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Paralisia de Bell

  • Обзор
  • Теория
  • Диагноз
  • Лечение
  • Последующее наблюдение
  • Источники
Последний просмотренный: 15 Aug 2025
Last updated: 01 Oct 2024

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

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

Другие диагностические факторы

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

Факторы риска

  • vacinação intranasal contra a gripe (influenza)
  • gestação
  • infecção do trato respiratório superior
  • clima árido/frio
  • hipertensão
  • história familiar de paralisia de Bell
  • diabetes
  • procedimentos odontológicos
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • diagnóstico clínico
  • eletroneuronografia (ENoG) (eletromiografia evocada – eEMG)
  • eletromiografia com agulha
  • Sorologia para Borrelia burgdorferi
Полная информация

Исследования, проведение которых нужно рассмотреть

  • 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)
Полная информация

Алгоритм лечения

Острый

todos os pacientes

Составители

Авторы

Matthew Q. Miller, MD

Assistant Professor Otolaryngology-Head and Neck Surgery

Director UNC Facial Nerve Center

University of North Carolina-Chapel Hill

Chapel Hill

NC

Раскрытие информации

MQM is a paid consultant for Checkpoint Surgical, Inc.

Liliana Ein, MD

Assistant Professor Otolaryngology-Head and Neck Surgery

Division of Facial Plastic and Reconstructive Surgery

University of Miami

Miami

FL

Раскрытие информации

LE declares that she has no competing interests.

Выражение благодарностей

Dr Matthew Q. Miller and Dr Liliana Ein would like to gratefully acknowledge Dr Tessa Hadlock, Dr Nathan Jowett, Dr Vishnu Madhok, Dr Iain Swan, Dr Pauline Lockhart, Dr Michael Norbury, and Dr John Gail Neely, previous contributors to this topic.

Раскрытие информации

TH, VM, IS, PL, MN, and JGN declare that they have no competing interests. NJ holds a patent on the methods and systems for functional electrical stimulation of the paralysed face (WO2017124019A1).

Рецензенты

Giles Elrington, MBBS (Hons), MD, FRCP

Consultant Neurologist

Barts Health NHS Trust

London

UK

Раскрытие информации

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, AstraZeneca, MSD, Almirall, Pfizer, Menarini, Allergan, Biogen, Teva, Conference Plus, Infomed, and BMJ.

Patrick Grogan, MD

Major

US Air Force

MC Program Director

Department of Neurology

MMCN

Wilford Hall Medical Center

Lackland Air Force Base

TX

Раскрытие информации

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

Раскрытие информации

VS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Gronseth GS, Paduga R; American Academy of Neurology. Evidence-based guideline update: steroids and antivirals for Bell palsy. Neurology. 2012 (reaffirmed 2023) Nov 27;79(22):2209-13.Полный текст  Аннотация

Madhok VB, Gagyor I, Daly F, et al. Corticosteroids for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2016;(7):CD001942.Полный текст  Аннотация

Gagyor I, Madhok VB, Daly F, et al. Antiviral treatment for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2019 Sep 5;9:CD001869.Полный текст  Аннотация

Gantz BJ, Rubinstein JT, Gidley P, et al. Surgical management of Bell palsy. Laryngoscope. 1999 Aug;109(8):1177-88. Аннотация

Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 2013 Nov;149(3 Suppl):S1-27.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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