The Experts below are selected from a list of 225 Experts worldwide ranked by ideXlab platform
Eduardo Fernandez - One of the best experts on this subject based on the ideXlab platform.
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Quantitative, morphological, and somatotopic nuclear changes after facial nerve regeneration in adult rats: A possible challenge to the “no new neurons” dogma
Neurosurgery, 1995Co-Authors: Eduardo Fernandez, Roberto Pallini, Liverana Lauretti, Enrico Marchese, Frank La MarcaAbstract:The anatomic reorganization of the subnucleus that controls the Stylohyoid Muscle (the Stylohyoid subnucleus) within the brain stem facial nucleus was studied after regeneration of the facial nerve in adult rats. Horseradish peroxidase was injected into the right Stylohyoid Muscle 3 to 21 months after transection and repair of the right facial nerve at the level of the stylomastoid foramen. Position, number, and soma diameter of retrogradely horseradish peroxidase-labeled motoneurons were established, as well as the rostro-caudal extension of the Stylohyoid subnucleus. In experimental rats, the Stylohyoid subnucleus showed either an ipsilateral (50% of the rats) or a bilateral representation. In all of the experimental rats, the motoneurons composing the Stylohyoid subnucleus had a more dispersed horizontal distribution pattern when compared with controls. More than 80% of the motoneurons were located outside the borders of the normal Stylohyoid subnucleus, either ventrally or, especially in the rostral sections, dorsally closer to the floor of the fourth ventricle. The mean rostro-caudal length of the Stylohyoid subnucleus was 2028.6 +/- 152.7 microns. The mean motoneuron number was 481.4 +/- 109.5 (2.20-fold greater than control values), and the motoneuron diameter distribution ranged from 7 to 43 microns. This study demonstrates that after regeneration of the facial nerve in adult rats, major changes occur in both the location and number of motoneurons that make up the Stylohyoid subnucleus.(ABSTRACT TRUNCATED AT 250 WORDS)
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Somatotopic Changes of the Stylohyoid Muscle Subnucleus After Section and Repair of the Facial Nerve
The Facial Nerve, 1994Co-Authors: Roberto Pallini, Eduardo Fernandez, Liverana Lauretti, Enrico MarcheseAbstract:Peripheral nerve injury induces a series of changes along the circuit levels of the involved nerve, from the cortex to the periphery. Functional regeneration should be influenced by these changes. In the present work, the rat facial nerve was sectioned and repaired at the stylomastoid for-amen. From 3 to 21 monts after surgery, the somatotopic rearrangement of the motor facial nucleus was studied. Horseradish peroxidase (HRP) was injected in the isolated Stylohyoid Muscle to retrogradely label the parent motoneuron pool in the brain stem. The most important findings can be summarized as follows: (1) the volume of the subnucleus was markedly increased after regeneration because of the more dispersed motoneuron pattern as compared to the intact controls; (2) more than 80% of the HRP-labeled motoneurons were located outside the borders of the control Stylohyoid subnucleus overlying the other subnucleus either in the main nucleus of the facial nerve and dorsally to the main nucleus or outside the borders of the accessory nucleus of the facial nerve; (3) the Stylohyoid Muscle subnucleus showed a bilateral somatotopic representation in 50% of the operated animals because of HRP-labeled motoneurons in the contralateral facial nerve nucleus; (4) the number of HRP-labeled motoneurons was increased twofold with respect to the intact controls; (5) the mean soma diameter of motoneurons was similar in both the operated and intact control rats. This study provides original information on the plastic changes which occur in the Stylohyoid Muscle subucleus following regeneration of the facial nerve. These data provide the basis for comparative anatomofunctional studies.
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Reconstruction of peripheral nerves: the phenomenon of bilateral reinnervation of Muscles originally innervated by unilateral motoneurons.
