Cirpaciu D, Goanta C M, Cirpaciu M D
Alexandria County Emergency Hospital, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
J Med Life. 2014;7 Spec No. 3(Spec Iss 3):68-77.
Bell's palsy in known as the most common cause of facial paralysis, determined by the acute onset of lower motor neuron weakness of the facial nerve with no detectable cause. With a lifetime risk of 1 in 60 and an annual incidence of 11-40/100,000 population, the condition resolves completely in around 71% of the untreated cases. Clinical trials performed for Bell's palsy have reported some recurrences, ipsilateral or contralateral to the side affected in the primary episode of facial palsy. Only few data are found in the literature. Melkersson-Rosenthal is a rare neuromucocutaneous syndrome characterized by recurrent facial paralysis, fissured tongue (lingua plicata), orofacial edema.
We attempted to analyze some clinical and epidemiologic aspects of recurrent idiopathic palsy, and to develop relevant correlations between the existing data in literature and those obtained in this study.
METHODS & MATERIALS: This is a retrospective study carried out on a 10-years period for adults and a five-year period for children.
A number of 185 patients aged between 4 and 70 years old were analyzed. 136 of them were adults and 49 were children. 22 of 185 patients with Bell's palsy (12%) had a recurrent partial or complete facial paralysis with one to six episodes of palsy. From this group of 22 cases, 5 patients were diagnosed with Melkersson-Rosenthal syndrome. The patients' age was between 4 and 70 years old, with a medium age of 27,6 years. In the group studied, fifteen patients, meaning 68%, were women and seven were men. The majority of patients in our group with more than two facial palsy episodes had at least one episode on the contralateral side.
Our study found a significant incidence of recurrences of idiopathic facial palsy. Recurrent idiopathic facial palsy and Melkersson-Rosenthal syndrome is diagnosed more often in young females. Recurrence is more likely to occur in the first two years from the onset, which leads to the conclusion that we should have a follow up of patients diagnosed with Bell's palsy for at least two years from the onset, especially in children' case. The frequency of recurrent facial palsy in children was similar to that in adults. Recurrent idiopathic facial palsy is not known enough and needs further controlled studies.
贝尔麻痹是面瘫最常见的病因，其特征为面神经下运动神经元急性无力且无明显病因。终生患病风险为1/60，年发病率为11 - 40/10万人口，约71%的未治疗病例可完全康复。针对贝尔麻痹开展的临床试验报告了一些复发情况，复发可发生于面瘫首次发作侧的同侧或对侧。文献中相关数据较少。梅尔克森 - 罗森塔尔综合征是一种罕见的神经黏膜皮肤综合征，其特征为复发性面瘫、裂舌（皱襞舌）、口面部水肿。
我们试图分析复发性特发性面瘫的一些临床和流行病学特征，并在文献现有数据与本研究所得数据之间建立相关联系。
这是一项回顾性研究，对成年人进行了为期10年的研究，对儿童进行了为期5年的研究。
分析了185例年龄在4至70岁之间的患者。其中136例为成年人，49例为儿童。185例贝尔麻痹患者中有22例（12%）出现了复发性部分或完全性面瘫，发作次数为1至6次。在这22例患者中，5例被诊断为梅尔克森 - 罗森塔尔综合征。患者年龄在4至70岁之间，平均年龄为27.6岁。在研究组中，15例患者（即68%）为女性，7例为男性。我们组中面瘫发作超过两次的大多数患者至少有一次发作发生在对侧。
我们的研究发现特发性面瘫复发率较高。复发性特发性面瘫和梅尔克森 - 罗森塔尔综合征在年轻女性中诊断更为常见。复发更有可能在发病后的头两年内发生，由此得出结论，对于诊断为贝尔麻痹的患者，应从发病起至少随访两年，尤其是儿童患者。儿童复发性面瘫的频率与成年人相似。复发性特发性面瘫的相关情况了解不足，需要进一步的对照研究。
