末梢性顔面神経麻痺についての1私見 (京都大学医学部耳鼻咽喉科学教室6年間の歩み(1977-1982年)--檜学教授還暦によせて)
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Recently, the degree of facial paralysis has been described numerically using May's paralysis score method. In complete recovery, the time course of Bell's palsy can be analysed by the following equation.y=B. log x+Awhere y: value of scorex: days post onsetB: recovery rateA: constantA pathological process of facial paralysis was analysed by this equation and reviewed from the "axonal flow" point of view.The integrated EMG represents the strength of the corresponding muscle and its value indicates the degree of paralysis in facial palsy. From the study of an integrated EMG and the paralysis score method, a close relation between the two methods was revealed, with a high value of correlation coefficient. This indicates that the paralysis score method was substantiated by the objective method, namely integrated EMG. To aquire constant results, the same person should rate the paralysis score during the whole time sequence.Because the facial nerve has several types of branches besides the main trunk, the thread lacrimation test, stapedial reflex test, and integrated EMG enable determination of the site of the lesion and the pattern of recovery. The combined use of these tests with the score method facilitates understanding of the following results.1) When the stapedial reflex is present and do not disappear, paralysis recovers quickly.2) Recovery from paralysis is sometimes accompanied by a high value in the thread lacrimation test.3) The integrated EMG represents patients complaints more accurately than the score method.
- 耳鼻咽喉科臨床学会の論文
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