Öz
Bilateral facial paralysis is an extremely rare clinical entity. It most often appears a special finding in a symptom complex of a systemic disease; many of them are potentially life-threatening. Failure to diagnose and treat at an early stage can have adverse clinical outcomes, and therefore clinicians should be aware of the differential diagnosis when evaluating a case. Lyme disease, Guillain-Barre syndrome, Bell's palsy, leukemia, sarcoidosis, bacterial menengitis, syphilis, leprosy, Moebius syndrome, infectious mononucleosis, and skull fracture are the most common causes of bilateral facial paralysis. A 55 years old man suffering from fatiguability, myalgia and ear pain since one month, has delivered peripheral facial paralysis after six days in addition to mentioned symptoms first on the right then on the left side. Specific antibody positivity against Borrelia burgdorferi was measured in the patient's serum, in addition to a tickbite history. Our case diagnosed Lyme disease was begun amoxicilline theraphy and in a short-time, his symptoms relieved. Through this case, we wanted to notice Lyme disease that is one of the causes of bilateral facial paralysis and to emphasize the necessity to ascertain ‘' a tick-bite,, history and to search the specific antibodies against Borrelia burgdorferi in such cases. Key words: Bilateral facial paralysis, Lyme disease, Tick-bite, Erythema migrans
Anahtar Kelimeler
Bilateral facial paralysis Lyme disease Tick-bite Erythema migrans
Kaynakça
- Agarwal S, Ferrilo M, Pobre T, Weiss L. Bilateral simultaneous facial nerve paralysis: A case report. Arch Phys Med Rehabil 2004 Sep;85(9):E36.
- Marques A, Martin R. Lyme Disease. In: Noseworthy JH, ed(s). Neurological Therapeutics Principles and Practice. 1st ed. London 2003:917-29.
- Speelman P, de Jongh BM, Wolfs TF, Wittenberg J. Guideline ‘Lyme borreliosis’. Ned Tijdschr Geneeskd 2004 Apr 3;148(14):659-63.
- Bradley W, Daroff R, Fenichel G, Marsden D. Neurology in Clinical Practice.2 nd ed. USA.1996.
- Gevers G, Lemkens P. Bilateral simultaneous facial paralysis-differantial diagnosis treatment options. A case report and review of literature. Acta Otorhinolaryngol Belg 2003;57(2):139-46.
- Laubert A, Malin JP. Prognosis of peripheral facial paralysis in Lyme borreliosis(Garin- Bujadoux, Bannwarth meningopolyradiculitis). HNO 1989 Apr;37(4):158-61.
- Rowland L.P. Merritt’s Neurology. Tenth ed. USA. 2000.
- Kuiper H. Clinical spectrum and incidence of neuro-borreliosis in the Netherlands. Ned Tijdschr Geneeskd 2004 Apr 3;148(14):670-3.
- Peltomaa M, Pyykko I, Seppala I, Viljanen M. Lyme borreliosis and facial paralysis-a prospective analysis risk factors and outcome. Am J Otolarynngol 2002 May- Jun;23(3):125-32.
- Lynn D. J, Newton H.B, Rae-Grant A. D. The 5-Minute Neurology Consult; 1st ed. Istanbul.2005.
Öz
Bilateral fasiyal paralizi nadir bir klinik antitedir. Sıklıkla potansiyel olarak hayati tehlike taşıyan sistemik bir hastalığın bulgusu olarak karşımıza çıkar. Erken evrede yetersiz tanı ve tedavi klinik sonuçları olumsuz etkileyebilir. Bu durum klinisyenlerin ayırıcı tanıda dikkatli olmalarını gerektirir. Bilateral fasiyal paralizinin en yaygın nedenleri arasında Lyme hastalığı, Guillain-Barre sendromu, Bell paralizisi, lösemi, sarkoidoz, bakteriyel menenjit, sifiliz, lepra, Moebius sendromu, infeksiyöz mononükleozis ve kafatası fraktürü yer alır. Bir aydır varolan halsizlik, kas ağrısı ve kulak ağrısı şikayetlerine altı gün arayla önce sağ, sonra sol periferik fasiyal paralizi eklenen ellibeş yaşında erkek hastada, kene ısırığı öyküsüne ek olarak serumda Borrelia burgdorferi'ye spesifik antikor pozitifliği saptandı. Lyme hastalığı tanısı alan olgumuza amoksisilin tedavisi başlandı ve kısa sürede semptomlarında düzelme gözlendi. Biz bu vaka aracılığıyla bilateral fasiyal paralizi nedenlerinden biri olan Lyme hastalığına dikkat çekmek, böyle vakalarda kene ısırığını sorgulamanın ve Borrelia burgdorferi' ye spesifik antikorların araştırılmasının gerekliliğini vurgulamak istedik. Anahtar kelimeler: Bilateral fasiyal paralizi, Lyme hastalığı, Kene ısırığı, Eritema migrans
Anahtar Kelimeler
Bilateral fasiyal paralizi Lyme hastalığı Kene ısırığı Eritema migrans
Kaynakça
- Agarwal S, Ferrilo M, Pobre T, Weiss L. Bilateral simultaneous facial nerve paralysis: A case report. Arch Phys Med Rehabil 2004 Sep;85(9):E36.
- Marques A, Martin R. Lyme Disease. In: Noseworthy JH, ed(s). Neurological Therapeutics Principles and Practice. 1st ed. London 2003:917-29.
- Speelman P, de Jongh BM, Wolfs TF, Wittenberg J. Guideline ‘Lyme borreliosis’. Ned Tijdschr Geneeskd 2004 Apr 3;148(14):659-63.
- Bradley W, Daroff R, Fenichel G, Marsden D. Neurology in Clinical Practice.2 nd ed. USA.1996.
- Gevers G, Lemkens P. Bilateral simultaneous facial paralysis-differantial diagnosis treatment options. A case report and review of literature. Acta Otorhinolaryngol Belg 2003;57(2):139-46.
- Laubert A, Malin JP. Prognosis of peripheral facial paralysis in Lyme borreliosis(Garin- Bujadoux, Bannwarth meningopolyradiculitis). HNO 1989 Apr;37(4):158-61.
- Rowland L.P. Merritt’s Neurology. Tenth ed. USA. 2000.
- Kuiper H. Clinical spectrum and incidence of neuro-borreliosis in the Netherlands. Ned Tijdschr Geneeskd 2004 Apr 3;148(14):670-3.
- Peltomaa M, Pyykko I, Seppala I, Viljanen M. Lyme borreliosis and facial paralysis-a prospective analysis risk factors and outcome. Am J Otolarynngol 2002 May- Jun;23(3):125-32.
- Lynn D. J, Newton H.B, Rae-Grant A. D. The 5-Minute Neurology Consult; 1st ed. Istanbul.2005.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Nisan 2005 |
| Yayımlandığı Sayı | Yıl 2005 Cilt: 12 Sayı: 2 |