Fuller Geraint, Morgan Cathy
Department of Neurology, Gloucester Royal Hospital, Gloucester, UK.
Pract Neurol. 2016 Dec;16(6):439-444. doi: 10.1136/practneurol-2016-001383. Epub 2016 Mar 31.
In this article we will explore the mimics and chameleons of Bell's palsy and in addition argue that we should use the term 'Bell's palsy syndrome' to help guide clinical reasoning when thinking about patients with facial weakness. The diagnosis of Bell's palsy can usually be made on clinical grounds without the need for further investigations. This is because the diagnosis is not one of exclusion (despite this being commonly how it is described), a lower motor neurone facial weakness where all alternative causes have been eliminated, but rather a positive recognition of a clinical syndrome, with a number of exclusions, which are described below. This perhaps would be more accurately referred to a 'Bell's palsy syndrome'. Treatment with corticosteroids improves outcome; adding an antiviral probably reduces the rates of long-term complications.
在本文中,我们将探讨贝尔麻痹的模仿者和变色龙,并主张我们应使用“贝尔麻痹综合征”这一术语,以在思考面部无力患者时帮助指导临床推理。贝尔麻痹的诊断通常可基于临床做出,无需进一步检查。这是因为该诊断并非排除性诊断(尽管通常是这样描述的,即排除所有其他原因后的下运动神经元性面部无力),而是对一种临床综合征的肯定性识别,有一些需要排除的情况,如下所述。这或许更准确地应称为“贝尔麻痹综合征”。使用皮质类固醇治疗可改善预后;加用抗病毒药物可能会降低长期并发症的发生率。