Eidlitz-Markus T, Gilai A, Mimouni M, Shuper A
Day Care Unit, Schneider Children's Medical Centre of Israel, Petah Tiqva.
Eur J Pediatr. 2001 Nov;160(11):659-63. doi: 10.1007/s004310100836.
The aim of the study was to investigate the clinical presentation and prognosis of recurrent facial nerve palsy (RFNP) in children. The files of 182 patients referred to the Schneider Children's Medical Centre of Israel for neurological evaluation of isolated peripheral facial nerve palsy between October 1992 and December 1998 were reviewed. RFNP was found in 11 patients (9 females, 2 males), with an incidence of 6%. In two males, the aetiology was traced to Melkersson-Rosenthal syndrome and these patients were separated from the rest of the group. Three children had two episodes of facial nerve paresis which completely resolved clinically within several weeks. Six other children underwent electrophysiological studies. Two of the latter with residual neurological damage, and one child with abnormal blink reflex only, showed decreased facial nerve conduction velocity and abnormal blink reflex. Three children with complete recovery had disturbed blink reflex only with normal nerve conduction. Brain imaging studies as well as laboratory work-up were non-contributory in all cases.
The frequency of recurrent facial nerve palsy in children was similar to that in adults. The most significant factors in the evaluation of recurrent facial nerve palsy are medical history and physical findings at diagnosis and after short follow-up. In our patients, electrophysiological studies did not have either clinical or prognostic significance. The rate of full clinical recovery is about 70%, lower than in Bell palsy.
本研究的目的是调查儿童复发性面神经麻痹（RFNP）的临床表现和预后。回顾了1992年10月至1998年12月间转诊至以色列施耐德儿童医学中心进行孤立性周围性面神经麻痹神经学评估的182例患者的病历。11例患者（9例女性，2例男性）被发现患有RFNP，发病率为6%。2例男性患者的病因可追溯至梅尔克森-罗森塔尔综合征，这两名患者被从该组其他患者中分离出来。3名儿童有两次面神经麻痹发作，临床症状在数周内完全缓解。另外6名儿童接受了电生理研究。其中2例有残留神经损伤，1例仅有异常眨眼反射，显示面神经传导速度降低和眨眼反射异常。3例完全恢复的儿童仅有眨眼反射异常而神经传导正常。所有病例的脑成像研究和实验室检查均无诊断价值。
儿童复发性面神经麻痹的发生率与成人相似。评估复发性面神经麻痹最重要的因素是诊断时和短期随访后的病史及体格检查结果。在我们的患者中，电生理研究没有临床或预后意义。临床完全恢复率约为70%，低于贝尔麻痹。
