Bell麻痺及びRamsay-Hunt症候群の統計的観察 : 臨床像の検討と鑑別診断について

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概要

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• Based upon observations on clinical pictures of 98 patients with Bells palsy or RamsayHunts syndrome, the following results were obtained.1) Bells palsy was frequently found in children under 3 years of age, while no Ramsay-Huntssyndrome was found.2) As to sex-difference, males were more frequently suffered from Ramsay-Hunts syndrome.3) Periauricular pain, in a broad sense, was noticed in about 90% of cases with RamsayHunts syndrome, and it seemed to be diagnostic of the disease.4) The clinical pictures of Ramsay-Hunts syndrome were various, and atypical types were noticed more frequently than typical ones.5) Occurrence of each of three major manifestations Ramsay-Hunts syndrome was about 80%.6) The diagnosis of geniculate herpes zoster should carefully be made, because the clinical findings varied according to the clinical stages, and the clinical course was not always typical.7) Of VIIIth nerve involvement, cochlear symptoms (tinnitus and hearing loss) were often found independently. Vestibular symptoms without cochlear signs were seldom found.8) The primary lesion of Ramsay-Hunts syndrome was considered to be the geniculate ganglion or the vestibulocochlear ganglion.9) At least, one third of Bells palsy were actually considered to be of atypical Ramsay-Hunts syndrome.10) Some cases with clinical diagnosis of sudden deafness or cochlear neuronitis could possibly be of atypical Ramsay-Hunts syndrome.11) Differential diagnosis of Bells palsy from Ramsay-Hunts syndrome should be made by careful taking of the patients history and the physical examinations. Especially the existence of geniculate herpes zoster and hearing loss should carefully be confirmed.

著者

• 阿部 隆

  岩手医科大学 耳鼻咽喉科

• 阿部 隆

  岩手医科大学耳鼻咽喉科学教室

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