軟口蓋麻痺の16症例

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We have treated 16 patients with soft palate paralysis, and present two cases here. One patient had a viral infection and the other myasthenia gravis.Among the causes of soft palate paralysis, the incidence of diphtheria is decreasing, and viral infections and cerebrovascular disorders are most common.Bilateral paralysis was noted in cases of amyotrophic lateral sclerosis and myasthenia gravis of the soft palate alone. When the paralysis is bilateral, diseases of the nervous system or hysteria should be suspected. In myasthenia gravis the antilex (Edrophonium) test is useful for diagnosis.In all cases of viral infection, the paralysis was unilateral. In some cases other areas were also paralyzed. Four patients had laryngeal palsy, one had facial palsy, and one had accessory nerve palsy. These cases remind us that the soft palate receives nerve fibers from the nucleus ambiguus.When viral infection is suspected the measurement of viral antibody titers is useful for diagnosis. In positive cases, we recommend r-globulin or interferon as the intial therapy.
耳鼻咽喉科臨床学会の論文