Neurosurgery, 1992Co-Authors: Eduardo Fernandez, Roberto Pallini, Liverana Lauretti, Enrico Marchese, Vincenzo Bozzini, Alessandro SbriccoliAbstract:It is well known that after reconstruction of sectioned peripheral nerves in adult mammals, denervated Muscles are reinnervated by the axotomized motoneurons lying in the original motonucleus. It is less well known that these Muscles can also be reinnervated by uninjured motoneurons lying in the homologous contralateral motonucleus. Therefore, after nerve reconstruction, bilateral motoneuron reinnervation of Muscles can occur. Contralateral motoneurons sprout axons that cross the midline, grow in the reconstructed nerve, and reach Muscle targets. This phenomenon was observed after reconstruction of several different peripheral nerves in adult mammals, including the oculomotor nerve in guinea pigs and the facial and sciatic nerves in rats. The retrograde axonal transport of horseradish peroxidase was used for the study of the organization of the brainstem and spinal cord motonuclei. Horseradish peroxidase was injected into the medial rectus Muscle, the Stylohyoid Muscle, and the trunk of the sciatic nerve. The distance between the homologous motonuclei of both sides influenced the occurrence of this phenomenon. In fact, bilateral reinnervation of Muscles after nerve reconstruction was found in 36% (sciatic nerve), 50% (facial nerve), and 100% (oculomotor nerve) of the operated animals. The total number of contralateral motoneurons found were 14% (oculomotor nerve), 8% (facial nerve), and 5% (sciatic nerve). Bilateral reinnervation of Muscles was evoked by both immediate and delayed peripheral nerve repair and was a stable phenomenon, seen between 3 and 21 months after facial nerve reconstruction.
Enrico Marchese - One of the best experts on this subject based on the ideXlab platform.
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Quantitative, morphological, and somatotopic nuclear changes after facial nerve regeneration in adult rats: A possible challenge to the “no new neurons” dogma
Neurosurgery, 1995Co-Authors: Eduardo Fernandez, Roberto Pallini, Liverana Lauretti, Enrico Marchese, Frank La MarcaAbstract:The anatomic reorganization of the subnucleus that controls the Stylohyoid Muscle (the Stylohyoid subnucleus) within the brain stem facial nucleus was studied after regeneration of the facial nerve in adult rats. Horseradish peroxidase was injected into the right Stylohyoid Muscle 3 to 21 months after transection and repair of the right facial nerve at the level of the stylomastoid foramen. Position, number, and soma diameter of retrogradely horseradish peroxidase-labeled motoneurons were established, as well as the rostro-caudal extension of the Stylohyoid subnucleus. In experimental rats, the Stylohyoid subnucleus showed either an ipsilateral (50% of the rats) or a bilateral representation. In all of the experimental rats, the motoneurons composing the Stylohyoid subnucleus had a more dispersed horizontal distribution pattern when compared with controls. More than 80% of the motoneurons were located outside the borders of the normal Stylohyoid subnucleus, either ventrally or, especially in the rostral sections, dorsally closer to the floor of the fourth ventricle. The mean rostro-caudal length of the Stylohyoid subnucleus was 2028.6 +/- 152.7 microns. The mean motoneuron number was 481.4 +/- 109.5 (2.20-fold greater than control values), and the motoneuron diameter distribution ranged from 7 to 43 microns. This study demonstrates that after regeneration of the facial nerve in adult rats, major changes occur in both the location and number of motoneurons that make up the Stylohyoid subnucleus.(ABSTRACT TRUNCATED AT 250 WORDS)
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Somatotopic Changes of the Stylohyoid Muscle Subnucleus After Section and Repair of the Facial Nerve
The Facial Nerve, 1994Co-Authors: Roberto Pallini, Eduardo Fernandez, Liverana Lauretti, Enrico MarcheseAbstract:Peripheral nerve injury induces a series of changes along the circuit levels of the involved nerve, from the cortex to the periphery. Functional regeneration should be influenced by these changes. In the present work, the rat facial nerve was sectioned and repaired at the stylomastoid for-amen. From 3 to 21 monts after surgery, the somatotopic rearrangement of the motor facial nucleus was studied. Horseradish peroxidase (HRP) was injected in the isolated Stylohyoid Muscle to retrogradely label the parent motoneuron pool in the brain stem. The most important findings can be summarized as follows: (1) the volume of the subnucleus was markedly increased after regeneration because of the more dispersed motoneuron pattern as compared to the intact controls; (2) more than 80% of the HRP-labeled motoneurons were located outside the borders of the control Stylohyoid subnucleus overlying the other subnucleus either in the main nucleus of the facial nerve and dorsally to the main nucleus or outside the borders of the accessory nucleus of the facial nerve; (3) the Stylohyoid Muscle subnucleus showed a bilateral somatotopic representation in 50% of the operated animals because of HRP-labeled motoneurons in the contralateral facial nerve nucleus; (4) the number of HRP-labeled motoneurons was increased twofold with respect to the intact controls; (5) the mean soma diameter of motoneurons was similar in both the operated and intact control rats. This study provides original information on the plastic changes which occur in the Stylohyoid Muscle subucleus following regeneration of the facial nerve. These data provide the basis for comparative anatomofunctional studies.
