面癱 (facial paralysis) 的徵狀包括一邊臉無法控制、眼皮無法閉合等，若愈早求醫，治愈及康復的機會也會較高，而治療則要視乎病因而定，例如是病毒感染、中耳炎、腮腺腫瘤 (parotid tumors)、面部神經線腫瘤 (facial neuroma) 或貝爾氏面癱（神經線發炎） (Bell's palsy)。
治療貝爾氏面癱一般是先處方類固醇 (systemic steroid) 及維他命補充劑等藥物，幫助神經線復原，而物理治療就可以幫助病人重新掌握面部肌肉及神經的控制。只要及早治療，近八成人治療效果理想。
目前多項針對顏面神經癱瘓治療中，只有類固醇治療獲證實具有療效，其他治療如抗病毒藥物及針灸等都暫未有確實的療效數據。類固醇可能會帶來副作用，但醫生會權衡病人的情況而作出處方，按指示服用通常無不良反應。
面癱雖不會致命，部分人即使不接受任何治療也會好轉，但延誤治療有可能無法完全恢復顏面神經功能，或會導致面部出現肌肉抽搐、眼睛閉合不全及嘴歪等後遺症，而眼睛無法閉合則會令眼球過乾，可導致眼角膜受損。事實上，面癱對於愛美的人士來說等於毀容，帶來的心理影響可能更巨大。
Sources:
http://the-sun.on.cc/cnt/news/20110208/00410_033.html
Showing posts with label facial paralysis. Show all posts
Showing posts with label facial paralysis. Show all posts
Monday, February 7, 2011
Sunday, January 31, 2010
Bell's palsy
Bell’s palsy is the most common diagnosis given to patients with acute facial palsy. Despite substantial effort to study its disease process, the management of Bell’s palsy remains controversial.
Although Bell’s palsy is a diagnosis of exclusion, it is the most common diagnosis given for acute facial palsy (> 60%). It causes peripheral facial neuropathy that tends to be unilateral and has a rapid onset. Its incidence is about 30 per 100,000. There is an equal male to female ration and a 3.3 times greater incidence in pregnant females. The left and right sides of the face are equally involved, and less than 1% of cases are bilateral. The recurrence rate is about 10% and can be ipsilateral or bilateral. Patients with diabetes have 4 - 5 times more risk of developing the disease. A family history is positive in about 10% of patients with Bell's palsy.
In 1982, Peitersen et al. published an article on the natural history of Bell’s palsy based on more than a thousand Danish patients. He found that Bell’s palsy occurred in every decade of life, with a mean age of between 40 and 44 years. It was less common before the age of 15 and after the age of 60 years. The prognosis for Bell's palsy is generally good with 85 % of patients recovering completely within one month. The remaining 15% progress to complete degeneration and will not usually show signs of recovery for three to six months. The longer the time needed for recovery, the greater the probability of sequelae. Patients with incomplete paralysis will recover with no sequelae 95% of the time. Based on this study, poor outcome of Bell’s palsy is associated with advanced age, late return of muscular function or beginning of remission, complete palsy, abnormal taste, stapedial reflex, and lacrimation.
Treatment options of Bell’s palsy range from observation, medical treatment, surgical decompression, to facial rehabilitation. The efficacies of oral prednisone and anti-viral agents have been studied extensively, yet there is no consensus among experts on ideal regimen and dosage.
Eye care is of utmost importance in facial nerve paralysis due to the risk of exposure keratitis. Artificial tears and lacrilube ointment should be prescribed. Taping of the eye lids during sleep may be helpful as well as the use of a moisture chamber. Patients should avoid contact lens, fans and dust, and should have eye protection when outside in the wind. Gold weight implant to the upper eyelid should be considered in patients with long-standing facial paralysis.
Source:
Dr. Kevin Ho UTMB Grand Round presentation: "Bell's palsy - to treat or not to treat". Feb 2007
Although Bell’s palsy is a diagnosis of exclusion, it is the most common diagnosis given for acute facial palsy (> 60%). It causes peripheral facial neuropathy that tends to be unilateral and has a rapid onset. Its incidence is about 30 per 100,000. There is an equal male to female ration and a 3.3 times greater incidence in pregnant females. The left and right sides of the face are equally involved, and less than 1% of cases are bilateral. The recurrence rate is about 10% and can be ipsilateral or bilateral. Patients with diabetes have 4 - 5 times more risk of developing the disease. A family history is positive in about 10% of patients with Bell's palsy.
In 1982, Peitersen et al. published an article on the natural history of Bell’s palsy based on more than a thousand Danish patients. He found that Bell’s palsy occurred in every decade of life, with a mean age of between 40 and 44 years. It was less common before the age of 15 and after the age of 60 years. The prognosis for Bell's palsy is generally good with 85 % of patients recovering completely within one month. The remaining 15% progress to complete degeneration and will not usually show signs of recovery for three to six months. The longer the time needed for recovery, the greater the probability of sequelae. Patients with incomplete paralysis will recover with no sequelae 95% of the time. Based on this study, poor outcome of Bell’s palsy is associated with advanced age, late return of muscular function or beginning of remission, complete palsy, abnormal taste, stapedial reflex, and lacrimation.
Treatment options of Bell’s palsy range from observation, medical treatment, surgical decompression, to facial rehabilitation. The efficacies of oral prednisone and anti-viral agents have been studied extensively, yet there is no consensus among experts on ideal regimen and dosage.
Eye care is of utmost importance in facial nerve paralysis due to the risk of exposure keratitis. Artificial tears and lacrilube ointment should be prescribed. Taping of the eye lids during sleep may be helpful as well as the use of a moisture chamber. Patients should avoid contact lens, fans and dust, and should have eye protection when outside in the wind. Gold weight implant to the upper eyelid should be considered in patients with long-standing facial paralysis.
Source:
Dr. Kevin Ho UTMB Grand Round presentation: "Bell's palsy - to treat or not to treat". Feb 2007
Subscribe to:
Posts (Atom)