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Nascer e Crescer

versión impresa ISSN 0872-0754

Nascer e Crescer v.19 n.3 Porto sep. 2010

 

Paralisia Facial Periférica Diagnóstico, Tratamento e Orientação

 

Tiago Correia1, M. João Sampaio2, Rui Almeida3, Cristina Garrido3

1 Interno Complementar de Pediatria, CHPorto

2 Interno Complementar de Pediatria, CH Tâmega e Sousa

3 Assistente Hospitalar, CH Tâmega e Sousa

Correspondência

 

RESUMO

A paralisia facial periférica (PFP) é frequente em idade pediátrica. Inerente à sua designação existe um conceito anatómico que pressupõe a localização da lesão distalmente aos núcleos do sétimo nervo craniano. Contudo, define-se melhor pela clínica, consistindo na parésia dos músculos da mímica facial da hemiface ipsilateral à lesão, associada ou não a hiperacúsia, xeroftalmia e perda do paladar nos dois terços anteriores da língua. As principais causas médicas são a PFP idiopática ou de Bell (65%) e o Herpes Zoster Ótico (12%). Em áreas endémicas, também a doença de Lyme pode ter um papel relevante.

Sendo um tema de consensos difíceis, os autores apresentam uma revisão da literatura e propõem um protocolo de actuação na perspectiva do diagnóstico, tratamento e orientação.

Palavras-chave: Paralisia Facial Periférica, Paralisia de Bell, Herpes Zoster Ótico

 

Peripheral facial palsy – diagnosis, treatment and follow up

ABSTRACT

Facial palsy (FP) is a common disorder in children. It is caused by an aggression to the seventh cranial nerve distally to its emergence from the pons. The best way to define FP is by its clinical manifestations: paralisis of the muscles of the ipsilateral side of the face with or without hyperacusis, decreased production of tears, and loss of taste at the anterior two-thirds of the tongue. The most common medical causes are idiopathic FP, also known as Bell’s palsy (65%) and herpes zoster oticus (12%). In endemic areas, Lyme disease is also an important etiology.

As this is a controversial subject, the authors present a review of the most recent literature and propose a protocol to guide diagnosis, treatment and follow up.

Keywords: Facial nerve palsy, Bell Palsy, Herpes Zoster oticus

 

Texto completo disponível apenas em PDF.

Full text only available in PDf format.

 

BIBLIOGRAFIA

1. Harvey B, Sarnat. Bell Palsy, In: Beh­man, Kliegman, Jenson, editors. Nelson Textbook of Pediatrics. 18th ed. USA: Elsevier Saunders, p. 2566-7

2. Tiemstra JD, Khatkhate N. Bell’s palsy: Diagnosis and management. Am Fam Physicion 2007, 76:997-1002

3. Riordan M. Investigation and treatment of facial paralysis. Arch Dis Child 2001; 84. 286-8

4. Ko JY, Sheen T, Hsu MM. Herpes zoster oticus treated with acyclovir and prednisolone: clinical manisfestations and analysis of prognostic factors. Clin Otolaryngol 2000; 25:139-42

5. Valença MM, Valença LPAA, Lima MCM. Paralisia facial periférica idiopática de Bell, a propósito de 180 doentes. Arq Neuropsiquiatr 2001; 50:733-9

6. Vázquez M, Sparrow SS, Shapiro ED. Long-term neuropsychologic and health outcomes of children with facial nerve palsy attributable to lyme disease. Pediatrics 2003; 112: 93-7

7. Tveitnes D, Oymar K, Natas O. Acute facial nerve palsy in children: how often is in lyme borreliosis? Scand J Infect Dis 2007; 39:425-31

8. Eiffert H, Karsten A, Schlott T, Ohlenbusch A, Laskawi R, Hoppert M, Christen HJ. Acute peripheral facial palsy in Lyme disease-a distal neuritis at the infection site. Neuropediatrics 2004; 35:267-73

9. Bilavsky E, Scheuerman O, Marcus N, Hoffer V, Garty BZ. Facial paralysis as a presenting symptom of leukaemia. Pediatr Neurol 2006, 34: 502-4

10. Santiago MP, Garcia MC, Atienza AL, Frías EG. Parálisis facial bilateral como forma de presentación de síndrome de Guillain-Barré. An Pediatr 2003, 58:77-8

11. Holland NJ, Weiner GM. Recent developments in Bell’s palsy. BMJ 2004, 329: 553-7

12. Piercy J. Bell’s Palsy. BMJ 2005, 330:1374-5

13. Sullivan FM, et al. Early treatment with prednisolone or acyclovir in Bell’s palsy. N Engl J Med 2007; 357:1598­607

14. Nechama U, et al. Acyclovir in the treatment of Ramsay Hunt syndrome. Otolaryngol Head Neck Surg 2003; 129:379-81

15. Sweenwy CJ, Gilden DH. Ramsay Hunt syndrome. J Neurol Neurosurg Psychiatry 2001; 71:149-54

16. Furuta Y, et al. Quantification of varicella-zoster vírus DNA in patients with Ramsay Hunt syndrome and zoster sine herpete. J Clin Microbiol 2001; 39:2856-9

