贝尔氏麻痹症

最后审阅: 1 九月 2022
最后更新: 07 六月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 单次发作
  • 单侧耳鸣
  • 不存在全身症状
  • 累及所有神经分支
  • 干燥性角膜结膜炎
  • 疼痛
  • 联带运动
更多 关键诊断因素

其他诊断因素

  • 存在的危险因素
  • 任何年龄
  • 听觉过敏
  • 味觉障碍
其他诊断因素

危险因素

  • 鼻内流感疫苗接种
  • 妊娠
  • 上呼吸道感染
  • 干旱/寒冷气候
  • 高血压
  • 贝尔麻痹家族史
  • 糖尿病
  • 牙科操作
更多 危险因素

诊断性检查

首要检查

  • 临床诊断
  • 电神经描记 (ENoG)(诱发肌电图- eEMG)
  • 针极肌电图 (EMG)
  • 伯氏疏螺旋体血清学检测
更多 首要检查

需考虑的检查

  • 纯音测听
  • 鼓室测量法和镫骨肌反射
  • MRI(面神经分布区域钆增强的精细扫描)
  • CT(精细,非增强)
更多 需考虑的检查

治疗流程

急症处理

所有患者

撰稿人

作者

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

利益声明

MQM declares that he has no competing interests.

Liliana Ein, MD

Assistant Professor Otolaryngology-Head and Neck Surgery

Division of Facial Plastic and Reconstructive Surgery

University of Miami

Miami

FL

利益声明

LE declares that she has no competing interests.

鸣谢

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.

利益声明

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).

同行评议者

Giles Elrington, MBBS (Hons), MD, FRCP

Consultant Neurologist

Barts Health NHS Trust

London

UK

利益声明

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

利益声明

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

利益声明

VS declares that he has no competing interests.

  • 鉴别诊断

    • 耳部带状疱疹(拉姆齐亨特综合征)
    • 莱姆病
    • 良性面神经肿瘤(例如面神经施旺氏细胞瘤)
    更多 鉴别诊断
  • 指南

    • 美国放射学会适宜性标准:颅神经病变
    • 面神经麻痹(贝尔麻痹)
    更多 指南
  • 患者教育信息

    贝尔氏麻痹症

    更多 患者教育信息
  • padlock-locked登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容

内容使用需遵循免责声明