Etiología da paralisia facial periférica: relato de um caso inusitado

Fortes-Rêgo, J.

doi:10.1590/S0004-282X1974000200007

Resumos

Após conceituar a paralisia de Bell, ressaltar sua alta incidência e expor as teorias que se propõem a explicá-la, é relatado um caso de paralisia facial periférica isolada ocorrido durante o retorno de um mergulho, em paciente de 28 anos. Na revisão bibliográfica realizada são mencionadas e discutidas numerosas entidades que têm sido consideradas como causas de paralisia facial periférica, destacando-se um trabalho americano que relata dois casos ocorridos, de forma transitória, durante aumento de altitude e que foram atribuídos à variação de pressão no ouvido médio. Como conclusão, é admitido um mecanismo similar para o caso em pauta.

The case of a 28-year-old patient in which a peripheral facial paralysis occurred during raise of diving is reported. In reviewing the literature several conditions are mentioned and discussed as fortuitous causes of peripheral facial paralysis, being emphazised an North-American report about two patients suffering five episodes of transient seventh nerve paresis during ascent to altitude, where a disequilibrium of pressures between the middle ear and the nasopharynx was assumed to be the efective cause of the Bell's palsy. A similar mechanism was admited for the reported case.

Etiología da paralisia facial periférica. Relato de um caso inusitado

Aetiology of peripheral facial paralysis: report of an unusual case

J. Fortes-Rêgo

Deptartamento de Medicina Especializada da Faculdade de Ciências da Saúde da Universidade de Brasília: Professor-Assistente

RESUMO

Após conceituar a paralisia de Bell, ressaltar sua alta incidência e expor as teorias que se propõem a explicá-la, é relatado um caso de paralisia facial periférica isolada ocorrido durante o retorno de um mergulho, em paciente de 28 anos. Na revisão bibliográfica realizada são mencionadas e discutidas numerosas entidades que têm sido consideradas como causas de paralisia facial periférica, destacando-se um trabalho americano que relata dois casos ocorridos, de forma transitória, durante aumento de altitude e que foram atribuídos à variação de pressão no ouvido médio. Como conclusão, é admitido um mecanismo similar para o caso em pauta.

SUMMARY

The case of a 28-year-old patient in which a peripheral facial paralysis occurred during raise of diving is reported. In reviewing the literature several conditions are mentioned and discussed as fortuitous causes of peripheral facial paralysis, being emphazised an North-American report about two patients suffering five episodes of transient seventh nerve paresis during ascent to altitude, where a disequilibrium of pressures between the middle ear and the nasopharynx was assumed to be the efective cause of the Bell's palsy. A similar mechanism was admited for the reported case.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Universidade de Brasília Unidade Integrada de Saúde de Sobradinho Distrito Federal Brasil.

Trabalho realizado no Deptartamento de Medicina Especializada da Faculdade de Ciências da Saúde da Universidade de Brasília, em colaboração com o dr. Pedro A. Cardoso, Médico residente

