一例被击倒致左枕顶部钝伤患者,曾有短暂的意识丧失,并发生左面瘫和血鼓室,原误诊为左颞骨骨折合并面神经损伤,实系面神经核上病变——右侧盖综合征(opercular syndrome)。该综合征可在对侧额叶受损时发生。盖(operculum)是指覆盖在脑岛(insula Rei-lii)的大脑皮层,可因外伤、血管病、新生物、脑炎而发生病变,是一种皮层型的假性球麻痹,表现为面、舌的随意活动受损,而不随意活动(如呵欠、欢笑)存在甚而加强,如本例就有自左侧鼻唇沟开始,扩及左侧整个面部、嚼肌、颞肌、胸锁乳突肌和左臂上部肌肉不自主阵挛性发 One case was knocked down to the left pillow at the top of patients with blunt trauma, there was a temporary loss of consciousness, and left facial paralysis and hemorrhage, originally misdiagnosed as left temporal bone fracture with facial nerve injury, the real facial nerve nucleus lesions - right cover syndrome (opercular syndrome). This syndrome can occur when the contralateral frontal lobe is damaged. Operculum refers to the cerebral cortex that covers the insula rei-lii and may be affected by trauma, vascular disease, neoplasm, and encephalitis. It is a cortical pseudobulbar palsy characterized by a face , Tongue free activity is impaired, but not random activities (such as yawning, laughter) there is even strengthened, as in this case there from the left nasolabial fold, spread to the left side of the entire face, chewing muscle, temporal muscle, chest lock Mastoid muscle and upper left arm muscular involuntary clonic hair