Benatar Michael, Edlow Jonathan
Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass., USA.
Arch Intern Med. 2004 Nov 22;164(21):2383-5. doi: 10.1001/archinte.164.21.2383.
There is controversy regarding whether, and how frequently, other cranial nerve deficits accompany Bell's palsy. We sought to determine prospectively the presence of signs indicating an associated cranial neuropathy in patients with Bell's palsy.
All subjects presenting to an emergency department with Bell's palsy over a 2-year period were evaluated. The study included 51 consecutive patients. One patient with Bell's palsy was not examined by a neurologist at the time of presentation and was excluded. The main outcome measure was presence of other cranial nerve deficits.
We identified 4 patients with additional cranial neuropathies (contralateral trigeminal [n=1], glossopharyngeal [n=2], and hypoglossal [n=1]). We also identified 13 patients with ipsilateral facial sensory loss, suggesting an ipsilateral trigeminal neuropathy; 3 patients with a contralateral facial palsy; and 3 patients with hearing impairment.
This prospective study indicates that a small percentage (approximately 8%) of patients with otherwise typical Bell's palsy may harbor additional cranial neuropathies.
关于贝尔麻痹是否伴有其他颅神经缺损以及其发生频率存在争议。我们试图前瞻性地确定贝尔麻痹患者中是否存在提示合并颅神经病变的体征。
对在两年期间因贝尔麻痹就诊于急诊科的所有受试者进行评估。该研究纳入了51例连续患者。1例贝尔麻痹患者在就诊时未接受神经科医生检查，被排除在外。主要观察指标是是否存在其他颅神经缺损。
我们发现4例患者合并有其他颅神经病变（对侧三叉神经病变[n = 1]、舌咽神经病变[n = 2]和舌下神经病变[n = 1]）。我们还发现13例患者存在同侧面部感觉丧失，提示同侧三叉神经病变；3例患者出现对侧面瘫；3例患者有听力障碍。
这项前瞻性研究表明，在其他方面表现典型的贝尔麻痹患者中，一小部分（约8%）可能合并有其他颅神经病变。
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