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Reconstruction of peripheral nerves: the phenomenon of bilateral reinnervation of Muscles originally innervated by unilateral motoneurons.
Neurosurgery, 1992Co-Authors: Eduardo Fernandez, Roberto Pallini, Liverana Lauretti, Enrico Marchese, Vincenzo Bozzini, Alessandro SbriccoliAbstract:It is well known that after reconstruction of sectioned peripheral nerves in adult mammals, denervated Muscles are reinnervated by the axotomized motoneurons lying in the original motonucleus. It is less well known that these Muscles can also be reinnervated by uninjured motoneurons lying in the homologous contralateral motonucleus. Therefore, after nerve reconstruction, bilateral motoneuron reinnervation of Muscles can occur. Contralateral motoneurons sprout axons that cross the midline, grow in the reconstructed nerve, and reach Muscle targets. This phenomenon was observed after reconstruction of several different peripheral nerves in adult mammals, including the oculomotor nerve in guinea pigs and the facial and sciatic nerves in rats. The retrograde axonal transport of horseradish peroxidase was used for the study of the organization of the brainstem and spinal cord motonuclei. Horseradish peroxidase was injected into the medial rectus Muscle, the Stylohyoid Muscle, and the trunk of the sciatic nerve. The distance between the homologous motonuclei of both sides influenced the occurrence of this phenomenon. In fact, bilateral reinnervation of Muscles after nerve reconstruction was found in 36% (sciatic nerve), 50% (facial nerve), and 100% (oculomotor nerve) of the operated animals. The total number of contralateral motoneurons found were 14% (oculomotor nerve), 8% (facial nerve), and 5% (sciatic nerve). Bilateral reinnervation of Muscles was evoked by both immediate and delayed peripheral nerve repair and was a stable phenomenon, seen between 3 and 21 months after facial nerve reconstruction.
Roberto Pallini - One of the best experts on this subject based on the ideXlab platform.
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Quantitative, morphological, and somatotopic nuclear changes after facial nerve regeneration in adult rats: A possible challenge to the “no new neurons” dogma
Neurosurgery, 1995Co-Authors: Eduardo Fernandez, Roberto Pallini, Liverana Lauretti, Enrico Marchese, Frank La MarcaAbstract:The anatomic reorganization of the subnucleus that controls the Stylohyoid Muscle (the Stylohyoid subnucleus) within the brain stem facial nucleus was studied after regeneration of the facial nerve in adult rats. Horseradish peroxidase was injected into the right Stylohyoid Muscle 3 to 21 months after transection and repair of the right facial nerve at the level of the stylomastoid foramen. Position, number, and soma diameter of retrogradely horseradish peroxidase-labeled motoneurons were established, as well as the rostro-caudal extension of the Stylohyoid subnucleus. In experimental rats, the Stylohyoid subnucleus showed either an ipsilateral (50% of the rats) or a bilateral representation. In all of the experimental rats, the motoneurons composing the Stylohyoid subnucleus had a more dispersed horizontal distribution pattern when compared with controls. More than 80% of the motoneurons were located outside the borders of the normal Stylohyoid subnucleus, either ventrally or, especially in the rostral sections, dorsally closer to the floor of the fourth ventricle. The mean rostro-caudal length of the Stylohyoid subnucleus was 2028.6 +/- 152.7 microns. The mean motoneuron number was 481.4 +/- 109.5 (2.20-fold greater than control values), and the motoneuron diameter distribution ranged from 7 to 43 microns. This study demonstrates that after regeneration of the facial nerve in adult rats, major changes occur in both the location and number of motoneurons that make up the Stylohyoid subnucleus.(ABSTRACT TRUNCATED AT 250 WORDS)
