Bell's palsy: The spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies
Bell's palsy: The spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies
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DOI：
10.1080/000164802760370736
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发表时间：
2002-01-01
影响因子：
1.4
通讯作者：
Peitersen, E
中科院分区：
文献类型：
--
作者：
Peitersen, E
哥本哈根面神经研究的目的是解释自发性周围性面神经麻痹的过程中发生的任何治疗。在这项研究中，贝尔麻痹和特发性麻痹被认为是同义词，并指定一个急性的，单一症状，单侧周围性面瘫的病因不明。材料和方法，材料包括2,570例周围性面神经麻痹的研究期间为25年。其中包括1，701例贝尔麻痹病例和869例非贝尔麻痹病例。在所有患者样本中，116例患有带状疱疹，76例患有糖尿病，46例妊娠，169例为新生儿。共观察到38种不同的病因。在第一次会诊时，进行了标准的耳鼻喉科检查，包括对轻瘫、味觉、镫骨肌反射和鼻泪反射测试的等级和定位的全面描述和声前庭检查。在第一个月内每周进行一次随访，随后每月进行一次，直到恢复正常功能或长达1 year.Results-The初步检查显示30%不完全和70%完全麻痹。随访显示，85%的患者在3周内恢复功能，其余15%在3-5个月后恢复功能。71%的患者获得了正常的模仿功能。12%的患者有轻微后遗症，13%的患者有轻度后遗症，4%的患者有重度后遗症。挛缩和相关的运动被发现在17%和16%的patients.Conclusion-A调查的文献表明，没有一种治疗，包括强的松，能够得到更好的预后。强的松的使用引起了一个很大的伦理问题，因为没有证据表明它的疗效，而且欣快的副作用会使患者产生一种虚假的获益感。
Objective-The Copenhagen Facial Nerve Study aims to explain the spontaneous course of idiopathic peripheral facial nerve palsy which occurs without any kind of treatment. In this study Bell's palsy and idiopathic palsy are considered to be synonymous and specify an acute, monosymptomatic, unilateral peripheral facial paresis of unknown etiology.Material and methods-The material includes 2,570 cases of peripheral facial nerve palsy studied during a period of 25 years. It includes 1, 701 cases of Bell's palsy and 869 of non-Bell's palsy. In the total patient sample, 116 had herpes zoster, 76 were diabetic, 46 were pregnant and 169 were neonates. A total of 38 different etiologies were observed. At the first consultation a standard ENT examination was performed, including a thorough description of the grade and localization of the paresis, taste, stapedius reflex and nasolacrimal reflex tests and acoustic-vestibular examination. Follow-up was done once a week during the first month and subsequently once a month until normal function was restored or for up to 1 year.Results-The initial examination revealed 30% incomplete and 70% complete palsies. Follow-up showed that in 85% of patients function was returned within 3 weeks and in the remaining 15% after 3-5 months. In 71% of patients normal mimical function was obtained. Sequelae were slight in 12% of patients, mild in 13% and severe in 4%. Contracture and associated movements were found in 17% and 16% of patients, respectively.Conclusion-A survey of the literature showed that no kind of treatment, including prednisone, was able to give a better prognosis. The use of prednisone raises a big ethical problem because no evidence of its efficacy exists and the euphoric side-effect induces a false feeling of benefit in the patients.