1. ADOUR, K.H.; WTNGERD, J.; BELL, D.N.; MANNING, J.J. & HURLEY, J.P. Prednisone treatment for idiopathic facial paralysis (Bell's palsy). New England J. Med. 287:1268, 1972.
2. ALEXANDER, J.C.; ESPIR, M.C. & PUGH, V.W. Facial diplegia in infectious mononucleosis. Brit. Med. J. 1:1570, 1964.
3. AMINOFF, M.J. & MILLER, A.L. The prevalence of diabetes mellitus in patients with Bell's palsy. Acta Neurol. Scandinavica 48:381, 1972.
4. BENNETT, D.R. & LISKE, E. Transient facial paralysis during ascent to altitude. Neurology (Minneapolis) 17:194, 1967.
5. BOWIE, J.C. Infectious mononucleosis. Brit. Med. J. 1:1316, 1964.
6. BOYLE, W.F. Experimental facial nerve paralysis. Arch. Otolaryng. 95:313, 1972.
7. BROOKLER, K.H.; PULEC, J.C. & HALLBERG, C.E. Congenital cholesteatoma of the temporal bone. Arch. Otolaryng. 90:449, 1969.
8. CAWTHORNE, T. Intratemporal facial palsy. Arch. Otolaryng. 90:789, 1969.
9. CAWTHORNE, T. & HAYNES, D.R. Facial palsy. Brit. Med. J. 1:1197, 1956.
10. CHALMERS, R.B. Facial diplegia in infectious mononucleosis. Brit. Med. J. 1:1316, 1964.
11. DAVIDSON, R.J.L. & SALTER, H.H. Infectious mononucleosis presenting with facial diplegia. Brit. Med. J. 1:954, 1964.
12. DUDLEY, J.P. & GOODMAN, M. Periarteritis nodosa and bilateral facial paralysis. Arch. Otolaryng. 90:139, 1969.
13. EDITORIAL Aetiology of Bell's palsy. Brit. Med. J. 4:2, 1971.
14. ENEROTH, CM. Facial nerve paralysis. Arch. Otolaryng. 95:300, 1972.
15. FERNÁNDEZ-BLASINI, N. & BUNKER, R.J. Traumatic facial palsy. Arch. Otolaryng. 90:137, 1969.
16. FISCH, U. & ESSLEN, E. Total intratemporal exposure of the facial nerve. Arch. Otolaryng. 95:335, 1972.
17. FORTES-RÊGO, J.; ARIAS, L.P. & REBOLLO, M.A. Tumores del tronco cerebral en la infancia. Neurobiologia (Recife) 33:251, 1970.
18. FORTES-RÊGO, J. & REBOLLO, M.A. Síndrome de Melkersson familiar. Neurobiologia (Recife) 34:139, 1971.
19. GELLIS, S.S. & FEINGOLD, M. Peripheral facial paralysis and hypertension. Amer. J. Dis. Child. 119:59, 1970.
20. HARBOTT, A.J. Facial diplegia and infectious mononucleosis. Brit. Med. J. 1:1257, 1964.
21. HAUSER, W.A.; KARNES, W.E.; ANNIS, J. & KURLAND, L.T. Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. Mayo Clinic Proc. 46:258, 1971.
22. HAZAMA, H.; TAMAKI, H.; NOMURA, A.; FURUKAWA, Y. & UETSUKA, H. Compression of the facial nerve. Otolaryng. 95:346, 1972.
23. JONGKEES, L.B.W. On peripheral facial nerve paralysis. Arch. Otolaryng. 95:317, 1972.
24. KELLY, A. Ramsay Hunt with contralateral Bell's. New England J. Med. 288:266, 1973.
25. KITAMURA, T.; TOGAWA, K.; TSUKAMOTO, K. & NAITO, J. Extra-temporal facial nerve surgery. Arch. Otolaryng. 95:369, 1972.
26. KORCZYN, A.D. Bell's palsy and pregnancy. Acta Neurol. Scandinavica 47:603, 1971.
27. KORCZYN, A.D. Bell's palsy and diabetes mellitus. Lancet 7690:108, 1971.
28. KORCZYN, A.D. Aetiology of Bell's palsy. Brit. Med. J. 4:491, 1971.
29. KUMAGAMI, H. Experimental facial nerve paralysis. Arch. Otolaryng. 95: 305, 1972.
30. LaVENUTA, F.; FLYNN, W.F. & MOORE, J.A. Facial nerve paralysis secondary to benign parotid tumor. Arch. Otolaryng. 90:603, 1969.
31. LEIBOWITZ, U. Epidemic incidence of Bell's palsy. Brain 92:109, 1969.
32. LUNDGREN, C.E.G. Alternobaric vertigo a diving hazard. Brit. Med. J. 2:511, 1965.
33. MANNING, J.J. & ADOUR, K.K. Diagnosis and treatment of facial paralysis in children. Pediatrics 49:102, 1972.
34. MAY, M. & LUCENTE, R.E. Bell's palsy caused by basal cell carcinoma. JAMA 220:1596, 1972.
35. McGOVERN, F.H. Facial paralysis. Arch. Otolaryng. 96:92, 1972.
36. McGOVERN, F.H.; EDGEMON, L.J. & KONIGSMARK, M.D. Experimental ischemic facial paralysis. Arch. Otolaryng. 95:331, 1972.
37. MOURIN, K.A. Paraquat poisoning. Brit. Med. J. 4:486, 1967.
38. ROSKES, S.D. Hypertension as a cause of facial paralysis. Pediatrics 50: 171, 1972.
39. SADÉ, J. Pathology of Bell's palsy. Arch. Otolaryng. 95:406, 1972.
40. SWAN, A.A.B. Paraquat poisoning. Brit. Med. J. 4:551, 1967.
41. TAVERNER, D.; COHEN, S.B. & HUTCHISON, B.C. Comparison of corticotrophin and prednisolone in treatment of idiopathic facial paralysis (Bell's palsy). Brit. Med. J. 4:20, 1971.
42. TAVERNER, D.; KEMBLE, F. & COHEN, S.B. Prognosis and treatment of idiopathic facial (Bell's) palsy. Brit. Med. J. 4:581, 1967.
43. TOMITA, H.; HAYAKAWA, W. & HONDO, R. Varicella-zoster virus in idiopathic facial palsy. Arch. Otolaryng. 95:364, 1972.
44. TOMITA, H.; OKUDA, Y.; TOMIYAMA, H. & KIDA, A. Electrogastrometry in facial palsy. Arch. Otolaryng. 95:383, 1972.
45. TOS, M. Facial palsy in Hand-Schuller-Christian's disease. Arch. Otolaryng. 90:563, 1969.
46. VASSALO, L. & GALEA-DEBONO, A. Etiology of Bell's palsy. Lancet 7773: 383, 1972.
47. WIGAND, M.E.; SPRENG, M.; BUMM, P. & MEDERER, R. Electronic evaluation of electromyograms in facial nerve paralysis. Arch. Otolaryng. 95:324, 1972.
48. YANAGIHARA, N. & KISHIMOTO, M. Electrodiagnosis in facial palsy. Arch. Otolaryng. 95:376, 1972.

