Diplegia facial: etiologia, manifestações clínicas, e avaliação diagnóstica

Varol, Sefer; Ozdemir, Hasan Huseyin; Akil, Esref; Arslan, Demet; Aluclu, M. Ufuk; Demir, Caner F.; Yucel, Yavuz

doi:10.1590/0004-282X20150174

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Sumário

ARTICLES • Arq. Neuro-Psiquiatr. 73 (12) • Dez 2015 • https://doi.org/10.1590/0004-282X20150174 copiar

Diplegia facial: etiologia, manifestações clínicas, e avaliação diagnóstica

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo

Diplegia facial (DF) é uma manifestação neurológica rara proveniente de diferentes causas. Este artigo visa avaliar sistematicamente a etiologia, avaliação diagnóstica e tratamento de DF.

Método

O estudo foi retrospectivo e incluiu 17 pacientes com diagnóstico de FD.

Resultados

Os pacientes foram diagnosticados como casos de síndrome de Guillain-Barré (SGB) (11), encefalite de tronco de Bickerstaff (1), neurosarcoidose (1), linfoma não-Hodgkin’s (1), meningite tuberculosa (1) reativação de herpes simplex (1) e causa idiopática (1). Além disto, duas pacientes haviam desenvolvido DF durante a gestação.

Conclusão

Diplegia facial é uma manifestação com diversas causas que requer investigação cuidadosa.

diplegia facial; síndrome de Guillain-Barré; gravidez; tratamento

Patient No/Age/Gender/Diagnosis	Neurological Examination/House Brackmann scale Right-Left	Laboratory findings /Peripheral EMG	*Facial Nerve EMG	lumbar puncture findings	Treatment/Prognosis **House Brackmann scale Right-Left	Brain MRI findings
1/25/F/GBS (AIDP)	Paraparesis/FD/III-III	N/ demyelinating neuropathy-prolonged F wave latencies	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/I-I	N
2/33/F/GBS (AIDP)	Paraparesis/FD/II-III	N/ demyelinating neuropathy- prolonged F wave latencies	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/I-I	N
3/32/F /GBS (AIDP)	Paraparesis/FD/III-III	N/ demyelinating neuropathy-prolonged F wave latencies	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/I-I	N
4/55/M/GBS (AIDP)	Paraparesis/FD/IV-III	N/ demyelinating neuropathy-prolonged F wave latencies	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/II- II	N
5/30/F/GBS (AIDP)	Paraparesis/FD/IV-III	N/ demyelinating neuropathy-prolonged F wave latencies	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/II- II	N
6/54/M/GBS (AIDP)	Paraplegia/FD/V-V	N/ demyelinating neuropathy-absent F-wave	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/III-II	N
7/55/M/GBS (AIDP)	Paraparesis/FD/IV-IV	N/demyelinating neuropathy-prolonged F wave latencies	Axonal loss, partial denervation,	albuminocytologic dissociation	IVIG/III-III	N
8/30/F/GBS (AIDP)	Paraparesis,/FD/IV-III	N/ demyelinating neuropathy-prolonged F wave latencies	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/ I-I	N
9/54/F/GBS-DM (AMSAN)	Paraplegia/FD/VI-VI	N/ demyelinating neuropathy-absent F-wave -axonal degeneration	Axonal loss, total denervation	albuminocytologic dissociation	IVIG/ex	N
10/50/M/ GBS (AIDP)	Paraparesis/FD/III-IV	N/demyelinating neuropathy-prolonged F wave latencies	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/II-II	N
11/32/F/probable HSV infection	isolated FD/III-III	HSV-1 IgG(+) -HSV-1 IgM (-)/N	Axonal loss, partial denervation	HSV-1 DNA (+)	Prednisolone-acyclovir/II-II	N
12/40/F/non-Hodgin’s lymphoma (Stage IV)	Paraplegia, 9,10 and 11 cranial nerve paralysis/FD/IV-IV	diffuse large B-cell lymphoma (lymph node biopsy)/ sensorimotor polyneuropathy	Axonal loss, partial denervation	Increased protein	IVIG/ex	Diffuse hyperintensity in the bilateral periventricular areas
13/60/F/GBS (AIDP)	Paraplegia/FD/III-III	N/ demyelinating neuropathy-absent F-wave	Axonal loss, partial denervation	albuminocytologic dissociation	IVIG/II-I	N
14/21/F/idiopathic-pregnant (7 Months)	isolated FD/IV-IV	N/N	Axonal loss, partial denervation	N	Prednisolone/I-II	N
15/39/F/tuberculous meningitis pregnant (8 Months)	neck stiffness/FD/V-V	Increased leukocyte/N	Axonal loss, total denervation	Increased protein-staining tubercle bacilli	Antibiotic/ex	Focal pachymeningitis
16/35/M/ neurosarcoidosis	isolated FD/IV-III	sensorimotor demyelinating polyneuropathy	Axonal loss, partial denervation	Lymphocytosis/elevated ACE	IVIG/II-II	Cortical and subcortical white matter lesions in the bilateral cerebral hemispheres
17/36/F/Bickerstaff’s brainstem encephalitis	ophtalmoplegia, ataxia/V-V	Anti-GQ1b(+)/N	Axonal loss, total denervation	albuminocytologic dissociation	IVIG/IV-I	White matter lesions in the brainstem

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[1] Correspondence
: Hasan Huseyin Ozdemir; Dicle University, Department of Neurology; Diyarbakir 21280, Turkey; E-mail:drhasanh@gmail.com