17. Bloem C, Doty C, Hirshon JM. Herpes Zoster Oticus. eMedicine, Last updated: May 2006

18. Pereira MC, Franca I. Borreliose de Lyme: ocorrência em Portugal. Trab Soc Port Dermatol Venerol 2000; 58:107-17

19. Shapiro ED. Lyme disease (Borrelia burgdorferi). In: Behrman, Kliegman, Jenson, editors. Nelson Textbook of Pediatrics. 18th ed. USA: Elsevier Saunders, P. 1274-8

20. Kanazawa A, Haginomori S, Takamaki A, Nonaka R, Araki M, Takenaka H. Prognostic for Bell’s palsy: a comparison of diabetic and nondiabetic patients. Acta Otolaryngol 2007; 127: 888-91

21. Stowe J, Andrews N, Wise L, Miller E. Bell´s palsy and parenteral influenza vaccine. Human Vaccines 2006; 110-2

22. Izurieta HS, et al. Adverse events reported following live, cold-adapted, intranasal influenza vaccine. JAMA 2005, 294:2720-5

23. House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93:146-7.

24. Adelson RT. Botulinum neurotoxins: Fundamentals for facial plastic surgeon. Am J Otolaryngol 2007; 28(4):260-6

25. Manikandan N. effect of facial neuromuscular re-education on facial symmetry in patients with Bell’s palsy: a randomized controlled trial. Clin Rehabil 2007; 21:338-43

26. Garanbani MR, Cardoso JR, Capelli AMG, Ribeiro MC. Physical therapy in peripheral facial paralysis: retrospective study. Rev Bras Otorrinolaringol 2007; 73:112-5.

27. Shafshak TS. The treatment of facial palsy from the poit of view of physical and rehabilitation medicine. Eura Medicophys 2006; 42:41-7

28. Cederwall E, Olsén MF, Hanner P; GFogdestam I. Evaluaion of a physio­therapeutic treatment intervention in Bell’s facial palsy. Physiother Theory Pract 2006; 22:43-52.

29. Hato N, et al. Valacyclovir and prednisolone treatment for Bell’s palsy: a multicenter, randomized, placebo controlled study. Otol Neurotol. 2007; 28:408-13

30. Kawaguchi K, et al. Reactivation of herpes simplex vírus type 1 and varicella-zoste virus and therapeutic effects of combination therapy with prednisolone and valacyclovir in patients with Bell’s palsy. Laryngoscope 2007; 117:147-56

31. Lazarini PR, Vianna MF, Alcantara MPA, Scalia RA, Filho HHC. Herpes Simplex in the saliva of peripheral Bell’s palsy patients. Rev Bras Otorrinolaringol 2006; 72:7-11         [ Links ]

32. Allen D, Dunn L. Aciclovir or valaciclo­vir for Bell’s palsy (idiopathic facial paralysis). Cochrane Database of Systematic Reviews 2004, Issue 3. Art No.: CD001869.DOI:10.1002/14651858. CD001869.pub2

33. Coudakos JK, Markou KD. Corticosteroids vs corticosteroids plus antiviral agents in the treatment of bell palsy: a systematic review and meta-analysis. Arch Otolaryngol Head Neck Surg. 2009; 135:558-64.

34. Engström M, Berg T, Stjernquist-Desatnik A, Axelsson S, Pitkäranta A, Hultcrantz M, Kanerva M, Hanner P, Jonsson L. Prednisolone and valaci­clovir in Bell’s palsy: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet Neurol. 2008; 7:976-7

35. Gilchrist JM. Seventh cranial neuropathy. Semin Neurol 2009; 29:5-13

36. Chen WX, Wong V. Prognosis of Bell’s palsy in children – analysis of 29 cases. Brain Dev 2005; 27: 504-8

37. Yeo W, Lee DH, Jun BC, Chang KH, Park Ys. Analysis of prognosis factors in Bell´s palsy and Ramsay Hunt syndrome. Auris Nasus Larynx 2007; 34:159-64

38. Kasse CA, et al. The Value of prognostic clinical Data in Bell’s palsy. Rev Bras Otorrinolaringol 2005; 71: 454-8

39. Depoorter M, Kerpel W. Reanimation of the paralysed face by entire temporalis mscle transposition. An endoscope approach. Eur J Plast Surg 2005; 28:190-4

40. Harrison DH. Surgical correction of unilateral and bilateral facial palsy. Postgrad Med J 2005; 81:562-7

41. Bruce L. Bell Palsy. EMedicine, updated: Feb 24, 2010

 

CORRESPONDÊNCIA

Tiago Correia

Serviço de Pediatria Hospital Geral de Santo António, EPE

Largo do Professor Abel Salazar

4099-001 Porto

Tel: 222 077 500

tiagojvcorreia@iol.pt

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