特発性顔面神経麻痺におけるウイルス感染の実態に関する研究

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It is of great importance to know the incidence of viral infection on Bells palsy and to establish an early differential diagnosis, not only for elucidating the causes of Bells palsy but also for deciding the proper treatment, in 11 research facilities located throughout Japan were studied on 257 cases diagnosed as Bells palsy and compared with the result on a healthy control group and a Ramsay Hunts syndrome group. Antibody titers to eight viruses: varicella-zoster virus, herpes simplex virus, influenza A and B virus, mumps virus, adenovirus (all the above by complement-fixing reaction), rubella virus, and Japanese encephalitis virus (the last two by hemoagglutination inhibitation test). Viral infection was judged positive in such a case that titer differerence between the acuteand convalescent-phase specimens was four times or more. For the Ramsay Hunts syndrome group (47 cases), all except the extremely mild cases exhibited significant increase in the antibody titer to varicella-zoster virus, re-confirming that V-Z virus caused Ramsay Hunts syndrome. Out of the 257 cases of Bells palsy, 94 cases (37%) showed significant increase in one or more of the types of virus by repetitive examination. Forty-five cases (18%) in the patients showed a significant rise in V-Z antibody titers. There were 14 cases (5%) for which herpes simplex virus can be the cause of paralysis. The fact that the incidence of mixed infection with influenza A virus, influenza B virus, or adenovirus in patients of zoster sine herpete (27%) was markedly greater than in the case of Ramsay Hunts syndrome (4%) may indicate that owing to mixed infection with these viruses, lowvirulence varicellazoster virus may interact to generate facial paralysis

特発性顔面神経麻痺におけるウイルス感染の実態に関する研究

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