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== introducción ==
== Introduction ==
Antes de llegar al meollo de la discusión sobre la patología de nuestra paciente Mary Poppins, quien por los capítulos anteriores parece tener un tipo neuromotor, en concreto un “espasmo hemimasticatorio”, debemos centrarnos en algunos puntos fundamentales que nos ayudarán a comprender la importancia de la digresión de los capítulos y al mismo tiempo entender mejor la esencia del proceso de decodificación de la señal neurológica ya mencionada varias veces.  
Before getting to the heart of the discussion regarding the pathology of our patient Mary Poppins, which from the previous chapters seems to be of a neuromotor type, in particular a 'Hemimasticatory Spasm', we should focus on some fundamental points that will help us to understand the importance of the ''excursus'' of the chapters and at the same time to better understand the essence of the decryption process of the neurological signal, already mentioned several times.  


Comenzamos diciendo que no es tan complejo hacer un diagnóstico de 'Espasmo Hemimasticatorio', es hacer un diagnóstico diferencial entre Espasmo Hemimasticatorio y Hemifacial porque no depende solo de las nerviosas involucradas, sino que más aún lo es de comprender la naturaleza de la enfermedad Abs abordar , posteriormente, una terapia adecuada.
Let's start by saying that it is not so complex to make a diagnosis of 'Hemimasticatory Spasm', it is to make a differential diagnosis between Hemimasticatory and Hemifacial Spasm because it does not depend only on the nervous districts involved, but even more it is to understand the nature of the disease to address, subsequently, adequate therapy.


En primer lugar, debemos considerar los trastornos del movimiento, que pueden definirse como movimientos involuntarios o anormales inducidos por un traumatismo en los nervios o raíces craneales o periféricos..<ref>{{cita libro  
We should, first of all, consider movement disorders which can be defined as involuntary or abnormal movements triggered by trauma to the nerves or cranial or peripheral roots.<ref>{{cita libro  
  | autore = Jankovic J
  | autore = Jankovic J
  | titolo = Peripherally induced movement disorders
  | titolo = Peripherally induced movement disorders
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  | LCCN =  
  | LCCN =  
  | OCLC =  
  | OCLC =  
  }}</ref> Por lo tanto, es contextual considerar movimientos involuntarios, incluidos los espasmos, también patologías del sistema nervioso central y del sistema nervioso periférico. En un estudio de Seung Hwan Lee et al. Se incluyeron dos schwannomas vestibulares, cinco meningiomas y dos tumores epidermoides. El espasmo hemifacial ocurrió en el mismo lado de la lesión en ocho pacientes, mientras que ocurrió en el lado opuesto de la lesión en un paciente. En cuanto a la patogenia de los espasmos hemifaciales, se encontró compromiso vascular en seis pacientes, en un paciente el tumor afectó el revestimiento del nervio facial, en un paciente el tumor hipervascular y en un paciente compresión del nervio facial sin daño a los vasos. Enorme tumor que comprime el tronco encefálico y, por lo tanto, afecta el nervio facial contralateral en otro paciente. El espasmo hemifacial se resolvió en siete pacientes, mientras que en dos pacientes con schwannoma vestibular y tumor epidermoide mejoró transitoriamente y luego reapareció después de un mes.   
  }}</ref> From this it is contextual to consider involuntary movements including spasms also pathologies of the Central Nervous System as well as the peripheral one. In a study by Seung Hwan Lee et al.<ref>{{cita libro
| autore = Lee SH
| autore2 = Rhee BA
| autore3 = Choi SK
| autore4 = Koh JS
| autore5 = Lim YJ
| titolo = Cerebellopontine angle tumors causing hemifacial spasm: types, incidence, and mechanism in nine reported cases and literature review
| url = https://pubmed.ncbi.nlm.nih.gov/20845049/
| volume =
| opera = Acta Neurochir (Wien)
| anno = 2010
| editore =
| città =
| ISBN =
| DOI = 10.1007/s00701-010-0796-1
| PMID = 20845049
| PMCID =
| oaf = <!-- qualsiasi valore -->
| LCCN =
| OCLC =
}}</ref> two vestibular schwannomas, five meningiomas and two epidermoid tumors were included. Hemifacial spasm occurred on the same side of the lesion in eight patients while it occurred on the opposite side of the lesion in one patient. Regarding the pathogenesis of hemifacial spasms, in six patients the vessels were found to be involved, in one patient the tumor involved the facial nerve lining, compression of the facial nerve hypervascular tumor without damage to the vessels in one patient and a huge tumor which compressed the brainstem thus involving the contralateral facial nerve in another patient. Hemifacial spasm resolved in seven patients, while in two patients with vestibular schwannoma and epidermoid tumor they improved transiently and then recurred at one month.   


<blockquote>Por lo tanto, se deben considerar las causas contributivas de tipo intracraneal central que podrían ser una causa contributiva de los espasmos faciales y/o masticatorios, como los casos de schwannoma vestibular y tumores epidermoides.   
<blockquote>Therefore, the contributing causes of the central intracranial type should be kept in mind, which could be a contributory cause of facial and / or masticatory spasm, for example, cases of vestibular schwannoma and epidermoid tumors.   


</blockquote>
</blockquote>

Latest revision as of 11:38, 1 May 2023

Introduction

Before getting to the heart of the discussion regarding the pathology of our patient Mary Poppins, which from the previous chapters seems to be of a neuromotor type, in particular a 'Hemimasticatory Spasm', we should focus on some fundamental points that will help us to understand the importance of the excursus of the chapters and at the same time to better understand the essence of the decryption process of the neurological signal, already mentioned several times.

Let's start by saying that it is not so complex to make a diagnosis of 'Hemimasticatory Spasm', it is to make a differential diagnosis between Hemimasticatory and Hemifacial Spasm because it does not depend only on the nervous districts involved, but even more it is to understand the nature of the disease to address, subsequently, adequate therapy.

We should, first of all, consider movement disorders which can be defined as involuntary or abnormal movements triggered by trauma to the nerves or cranial or peripheral roots.[1] From this it is contextual to consider involuntary movements including spasms also pathologies of the Central Nervous System as well as the peripheral one. In a study by Seung Hwan Lee et al.[2] two vestibular schwannomas, five meningiomas and two epidermoid tumors were included. Hemifacial spasm occurred on the same side of the lesion in eight patients while it occurred on the opposite side of the lesion in one patient. Regarding the pathogenesis of hemifacial spasms, in six patients the vessels were found to be involved, in one patient the tumor involved the facial nerve lining, compression of the facial nerve hypervascular tumor without damage to the vessels in one patient and a huge tumor which compressed the brainstem thus involving the contralateral facial nerve in another patient. Hemifacial spasm resolved in seven patients, while in two patients with vestibular schwannoma and epidermoid tumor they improved transiently and then recurred at one month.

Therefore, the contributing causes of the central intracranial type should be kept in mind, which could be a contributory cause of facial and / or masticatory spasm, for example, cases of vestibular schwannoma and epidermoid tumors.