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揭示贝尔氏面瘫:一例引人注目的妊娠期面神经麻痹病例研究

Bell's Palsy Unmasked: A Compelling Case Study of Facial Nerve Palsy During Pregnancy.

作者信息

Patel Dharmesh J, Chaudhari Kamlesh, Shrivastava Deepti, Dave Apoorva

机构信息

Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2023 Dec 30;15(12):e51369. doi: 10.7759/cureus.51369. eCollection 2023 Dec.

DOI:10.7759/cureus.51369
PMID:38292948
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10825380/
Abstract

Facial paralysis occurs more frequently in pregnant individuals, affecting them two to four times more often than those who are not pregnant, making it the most frequent unilateral cranial nerve pathology in pregnancy. This case report describes a 29-year-old primigravida's presentation, examination, and treatment of left-sided (unilateral) facial nerve palsy during 32 weeks of gestation. Concerns regarding possible underlying reasons were raised when the patient suddenly developed left-side facial weakness. We examined her history, clinical assessment, and diagnosis methods, which included laboratory and neuro-imaging tests. The difficulties of managing this illness during pregnancy are explored, taking into account the well-being of the developing fetus and mother. There are several causes for facial nerve palsy during pregnancy, including idiopathic causes, vascular problems, and viral infections. Here, we emphasize the value of a multidisciplinary approach comprising obstetricians, neurologists, and other medical professionals to guarantee the best possible care. The paper also underscores the necessity for prompt diagnosis and suitable interventions to reduce problems and foster a successful outcome. This case report adds to the limited literature on facial nerve palsy in pregnancy by highlighting individualized medical care and teamwork in addressing this uncommon but serious condition.

摘要

面瘫在孕妇中更为常见,其发病率比非孕妇高出两到四倍,使其成为孕期最常见的单侧颅神经病变。本病例报告描述了一名29岁初产妇在妊娠32周时左侧(单侧)面神经麻痹的表现、检查和治疗情况。当患者突然出现左侧面部无力时,引发了对可能潜在原因的担忧。我们检查了她的病史、临床评估以及诊断方法,其中包括实验室检查和神经影像学检查。考虑到发育中胎儿和母亲的健康,探讨了孕期管理这种疾病的困难。孕期面神经麻痹有多种原因,包括特发性原因、血管问题和病毒感染。在此,我们强调由产科医生、神经科医生和其他医学专业人员组成的多学科方法的价值,以确保提供尽可能最佳的护理。本文还强调了及时诊断和适当干预的必要性,以减少问题并促成成功的结果。本病例报告通过突出针对这种罕见但严重病症的个性化医疗护理和团队合作,为关于孕期面神经麻痹的有限文献增添了内容。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df8a/10825380/5b6abe4e030e/cureus-0015-00000051369-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df8a/10825380/9745ec5df872/cureus-0015-00000051369-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df8a/10825380/f5ad1cd437d9/cureus-0015-00000051369-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df8a/10825380/5b6abe4e030e/cureus-0015-00000051369-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df8a/10825380/9745ec5df872/cureus-0015-00000051369-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df8a/10825380/f5ad1cd437d9/cureus-0015-00000051369-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df8a/10825380/5b6abe4e030e/cureus-0015-00000051369-i03.jpg

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本文引用的文献

1
Pregnancy Does Not Increase the Risk of Bell's Palsy: A National Cohort Study.妊娠不会增加贝尔麻痹的风险:一项全国队列研究。
Otol Neurotol. 2020 Jan;41(1):e111-e117. doi: 10.1097/MAO.0000000000002421.
2
The etiology of Bell's palsy: a review.贝尔面瘫的病因:综述
J Neurol. 2020 Jul;267(7):1896-1905. doi: 10.1007/s00415-019-09282-4. Epub 2019 Mar 28.
3
Onset of bell's palsy in late pregnancy and early puerperium is associated with worse long-term outcomes.妊娠晚期和产褥早期发生的贝尔麻痹与更差的长期预后相关。
Laryngoscope. 2017 Dec;127(12):2854-2859. doi: 10.1002/lary.26569. Epub 2017 Mar 27.
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A Contemporary Approach to Facial Reanimation.面部修复的当代方法。
JAMA Facial Plast Surg. 2015 Jul-Aug;17(4):293-300. doi: 10.1001/jamafacial.2015.0399.
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Clinical practice guideline: Bell's palsy.临床实践指南:贝尔氏麻痹。
Otolaryngol Head Neck Surg. 2013 Nov;149(3 Suppl):S1-27. doi: 10.1177/0194599813505967.
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Bell's palsy and pregnancy.贝尔氏面瘫与妊娠
Otolaryngol Head Neck Surg. 2007 Dec;137(6):858-61. doi: 10.1016/j.otohns.2007.09.009.
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[Mona Lisa syndrome: idiopathic facial paralysis during pregnancy].[蒙娜丽莎综合征:妊娠期特发性面神经麻痹]
Z Geburtshilfe Neonatol. 2006 Aug;210(4):126-34. doi: 10.1055/s-2006-947216.
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Idiopathic facial paralysis (Bell's palsy) in the immediate puerperium in a patient with mild preeclampsia: a case report.一例轻度子痫前期患者产褥早期的特发性面神经麻痹(贝尔麻痹):病例报告
Arch Gynecol Obstet. 2005 Sep;272(3):241-3. doi: 10.1007/s00404-005-0742-2. Epub 2005 May 3.
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Oral herpes simplex reactivation after intrathecal morphine: a prospective randomized trial in an obstetric population.鞘内注射吗啡后口腔单纯疱疹复发:一项针对产科人群的前瞻性随机试验。
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