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：
10.1080/000164802320401694
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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
客观 - 哥本哈根面部神经研究旨在解释特发性外周面神经麻痹的自发过程，该过程无需任何治疗而发生。在这项研究中，贝尔的麻痹和特发性麻痹被认为是同义词，并指定了未知病因的急性，单次，单方面的外周面部护理。材料和方法包括2,570例在25年期间研究的外周外神经瘫痪病例。它包括1个，701例贝尔的麻痹和869例非贝尔麻痹。在总患者样本中，有116个疱疹带状疱疹，76例糖尿病患者，46例怀孕，有169名是新生儿。总共观察到38种不同的病因。在第一次咨询中，进行了标准的测试，包括对麻痹的等级和定位，口味，stapedius反射和鼻腔反射测试以及声学 - 视觉检查的透彻描述。在第一个月每周进行一次随访，随后每月进行一次，直到正常功能恢复或最多1年。回报 - 初步检查显示30％不完整，而70％的完全麻痹。随访表明，在85％的患者功能中，在3周内返回了3-5个月后其余15％的功能。在71％的患者中，获得了正常的模仿功能。 peelae的患者的后遗症轻微，轻度为13％，重度为4％。在17％和16％的患者中发现了缔合和相关运动。判断A的文献调查表明，包括泼尼松在内的任何治疗方法都无法提供更好的预后。泼尼松的使用引起了一个大的道德问题，因为没有证据表明其功效，欣快的副作用会引起患者的错误感。
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.