Datas de Publicação

Publicação nesta coleção
16 Abr 2013
Data do Fascículo
Jun 1974

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ADOUR, K.H.; WTNGERD, J.; BELL, D.N.; MANNING, J.J. & HURLEY, J.P. Prednisone treatment for idiopathic facial paralysis (Bell's palsy). New England J. Med. 287:1268, 1972.

[2] 2. ALEXANDER, J.C.; ESPIR, M.C. & PUGH, V.W. Facial diplegia in infectious mononucleosis. Brit. Med. J. 1:1570, 1964.

[3] 3. AMINOFF, M.J. & MILLER, A.L. The prevalence of diabetes mellitus in patients with Bell's palsy. Acta Neurol. Scandinavica 48:381, 1972.

[4] 4. BENNETT, D.R. & LISKE, E. Transient facial paralysis during ascent to altitude. Neurology (Minneapolis) 17:194, 1967.

[5] 5. BOWIE, J.C. Infectious mononucleosis. Brit. Med. J. 1:1316, 1964.

[6] 6. BOYLE, W.F. Experimental facial nerve paralysis. Arch. Otolaryng. 95:313, 1972.

[7] 7. BROOKLER, K.H.; PULEC, J.C. & HALLBERG, C.E. Congenital cholesteatoma of the temporal bone. Arch. Otolaryng. 90:449, 1969.

[8] 8. CAWTHORNE, T. Intratemporal facial palsy. Arch. Otolaryng. 90:789, 1969.

[9] 9. CAWTHORNE, T. & HAYNES, D.R. Facial palsy. Brit. Med. J. 1:1197, 1956.

[10] 10. CHALMERS, R.B. Facial diplegia in infectious mononucleosis. Brit. Med. J. 1:1316, 1964.

[11] 11. DAVIDSON, R.J.L. & SALTER, H.H. Infectious mononucleosis presenting with facial diplegia. Brit. Med. J. 1:954, 1964.

[12] 12. DUDLEY, J.P. & GOODMAN, M. Periarteritis nodosa and bilateral facial paralysis. Arch. Otolaryng. 90:139, 1969.

[13] 13. EDITORIAL Aetiology of Bell's palsy. Brit. Med. J. 4:2, 1971.

[14] 14. ENEROTH, CM. Facial nerve paralysis. Arch. Otolaryng. 95:300, 1972.

[15] 15. FERNÁNDEZ-BLASINI, N. & BUNKER, R.J. Traumatic facial palsy. Arch. Otolaryng. 90:137, 1969.

[16] 16. FISCH, U. & ESSLEN, E. Total intratemporal exposure of the facial nerve. Arch. Otolaryng. 95:335, 1972.

[17] 17. FORTES-RÊGO, J.; ARIAS, L.P. & REBOLLO, M.A. Tumores del tronco cerebral en la infancia. Neurobiologia (Recife) 33:251, 1970.

[18] 18. FORTES-RÊGO, J. & REBOLLO, M.A. Síndrome de Melkersson familiar. Neurobiologia (Recife) 34:139, 1971.

[19] 19. GELLIS, S.S. & FEINGOLD, M. Peripheral facial paralysis and hypertension. Amer. J. Dis. Child. 119:59, 1970.

[20] 20. HARBOTT, A.J. Facial diplegia and infectious mononucleosis. Brit. Med. J. 1:1257, 1964.