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Somatotopic Changes of the Stylohyoid Muscle Subnucleus After Section and Repair of the Facial Nerve
The Facial Nerve, 1994Co-Authors: Roberto Pallini, Eduardo Fernandez, Liverana Lauretti, Enrico MarcheseAbstract:Peripheral nerve injury induces a series of changes along the circuit levels of the involved nerve, from the cortex to the periphery. Functional regeneration should be influenced by these changes. In the present work, the rat facial nerve was sectioned and repaired at the stylomastoid for-amen. From 3 to 21 monts after surgery, the somatotopic rearrangement of the motor facial nucleus was studied. Horseradish peroxidase (HRP) was injected in the isolated Stylohyoid Muscle to retrogradely label the parent motoneuron pool in the brain stem. The most important findings can be summarized as follows: (1) the volume of the subnucleus was markedly increased after regeneration because of the more dispersed motoneuron pattern as compared to the intact controls; (2) more than 80% of the HRP-labeled motoneurons were located outside the borders of the control Stylohyoid subnucleus overlying the other subnucleus either in the main nucleus of the facial nerve and dorsally to the main nucleus or outside the borders of the accessory nucleus of the facial nerve; (3) the Stylohyoid Muscle subnucleus showed a bilateral somatotopic representation in 50% of the operated animals because of HRP-labeled motoneurons in the contralateral facial nerve nucleus; (4) the number of HRP-labeled motoneurons was increased twofold with respect to the intact controls; (5) the mean soma diameter of motoneurons was similar in both the operated and intact control rats. This study provides original information on the plastic changes which occur in the Stylohyoid Muscle subucleus following regeneration of the facial nerve. These data provide the basis for comparative anatomofunctional studies.
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Reconstruction of peripheral nerves: the phenomenon of bilateral reinnervation of Muscles originally innervated by unilateral motoneurons.
Neurosurgery, 1992Co-Authors: Eduardo Fernandez, Roberto Pallini, Liverana Lauretti, Enrico Marchese, Vincenzo Bozzini, Alessandro SbriccoliAbstract:It is well known that after reconstruction of sectioned peripheral nerves in adult mammals, denervated Muscles are reinnervated by the axotomized motoneurons lying in the original motonucleus. It is less well known that these Muscles can also be reinnervated by uninjured motoneurons lying in the homologous contralateral motonucleus. Therefore, after nerve reconstruction, bilateral motoneuron reinnervation of Muscles can occur. Contralateral motoneurons sprout axons that cross the midline, grow in the reconstructed nerve, and reach Muscle targets. This phenomenon was observed after reconstruction of several different peripheral nerves in adult mammals, including the oculomotor nerve in guinea pigs and the facial and sciatic nerves in rats. The retrograde axonal transport of horseradish peroxidase was used for the study of the organization of the brainstem and spinal cord motonuclei. Horseradish peroxidase was injected into the medial rectus Muscle, the Stylohyoid Muscle, and the trunk of the sciatic nerve. The distance between the homologous motonuclei of both sides influenced the occurrence of this phenomenon. In fact, bilateral reinnervation of Muscles after nerve reconstruction was found in 36% (sciatic nerve), 50% (facial nerve), and 100% (oculomotor nerve) of the operated animals. The total number of contralateral motoneurons found were 14% (oculomotor nerve), 8% (facial nerve), and 5% (sciatic nerve). Bilateral reinnervation of Muscles was evoked by both immediate and delayed peripheral nerve repair and was a stable phenomenon, seen between 3 and 21 months after facial nerve reconstruction.
Liverana Lauretti - One of the best experts on this subject based on the ideXlab platform.
