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Departments of Neurology (Dr Hopf), Neuroradiology (Dr. Müller-Forell), and Neurosurgery (Dr. N.J. Hopf), University of Mainz, Mainz, Germany.
Emotional facial paresis is characterized by impaired activation of face muscles with emotion but normal voluntary activation. We report seven patients with this sign. Their lesions involved the frontal lobe white matter, the striatocapsular territory, the anterolateral thalamus and insula, the posterior thalamus and operculum, and the mesial temporal lobe and insula each in one patient, and the posterior thalamus in two patients. Volitional facial paresis affects facial movements with voluntary effort, sparing activation on emotion. We report four such patients, with lesions involving the motor cortex in one and the pyramidal tract in the cerebral hemisphere in three.
Address correspondence and reprint requests to Dr. Hanns C. Hopf, Neurologische Klinik, Universität Mainz, Langenbeckstrasse 1, D–6500 Mainz, Germany.
Received December 4, 1991. Accepted for publication in final form March 25, 1992.
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