[21] 21. HAUSER, W.A.; KARNES, W.E.; ANNIS, J. & KURLAND, L.T. Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. Mayo Clinic Proc. 46:258, 1971.

[22] 22. HAZAMA, H.; TAMAKI, H.; NOMURA, A.; FURUKAWA, Y. & UETSUKA, H. Compression of the facial nerve. Otolaryng. 95:346, 1972.

[23] 23. JONGKEES, L.B.W. On peripheral facial nerve paralysis. Arch. Otolaryng. 95:317, 1972.

[24] 24. KELLY, A. Ramsay Hunt with contralateral Bell's. New England J. Med. 288:266, 1973.

[25] 25. KITAMURA, T.; TOGAWA, K.; TSUKAMOTO, K. & NAITO, J. Extra-temporal facial nerve surgery. Arch. Otolaryng. 95:369, 1972.

[26] 26. KORCZYN, A.D. Bell's palsy and pregnancy. Acta Neurol. Scandinavica 47:603, 1971.

[27] 27. KORCZYN, A.D. Bell's palsy and diabetes mellitus. Lancet 7690:108, 1971.

[28] 28. KORCZYN, A.D. Aetiology of Bell's palsy. Brit. Med. J. 4:491, 1971.

[29] 29. KUMAGAMI, H. Experimental facial nerve paralysis. Arch. Otolaryng. 95: 305, 1972.

[30] 30. LaVENUTA, F.; FLYNN, W.F. & MOORE, J.A. Facial nerve paralysis secondary to benign parotid tumor. Arch. Otolaryng. 90:603, 1969.

[31] 31. LEIBOWITZ, U. Epidemic incidence of Bell's palsy. Brain 92:109, 1969.

[32] 32. LUNDGREN, C.E.G. Alternobaric vertigo a diving hazard. Brit. Med. J. 2:511, 1965.

[33] 33. MANNING, J.J. & ADOUR, K.K. Diagnosis and treatment of facial paralysis in children. Pediatrics 49:102, 1972.

[34] 34. MAY, M. & LUCENTE, R.E. Bell's palsy caused by basal cell carcinoma. JAMA 220:1596, 1972.

[35] 35. McGOVERN, F.H. Facial paralysis. Arch. Otolaryng. 96:92, 1972.

[36] 36. McGOVERN, F.H.; EDGEMON, L.J. & KONIGSMARK, M.D. Experimental ischemic facial paralysis. Arch. Otolaryng. 95:331, 1972.

[37] 37. MOURIN, K.A. Paraquat poisoning. Brit. Med. J. 4:486, 1967.

[38] 38. ROSKES, S.D. Hypertension as a cause of facial paralysis. Pediatrics 50: 171, 1972.

[39] 39. SADÉ, J. Pathology of Bell's palsy. Arch. Otolaryng. 95:406, 1972.

[40] 40. SWAN, A.A.B. Paraquat poisoning. Brit. Med. J. 4:551, 1967.

[41] 41. TAVERNER, D.; COHEN, S.B. & HUTCHISON, B.C. Comparison of corticotrophin and prednisolone in treatment of idiopathic facial paralysis (Bell's palsy). Brit. Med. J. 4:20, 1971.

[42] 42. TAVERNER, D.; KEMBLE, F. & COHEN, S.B. Prognosis and treatment of idiopathic facial (Bell's) palsy. Brit. Med. J. 4:581, 1967.

[43] 43. TOMITA, H.; HAYAKAWA, W. & HONDO, R. Varicella-zoster virus in idiopathic facial palsy. Arch. Otolaryng. 95:364, 1972.

[44] 44. TOMITA, H.; OKUDA, Y.; TOMIYAMA, H. & KIDA, A. Electrogastrometry in facial palsy. Arch. Otolaryng. 95:383, 1972.

[45] 45. TOS, M. Facial palsy in Hand-Schuller-Christian's disease. Arch. Otolaryng. 90:563, 1969.

[46] 46. VASSALO, L. & GALEA-DEBONO, A. Etiology of Bell's palsy. Lancet 7773: 383, 1972.

[47] 47. WIGAND, M.E.; SPRENG, M.; BUMM, P. & MEDERER, R. Electronic evaluation of electromyograms in facial nerve paralysis. Arch. Otolaryng. 95:324, 1972.

[48] 48. YANAGIHARA, N. & KISHIMOTO, M. Electrodiagnosis in facial palsy. Arch. Otolaryng. 95:376, 1972.