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Quantitative, morphological, and somatotopic nuclear changes after facial nerve regeneration in adult rats: A possible challenge to the “no new neurons” dogma
Neurosurgery, 1995Co-Authors: Eduardo Fernandez, Roberto Pallini, Liverana Lauretti, Enrico Marchese, Frank La MarcaAbstract:The anatomic reorganization of the subnucleus that controls the Stylohyoid Muscle (the Stylohyoid subnucleus) within the brain stem facial nucleus was studied after regeneration of the facial nerve in adult rats. Horseradish peroxidase was injected into the right Stylohyoid Muscle 3 to 21 months after transection and repair of the right facial nerve at the level of the stylomastoid foramen. Position, number, and soma diameter of retrogradely horseradish peroxidase-labeled motoneurons were established, as well as the rostro-caudal extension of the Stylohyoid subnucleus. In experimental rats, the Stylohyoid subnucleus showed either an ipsilateral (50% of the rats) or a bilateral representation. In all of the experimental rats, the motoneurons composing the Stylohyoid subnucleus had a more dispersed horizontal distribution pattern when compared with controls. More than 80% of the motoneurons were located outside the borders of the normal Stylohyoid subnucleus, either ventrally or, especially in the rostral sections, dorsally closer to the floor of the fourth ventricle. The mean rostro-caudal length of the Stylohyoid subnucleus was 2028.6 +/- 152.7 microns. The mean motoneuron number was 481.4 +/- 109.5 (2.20-fold greater than control values), and the motoneuron diameter distribution ranged from 7 to 43 microns. This study demonstrates that after regeneration of the facial nerve in adult rats, major changes occur in both the location and number of motoneurons that make up the Stylohyoid subnucleus.(ABSTRACT TRUNCATED AT 250 WORDS)
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Somatotopic Changes of the Stylohyoid Muscle Subnucleus After Section and Repair of the Facial Nerve
The Facial Nerve, 1994Co-Authors: Roberto Pallini, Eduardo Fernandez, Liverana Lauretti, Enrico MarcheseAbstract:Peripheral nerve injury induces a series of changes along the circuit levels of the involved nerve, from the cortex to the periphery. Functional regeneration should be influenced by these changes. In the present work, the rat facial nerve was sectioned and repaired at the stylomastoid for-amen. From 3 to 21 monts after surgery, the somatotopic rearrangement of the motor facial nucleus was studied. Horseradish peroxidase (HRP) was injected in the isolated Stylohyoid Muscle to retrogradely label the parent motoneuron pool in the brain stem. The most important findings can be summarized as follows: (1) the volume of the subnucleus was markedly increased after regeneration because of the more dispersed motoneuron pattern as compared to the intact controls; (2) more than 80% of the HRP-labeled motoneurons were located outside the borders of the control Stylohyoid subnucleus overlying the other subnucleus either in the main nucleus of the facial nerve and dorsally to the main nucleus or outside the borders of the accessory nucleus of the facial nerve; (3) the Stylohyoid Muscle subnucleus showed a bilateral somatotopic representation in 50% of the operated animals because of HRP-labeled motoneurons in the contralateral facial nerve nucleus; (4) the number of HRP-labeled motoneurons was increased twofold with respect to the intact controls; (5) the mean soma diameter of motoneurons was similar in both the operated and intact control rats. This study provides original information on the plastic changes which occur in the Stylohyoid Muscle subucleus following regeneration of the facial nerve. These data provide the basis for comparative anatomofunctional studies.
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Reconstruction of peripheral nerves: the phenomenon of bilateral reinnervation of Muscles originally innervated by unilateral motoneurons.
Neurosurgery, 1992Co-Authors: Eduardo Fernandez, Roberto Pallini, Liverana Lauretti, Enrico Marchese, Vincenzo Bozzini, Alessandro SbriccoliAbstract:It is well known that after reconstruction of sectioned peripheral nerves in adult mammals, denervated Muscles are reinnervated by the axotomized motoneurons lying in the original motonucleus. It is less well known that these Muscles can also be reinnervated by uninjured motoneurons lying in the homologous contralateral motonucleus. Therefore, after nerve reconstruction, bilateral motoneuron reinnervation of Muscles can occur. Contralateral motoneurons sprout axons that cross the midline, grow in the reconstructed nerve, and reach Muscle targets. This phenomenon was observed after reconstruction of several different peripheral nerves in adult mammals, including the oculomotor nerve in guinea pigs and the facial and sciatic nerves in rats. The retrograde axonal transport of horseradish peroxidase was used for the study of the organization of the brainstem and spinal cord motonuclei. Horseradish peroxidase was injected into the medial rectus Muscle, the Stylohyoid Muscle, and the trunk of the sciatic nerve. The distance between the homologous motonuclei of both sides influenced the occurrence of this phenomenon. In fact, bilateral reinnervation of Muscles after nerve reconstruction was found in 36% (sciatic nerve), 50% (facial nerve), and 100% (oculomotor nerve) of the operated animals. The total number of contralateral motoneurons found were 14% (oculomotor nerve), 8% (facial nerve), and 5% (sciatic nerve). Bilateral reinnervation of Muscles was evoked by both immediate and delayed peripheral nerve repair and was a stable phenomenon, seen between 3 and 21 months after facial nerve reconstruction.
