Sathirapanya Pornchai, Fujitnirun Chris, Setthawatcharawanich Suwanna, Phabphal Kanitpong, Limapichat Kitti, Chayakul Pantip, Silpapojakul Khachornsakdi, Jaruratanasirikul Sutep, Siripaitoon Pisud, Chusri Sarunyou, Kositpantawong Narongdet
Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110 Thailand.
Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110 Thailand.
Clin Neurol Neurosurg. 2018 Sep;172:124-129. doi: 10.1016/j.clineuro.2018.06.033. Epub 2018 Jul 2.
The association between peripheral facial paralysis (PFP) and HIV infection has been scarcely explained. The authors aimed to describe the association between PFP and HIV infection status, along with the related co-morbidities and the outcomes of PFP, as well as the literature review on this topic.
All HIV-infected patients who experienced PFP, both before and after a positive HIV serology test, between January 2002 and June 2015 were retrospectively reviewed. The patients' demographic data, clinical characteristics, HIV co-morbidities and outcomes of PFP were summarized. A literature review of PFP in HIV infection was also performed. Descriptive statistics were used in the data analysis. The Mann-Whitney U test was performed to compare the parameters between the current case series and cases from literature review to determine statistical significant differences (p < 0.05).
Sixteen patients (6 males and 10 females) were enrolled. Their median age was significantly higher than that of the cases in the literature review [46 (38, 49.75) vs. 33 (26, 41) years (p = 0.004)]. Nonetheless, a non-significant lower median CD4 count was observed [274 (134.5, 425.5) vs. 373 (265, 718) cells/μL (p = 0.058)]. In our series, unilateral PFP (UFP) was the most frequent, and it typically occurred long after a positive HIV serology test. However, bilateral PFP (BFP) was commonly found in the literature, and a simultaneous positive HIV serology test was reported in almost all cases. Consequently, most of our cases, except for those with HIV-related complications or co-morbidities, experienced a satisfactory recovery from PFP regardless of treatments received.
Most of the cases in our series were UPF with a higher median age and a lower median CD4 count. Moreover, facial paralysis presented later in our series than in the previously reported cases in the literature. Most of our cases experienced satisfactory recovery of facial weakness.
外周性面瘫（PFP）与HIV感染之间的关联鲜有阐述。作者旨在描述PFP与HIV感染状态之间的关联，以及相关合并症、PFP的结局，同时对该主题的文献进行综述。
对2002年1月至2015年6月期间所有在HIV血清学检测呈阳性之前及之后发生PFP的HIV感染患者进行回顾性研究。总结患者的人口统计学数据、临床特征、HIV合并症及PFP的结局。还对HIV感染中PFP的文献进行了综述。数据分析采用描述性统计。进行Mann-Whitney U检验以比较本病例系列与文献综述中的病例参数，确定统计学显著差异（p < 0.05）。
纳入16例患者（6例男性和10例女性）。他们的年龄中位数显著高于文献综述中的病例[46（38，49.75）岁 vs. 33（26，41）岁（p = 0.004）]。尽管如此，观察到CD4计数中位数略低但无统计学意义[274（134.5，425.5）个/μL vs. 373（265，718）个/μL（p = 0.058）]。在我们的系列中，单侧PFP（UFP）最为常见，且通常在HIV血清学检测呈阳性很久之后发生。然而，双侧PFP（BFP）在文献中较为常见，几乎所有病例均报告HIV血清学检测同时呈阳性。因此，我们的大多数病例，除了那些有HIV相关并发症或合并症的患者，无论接受何种治疗，PFP均恢复良好。
我们系列中的大多数病例为UPF，年龄中位数较高，CD4计数中位数较低。此外，我们系列中面瘫出现的时间比文献中先前报道的病例晚。我们的大多数病例面部无力恢复良好。
