小児顔面神経麻痺の臨床像

Abstract

Clinical studies were performed on 121 cases of facial paralysis (FP) in children under 15 years old who were treated at our department between October 1978 and March 1993. The percentage of children's FP (121 cases) was only 11.9% of all 1,012 cases of FP. Children's FP consisted of Bell's palsy (62.0%), Hunt syndrome (16.5%), congenital type (13.2%), traumatic type (6.6%) and otogenic type (1.7%). Bell's palsy was most frequent in children 2 or 3 years old and the incidence of Hunt syndrome increased in children over 6 or 7 years old. Bell's palsy in children was most frequent in July and Hunt syndrome in August. Two special complications in Bell's palsy were MCLS (Kawasaki disease) in a 5month-old girl and mycoplasma pneumonia in a 3-year-and-10-month-old boy. There were 5 special types of FP including 1 case of bilateral simultaneous FP,2 cases of alternating FP and 2 cases of recurrent FP. In Bell's palsy, significant changes in antibody titer of herpes simplex virus (HSV) was 15.2% while that of varicella zoster virus (VZV) was only 3%. In Hunt syndrome, changes were 0% in HSV and 40% in VZV. The recovery rate in Bell's palysy was 94.1% and that in Hunt syndrome was 75.0% in children. These figures were better than those in adult cases.