Última revisão: 2 Jul 2021
Última atualização: 20 Nov 2019

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • episódio único
  • unilateral
  • ausência de sintomas constitucionais
  • envolvimento de todos os ramos do nervo
  • ceratoconjuntivite seca
  • dor
  • sincinesia

Outros fatores diagnósticos

  • presença de fatores de risco
  • qualquer idade
  • hiperacusia
  • disgeusia

Fatores de risco

  • vacinação intranasal contra a gripe (influenza)
  • gestação
  • infecção do trato respiratório superior
  • ascendência negra ou hispânica
  • clima árido/frio
  • hipertensão
  • história familiar de paralisia de Bell
  • diabetes

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • diagnóstico clínico
  • eletroneurografia (ENoG) (eletromiografia evocada – eEMG)
  • eletromiografia com agulha (EMG)
  • Sorologia para Borrelia burgdorferi

Investigações a serem consideradas

  • audiometria de tons puros
  • timpanometria e reflexo estapediano
  • ressonância nuclear magnética (corte fino com realce de gadolínio do curso do nervo facial)
  • tomografia computadorizada (corte fino, sem contraste)

Algoritmo de tratamento

Colaboradores

Autores

Tessa Hadlock, MD

Professor of Otology and Laryngology

Director, Division of Facial Plastic and Reconstructive Surgery and Director, Facial Nerve Center

President, Sir Charles Bell Society

Massachusetts Eye and Ear Infirmary and Harvard Medical School

Boston

MA

Declarações

TH declares that she has no competing interests.

Nathan Jowett, MD

Fellow

Division of Facial Plastic and Reconstructive Surgery

Massachusetts Eye and Ear Infirmary

Boston

MA

Declarações

NJ holds a patent on the methods and systems for functional electrical stimulation of the paralysed face (WO2017124019A1).

Agradecimentos

Dr Tessa Hadlock and Dr Nathan Jowett would like to gratefully acknowledge Dr Vishnu Madhok, Dr Iain Swan, Dr Pauline Lockhart, Dr Michael Norbury, and Dr John Gail Neely, previous contributors to this topic. VM, IS, PL, MN, and JGN declare that they have no competing interests.

Revisores

Giles Elrington, MBBS (Hons), MD, FRCP

Consultant Neurologist

Barts Health NHS Trust

London

UK

Declarações

GE is involved in a number of clinical trials on multiple sclerosis sponsored by Genzyme, Roche, Teva, Novartis, Biogen, as well as one funded by the MRC. He is also involved in clinical trials sponsored by Allergan, NMT Medical, GlaxoSmithKline (GSK), Bristol-Myers, the UK's Parkinson's Disease Research Group, and Pharmacia. In addition, he has attended lectures, conferences and symposia with the following companies - GSK, Astra Zeneca, MSD, Almirall, Pfizer, Menarini, Allergan, Biogen, Teva, Conference Plus, Infomed, BMJ.

Patrick Grogan, MD

Major

US Air Force

MC Program Director

Department of Neurology

MMCN

Wilford Hall Medical Center

Lackland Air Force Base

TX

Declarações

PG declares that he has no competing interests.

Venkat Srinivasan, MBBS, DLO, FRCS (Ed), FRCS (ORL)

Consultant in ENT/Thyroid Surgery

Arrowe Park Hospital

Upton

Wirral

UK

Declarações

VS declares that he has no competing interests.

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