Brecheteau C, Laccourreye L, Gueden S, Breheret R
Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, centre hospitalier et universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, centre hospitalier et universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
Arch Pediatr. 2015 May;22(5):544-6. doi: 10.1016/j.arcped.2015.02.002. Epub 2015 Mar 24.
Approximately 40 cases of acute idiopathic velopharyngeal reversible paralysis in the pediatric population have been reported in the literature.
We present the case of a 12-year-old boy who had consulted in pediatric emergency departments for symptomatology including rhinolalia, nasal regurgitation, and deviation of the labial commissure. Paraclinical explorations helped diagnose rhombencephalitis with enterovirus. The introduction of oral corticosteroids was followed by rapid clinical improvement in 3 days. Monitoring 1 month later showed complete regression of symptoms.
Similar cases in the literature describe the occurrence of nasal regurgitation and rhinolalia, sometimes associated with other cranial nerve impairment. The pathogenesis is rarely highlighted and the imaging results are always normal. Ad integrum recovery with or without corticosteroids is the rule. In light of this literature review, it is possible to conclude that the occurrence of such a suggestive clinical picture should limit the often costly and unnecessary additional tests.
文献报道小儿群体中约有40例急性特发性腭咽可逆性麻痹病例。
我们报告一例12岁男孩的病例，该男孩因出现鼻音、鼻反流和口角偏斜等症状在儿科急诊科就诊。辅助检查有助于诊断肠道病毒所致的 rhombencephalitis。口服皮质类固醇后3天临床症状迅速改善。1个月后的监测显示症状完全消退。
文献中的类似病例描述了鼻反流和鼻音的出现，有时伴有其他颅神经损伤。发病机制很少被强调，影像学结果总是正常的。无论是否使用皮质类固醇，完全康复是常见情况。根据这篇文献综述，可以得出结论，出现这种提示性的临床症状应避免进行往往昂贵且不必要的额外检查。
