Resumo
Definição
História e exame físico
Principais fatores de diagnóstico
- episódio único
- unilateral
- ausência de sintomas constitucionais
- envolvimento de todos os ramos do nervo
- ceratoconjuntivite seca
- dor
- sincinesia
Outros fatores de diagnóstico
- 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
Exames diagnósticos
1° exames a serem solicitados
- diagnóstico clínico
- eletroneurografia (ENoG) (eletromiografia evocada – eEMG)
- eletromiografia com agulha (EMG)
- Sorologia para Borrelia burgdorferi
Exames a serem considerados
- 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
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
Divulgações
TH declares that she has no competing interests.
Fellow
Division of Facial Plastic and Reconstructive Surgery
Massachusetts Eye and Ear Infirmary
Boston
MA
Divulgações
NJ holds a patent on the methods and systems for functional electrical stimulation of the paralysed face (WO2017124019A1).
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.
Colegas revisores
Consultant Neurologist
Barts Health NHS Trust
London
UK
Divulgações
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.
Major
US Air Force
MC Program Director
Department of Neurology
MMCN
Wilford Hall Medical Center
Lackland Air Force Base
TX
Divulgações
PG declares that he has no competing interests.
Consultant in ENT/Thyroid Surgery
Arrowe Park Hospital
Upton
Wirral
UK
Divulgações
VS declares that he has no competing interests.
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