Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- episódio único
- unilateral
- ausência de sintomas constitucionais
- envolvimento de todos os ramos do nervo
- ceratoconjuntivite seca
- dor
- sincinesia
Outros fatores diagnósticos
- presença de fatores de risco
- qualquer idade
- hiperacusia
- disgeusia
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- diagnóstico clínico
- eletroneuronografia (ENoG) (eletromiografia evocada – eEMG)
- eletromiografia com agulha
- Sorologia para Borrelia burgdorferi
Investigações a serem consideradas
- 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
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
Declarações
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
Declarações
LE declares that she has no competing interests.
Agradecimentos
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.
Declarações
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).
Revisores
Giles Elrington, MBBS (Hons), MD, FRCP
Consultant Neurologist
Barts Health NHS Trust
London
UK
Declarações
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
Declarações
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
Declarações
VS declares that he has no competing interests.
O uso deste conteúdo está sujeito ao nosso aviso legal