单词 | facial palsy |
释义 | facial palsyfacial palsyfacial palsypalsy[pawl´ze]fa·cial pa·ral·y·sisBell’s palsyAcute peripheral paralysis of the face due to a herpes simplex immune-mediated condition, often characterised by severe pain arising in the trigeminal nerve, the chief sensory nerve of the face, which arises in cranial nerve VII.Clinical findings Abrupt onset, drooping mouth, unblinking eye, twisted nose, uneven smile, distorted expressions; paralysis hits maximum in 1 to 14 days; retroauricular pain, facial numbness, epiphora, parageusia, decreased tearing, hyperacusis, hypoesthesia or dysesthesia of cranial nerves (CN V and IX), motor paresis of CN IX and X, papillitis of tongue. Epidemiology Risk of Bell’s palsy increases with age; age 10 to 19, 2:1 female:male ratio; age 40, 3:2 men:women ratio; pregnant women have 3.3 times increased risk than nonpregnant; DM = 4.5 times increased risk of BP; 10% of patients have positive family Hx of BP. DiffDx, unilateral Tumours or masses, otitis media, sarcoid, Lyme disease, skull fracture, facial injury. DiffDx, bilateral Guillain-Barré syndrome, Melkersson-Rosenthal syndrome, Möbius syndrome, motor neuron disease, myasthenia gravis. Aetiology Trauma, Bell’s palsy, stroke, parotid tumours, intracranial tumours. Management Microvascular and micro-neurosurgical tissue transfers allow restoration of functional, unconscious, symmetrical facial movements; acyclovir; steroids (uncertain efficacy); artificial tears; neuromuscular retraining—e.g., mirror/visual feedback, biofeedback or electromyography feedback. Prognosis 60 to 80% recover, especially if incomplete paralysis, and patient is young. facial palsyBell's palsy, cranial mononeuropathy VII, facial mononeuropathy, facial nerve palsy, facial neuralgia Neurology Acute peripheral paralysis of the face due to a herpes simplex immune-mediated condition often characterized by severe pain in the trigeminal nerve Epidemiology Risk of FP ↑ with age; age 10 to 19, 2:1, ♀:♂; age 40, 3:2, ♂:♀; pregnant ♀ have 3.3 times ↑ risk than nonpregnant; DM = 4.5 times↑ risk of FP; 10% of Pts have positive family Hx of FP Pathogenesis FP is due to reactivation of the virus leading to replication of virus within the ganglion cells; the virus travels down the axons, inducing inflammation Clinical Abrupt onset, drooping mouth, unblinking eye, twisted nose, uneven smile, distorted expressions; paralysis hits maximum in 1 to 14 days; retroauricular pain, facial numbness, epiphora, parageusia, ↓ tearing, hyperacusis, hypoesthesia or dysesthesia of cranial nerves–CN V and IX, motor paresis of CN IX and X, papillitis of tongue DiffDx, unilateral Tumors or masses, otitis media, sarcoid, Lyme disease, skull fracture, facial injury DiffDx, bilateral Guillain-Barré syndrome, Melkersson-Rosenthal syndrome, Möbius syndrome, motor neuron disease, myasthenia gravis Etiology Trauma, Bell's palsy, stroke, parotid tumors, intracranial tumors Management Microvascular and micro-neurosurgical tissue transfers allow restoration of functional, unconscious, symmetrical facial movements, acyclovir, steroids–efficacy is uncertain, artificial tears, neuromuscular retraining–eg, mirror/visual feedback, biofeedback or electromyography feedback Prognosis 60 to 80% recover, especially if incomplete paralysis, and Pt is youngfa·cial pa·ral·y·sis(fā'shăl păr-al'i-sis)See also: Bell palsy Synonym(s): facial palsy, facioplegia, prosopoplegia. facial palsySee BELL'S PALSY.fa·cial pa·ral·y·sis(fā'shăl păr-al'i-sis)Synonym(s): facial palsy, facioplegia. |
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