Fernandez E. - One of the best experts on this subject based on the ideXlab platform.
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Quantitative, morphological, and somatotopic nuclear changes after facial nerve regeneration in adult rats: A possible challenge to the “no new neurons” dogma
'Ovid Technologies (Wolters Kluwer Health)', 1995Co-Authors: Fernandez E., Pallini R., Marchese E., Lauretti L., La Marca F.Abstract:THE ANATOMIC REORGANIZATION of the subnucleus that controls the Stylohyoid Muscle (the Stylohyoid subnucleus) within the brain stem facial nucleus was studied after regeneration of the facial nerve in adult rats. Horseradish peroxidase was injected into the right Stylohyoid Muscle 3 to 21 months after transection and repair of the right facial nerve at the level of the stylomastoid foramen. Position, number, and soma diameter of retrogradely horseradish peroxidase-labeled motoneurons were established, as well as the rostro-caudal extension of the Stylohyoid subnucleus. In experimental rats, the Stylohyoid subnucleus showed either an ipsilateral (50% of the rats) or a bilateral representation. In all of the experimental rats, the motoneurons composing the Stylohyoid subnucleus had a more dispersed horizontal distribution pattern when compared with controls. More than 80% of the motoneurons were located outside the borders of the normal Stylohyoid subnucleus, either ventrally or, especially in the rostral sections, dorsally closer to the floor of the fourth ventricle. The mean rostro-caudal length of the Stylohyoid subnucleus was 2028.6 \ub1 152.7 \u3bcm. The mean motoneuron number was 481.4 \ub1 109.5 (2.20-fold greater than control values), and the motoneuron diameter distribution ranged from 7 to 43 \u3bcm. This study demonstrates that after regeneration of the facial nerve in adult rats, major changes occur in both the location and number of motoneurons that make up the Stylohyoid subnucleus. The increase in the number of motoneurons, the location of the many cells in brain stem areas that normally do not contain motoneurons for facial Muscles, and the appearance of contralateral motoneurons are unexplained. One possible mechanism is new cell proliferation, migration, and differentiation in the central nervous system. This, rather than activation of adjacent \u201cdormant\u201d neurons, could explain both the significant increase in the number of motoneurons in the Stylohyoid subnucleus after facial nerve regeneration and the new somatotopic configuration of the subnucleus itself. Copyright \ua9 by the Congress of Neurological Surgeons
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Reconstruction of peripheral nerves: The phenomenon of bilateral reinnervation of Muscles originally innervated by unilateral motoneurons
'Ovid Technologies (Wolters Kluwer Health)', 1992Co-Authors: Fernandez E., Pallini R., Marchese E., Lauretti L., Sbriccoli A.Abstract:It is well known that after reconstruction of sectioned peripheral nerves in adult mammals, denervated Muscles are reinnervated by the axotomized motoneurons lying in the original motonucleus. It is less well known that these Muscles can also be reinnervated by uninjured motoneurons lying in the homologous contralateral motonucleus. Therefore, after nerve reconstruction, bilateral motoneuron reinnervation of Muscles can occur. Contralateral motoneurons sprout axons that cross the midline, grow in the reconstructed nerve, and reach Muscle targets. This phenomenon was observed after reconstruction of several different peripheral nerves in adult mammals, including the oculomotor nerve in guinea pigs and the facial and sciatic nerves in rats. The retrograde axonal transport of horseradish peroxidase was used for the study of the organization of the brainstem and spinal cord motonuclei. Horseradish peroxidase was injected into the medial rectus Muscle, the Stylohyoid Muscle, and the trunk of the sciatic nerve. The distance between the homologous motonuclei of both sides influenced the occurrence of this phenomenon. In fact, bilateral reinnervation of Muscles after nerve reconstruction was found in 36% (sciatic nerve), 50% (facial nerve), and 100% (oculomotor nerve) of the operated animals. The total number of contralateral motoneurons found were 14% (oculomotor nerve), 8% (facial nerve), and 5% (sciatic nerve). Bilateral reinnervation of Muscles was evoked by both immediate and delayed peripheral nerve repair and was a stable phenomenon, seen between 3 and 21 months after facial nerve reconstruction. \ua9 by the Congress of Neurological Surgeons
