突然并迅速昏迷，双瞳孔针尖样改变。根据临床表现结合CT、MRI检查诊断不难确立。 (二)岩尖综合征(radenigo’ssyndrome) 急性中耳炎的岩骨尖部局限性炎症及岩骨尖脑膜瘤可引起外展神经麻痹，并伴有听力减退及三叉神经分布区的疼痛，称为Gradenigo氏征群;X线摄片可发现该处骨质破坏或炎症性改变。结合病史及CT检查可确立诊断。 (三)鼻咽癌(nasopharyngedcarcinoma)外展神经在颅底前部被侵犯的原因以鼻咽癌最为多见，其次为海绵窦内动脉瘤及眶上裂区肿瘤。中年病人出现单独的外展神经麻痹或同时有海绵窦征群的其它表现时，应首先考虑鼻咽癌的存在。常伴有鼻衄、鼻塞，可出现颈淋巴结肿大，作鼻咽部检查、活检、颅底X线检查可确诊。 颅神经 - 三叉神经损害 三叉神经 在三叉神经损害的疾病中，以三叉神经痛为常见，单独三叉神经破坏性损害少见，多同时伴有其他颅神经受累。 病因和机理 1、三叉神经痛:可分为原发与继发性两种。继发性的三叉神经痛的病因有异位动脉或静脉、动静脉畸形、动脉瘤对三叉神经根的压迫、扭转，桥小脑角或半月节部位的肿瘤，蛛网膜炎所致的粘连、增厚、颅骨肿瘤、转移癌等。 、三叉神经麻痹:三叉神经麻痹可由脑干、颅底或颅外病变引起。如脑干肿瘤、三叉神经节2 的带状疱疹等。 由于病因不同，其发病机理亦不同。炎症所致者，三叉神经纤维有炎细胞浸润、脱髓鞘改变等;良性肿瘤者，瘤细胞分化成熟，肿瘤压迫三叉神经纤维，使纤维变性;恶性肿瘤转移至三叉神经，造成三叉神经纤维破坏性改变。 临床表现 1、三叉神经痛:特别是面部三叉神经分布区的阵发性放射性疼痛，性质剧烈，呈针刺、刀割、烧灼、撕裂样，持续数秒至1,2分钟，突发突停，每次疼痛情况相同。疼痛可由口、舌的运动或外来的刺激引起，如说话、吃饭、刷牙、洗脸、甚至眨眼、打呵欠，其它如受震动、风吹等。疼痛发作常有一触发点或称扳机点，多在上、下唇部、鼻翼、口角、颊部和舌等处，稍加以触动即引起疼痛发作。疼痛发作时伴有同侧眼或双眼流泪及流涎。偶有面部表情出现不能控制的抽搐，称为“痛性抽搐”。起初每次疼痛发作时间较短，发作间隔时间较长，以后疼痛时间渐加长面间隔时间缩短，以致终日不止。 2、三叉神经麻痹:主要表现为咀嚼肌瘫痪，受累的肌肉可萎缩。咀嚼肌力弱，患者常述咬食无力，咀嚼困难，张口时下颌向患侧偏斜。有时伴有三叉神经分布区的感觉障碍及同侧角膜反射的减弱与消失。 鉴别诊断 一、三叉神经痛 (一)三叉神经炎(trigeminalneuritis) 病程短，疼痛呈持续性，三叉神经分布区感觉过敏或减退，可伴有运动障碍，在受累的三叉神经分支有明显的压痛。神经炎多在感冒或副鼻窦炎后发病。 (二)小脑桥脑角肿瘤(cerebellopontineangletumours) 疼痛发作可与三叉神经痛相同或不典型，但多见于30岁以下年青人，多有三叉神经分布区感觉减退，并可逐渐产生小脑桥脑角其它症状和体征。以胆脂瘤多见，脑膜瘤、听神经瘤等次之，后两者其它颅神经受累，to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the 共济失调及颅内压增高表现较明显。X线片、特殊造影、CT等可协助确诊。 (三)颅底转移癌(metastaticcarcinomaofbeaeofskull)最常见为鼻咽癌，常伴有鼻衄、鼻塞，可出现多数颅神经麻痹，颈部淋巴结肿大，作咽部检查、活检、颅底X线检查可确诊。 (四)三叉神经半月节肿瘤(trigeminalgangliontumours) 可见神经节细胞瘤，脊索瘤等，可有持续性疼痛，患者三叉神经感觉，运动障碍明显。颅底X线可能有骨质破坏等改变。二、三叉神经麻痹单独出现较少，常与三叉神经疼痛(继发性三叉神经痛)同时出现。关于三叉神经麻痹的鉴别诊断参见三叉神经痛。 颅神经 - 面神经损害 面神经 面神经由支配面部表现肌的运动纤维和中间神经两部分组成。中间神经由感觉和副交感纤维组成。面部经损害的部位可在脑干内、颅底、面神经管及其远端。因展神经核及脑桥侧视中枢与面神经核相邻。故涉及面神经的脑干病变常伴有眼外展或侧视麻痹组成的交叉性瘫痪。面神经损害主要表现为面神经周围性瘫痪或面肌痉挛。 病因和机理 面神经损害的病因常见有，急性非化脓性面神经炎、带状疱疹、外伤、肿瘤、血管病、传染性单核细胞增多症、梅毒与中耳炎及血管畸形、血管扭转压迫等。其发病机理与病因有密切的关系，面神经炎的发病机理是由于神经干纤维水肿、受压与缺血等，外伤、手术多为压迫和手术损伤所致。 临床表现 1、面神经麻痹:表现为病侧面部表情肌麻痹，额纹消失或表浅，不能皱额蹙眉，眼裂不能闭合或闭合不全,试闭眼时,瘫痪侧眼球向上方转动,露出白色巩膜，称贝耳现象。病侧鼻唇沟变浅，口角下垂，面颊部被牵向健侧，闭眼、露齿、鼓颊、吹口哨等动作失灵，或完全不能完成。因颊肌瘫痪而食物易滞留于病侧齿颊之间。泪点随下睑而外翻，使泪液不能正常吸收而致外溢。如侵及鼓束神经时，会出现舌前2/3味觉障碍。 2、面肌痉挛:面肌痉挛的患者多在中年以后发病，女性略多。多由一侧眼部开始，逐渐延及口及全部面肌，额肌较少受累，严重者可累及同侧颈阔肌。为阵发性、快速、不规律的抽搐。初起抽搐较轻持续几秒钟，以后逐渐延长可达5分钟或更长，而间隔时间逐渐缩短，抽搐逐渐严重。严重者呈强直性，致同侧眼不能睁开，口角向同侧严重歪斜，无法说话。神经系统检查无阳性体征。 鉴别诊断 一、面神经麻痹 (一)特发性面神经麻痹(idiopathicfacialpalsy) 又称贝耳(Bell)麻痹，指原因不明，急性发病的单侧周围性面神经麻痹。主要表现为单侧典型的面神经麻痹。病前有面耳部风吹受凉病史。根据急性起病及典型的临床表现，诊断常无困难。 (二)急性感染性多发性神经根炎(acuteinflammatorypolyradiculoneuritis) 又称格林—巴利(Guillain-Barre)综合征。常有面神经的损害致周围性面神经麻痹，此病具有四肢远端对称性瘫痪，并可波及躯干，严重病例可累及肋间及隔肋而致呼吸麻痹，感觉障碍呈手套袜子型。脑脊液典型改变是蛋白质含量增高，而细胞数正常，称蛋白—细胞分离现象。 (三)各种中耳炎、迷路炎、乳突炎等 可并发耳源性面神经麻痹，但多有原发病的症状与病史，如中耳炎或有耳痛，外耳道异常分泌物;迷路炎而出现迷路水肿致眩晕、呕吐等，乳突炎则出现局部的红、肿、热、痛改变。 (四)急性传染性单核细胞增多症(acuteinfectionslymphocytosis)除有面神经周围性麻痹外，to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the 还有全身症状如发热、乏力、厌食等，周围血单核细胞显著增多。 (五)颅脑外伤(craniocerebralinjury)颅脑外伤后颅骨骨折可致面神经麻痹，具有明确的外伤史，有面部表情肌瘫痪的特点，颅骨(或颅底)X线摄片可协助诊断。乳突根治术较易损伤面神经，根据手术情况即可明确诊断。 (六)肿瘤(tumors) 脑干与小脑桥脑角的肿瘤除有面部表情肌瘫痪外，主要有听神经损害或其它颅神经同时受累、小脑性共济失调与上发底视乳头水肿、及长束受累的症状及体征。脑干诱发电位、X线、CT扫描等检查，可协助诊断。 (七)脑膜炎(cerebralmeningitis) 大多起病缓慢，且具有其他颅神经受损，脑脊液检查多有阳性发现。 二、面肌痉挛 (一)面神经麻痹(facialparalysis) 多有周围性面神经麻痹病史，加上典型的临床表现，诊断不难。 (二)三叉神经痛(trigminalneuralgia) 部分三叉神经痛患者可引起反射性面肌抽搐，口角牵向患侧，并有面红、流泪和流涎，称痛性抽搐。根据典型三叉神经痛状易于鉴别。 (三)肿瘤与运动神经元病(tumourandmotorneurondisease) 小脑桥脑角肿瘤、面神经膜瘤、桥脑瘤、延髓空洞症、运动神经元病等均可引起面肌痉挛，多伴有其它颅神经或长束受累的症状与体征，必要时进行脑脊液、脑起声波、X线、XT、MRI扫描等检查，以协助诊断 to find solutions. Especially valuable is, these two missions took the city in Beijing, the considerable work in blue, from yinglaisongwang, provide services to invite businessmen and for major projects, micromanaging, hands-on, real offices full service, full service role. Hotel in Pingliang, Pingliang building and printingBrush factory service quality and service levels have also been further enhanced. Second, creatively work towards funding projects onto a new stage. The Beijing liaison office LAN from simple secure funding, and the shift to a more directly involved in the project, from the small projects to large projects to introduce change, strengthening project work. Liaison Office in Beijing, always put the report convergence and implementation, as reported to national construction projects, I work a top priority, take the initiative to strengthen contacts with national ministries and provincial authorities on contact and, from top to bottom convergence projects in advance, timely feedback on the city and the County (district). Liaison Office in Beijing this year, and cooperate with, or directly with item 8 of the interface implemented on the national, provincial, for State investment of nearly 20 million Yuan. The blue Office closely around the city's four pillar industries, large projects and more mature projects, brand focus and direction of the project as an investment. Grasp the