Mamoli B, Neumann H, Ehrmann L
J Neurol. 1977 Sep 12;216(2):119-25. doi: 10.1007/BF00312945.
The etiology, frequency and prognosis of recurrent Bell's palsy were studied in patients with peripheral paresis of n.facialis of various etiology. Fourteen (11.9%) of 117 patients with Bell's palsy had a recurrent paresis of n.facialis. Nine of these were of homolateral and five contralateral type. Seven recurrent facial paralyses in idiopathic Bell's palsy (i.e. 10.4% of the patients with idiopathic facial palsy), 3 facial palsies of viral origin (i.e. 8.8% of the patients with viral facial palsy), one in association with diabetes mellitus, one during pregnancy, one combined with positive rheumatic serological tests, and one in a case of Melkersson-Rosenthal syndrome were found. The frequency and heterogenity of etiology of recurrent facial palsies suggest a predisposing factor or immune mechanisms. In eight patients there was within 6 to 8 weeks a good, in two patients a moderate and in four patients a poor recovery of function. The greater reduction of the compound action potential of the m.orbicularis oris in recurrent homolateral facial palsy in relation to patients with single manifestation point out the greater denervation and therefore the poorer prognosis of recurrent palsies. A prophylactic decompression to prevent a third attack of recurrent facial paresis is considered.
对各种病因导致的面神经周围性麻痹患者的复发性贝尔麻痹的病因、发生率及预后进行了研究。117例贝尔麻痹患者中有14例（11.9%）出现面神经复发性麻痹。其中9例为同侧型，5例为对侧型。发现特发性贝尔麻痹中有7例复发性面神经麻痹（即特发性面神经麻痹患者的10.4%），病毒源性面神经麻痹中有3例（即病毒性面神经麻痹患者的8.8%），1例合并糖尿病，1例发生于妊娠期，1例合并风湿血清学检查阳性，1例发生于梅尔克森 - 罗森塔尔综合征患者。复发性面神经麻痹病因的发生率及异质性提示存在易感因素或免疫机制。8例患者在6至8周内功能恢复良好，2例恢复中等，4例恢复较差。与单发患者相比，复发性同侧面神经麻痹中口轮匝肌复合动作电位的更大幅度降低表明失神经更严重，因此复发性麻痹的预后更差。考虑进行预防性减压以防止复发性面神经麻痹第三次发作。
