以單側周邊型顏面神經麻痺為表徵之橋腦梗塞－個案報告

A Rare Case of Pontine Infarction Presenting with Unilateral Peripheral-type Facial Palsy

陳建志(Jiann-Jy Chen) ； 陳登郎(Dem-Lion Chen) ； 劉崇祥(Chung-Hsiang Liu) ； 蔡崇豪(Chon-Haw Tsai)

《台灣老年醫學暨老年學雜誌》 8卷1期 (2013/02) Pp. 47-53

https://doi.org/10.29461/TGG.201302_8(1).0004

摘要

造成周邊型顏面神經麻痺最常見的原因為貝氏麻痺（54%），其次為耳性帶狀疱疹（Ramsay-Hunt症候群）（20%）、外傷性麻痹（12%）或其他（4%）。一71歲老年男性，因突發左側周邊型顏面神經麻痺（House-Brackmann分級第4級）至本院急診，合併左側突發性耳聾、眩暈及寬大步伐。腦部磁振造影顯示左側橋腦及小腦梗塞。美國國家衛生研究院中風評量表評為4分。橋腦梗塞僅以周邊型顏面神經麻痺為表徵者很罕見，本個案之單側周邊型顏面神經麻痺同時合併了同側突發性耳聾、眩暈及小腦徵兆，不應視為常見之貝氏麻痺，應考慮腦幹病變。

關鍵字

顏面神經麻痺 ； 突發性耳聾 ； 橋腦梗塞 ； 小腦梗塞

並列摘要

The most common etiology of peripheral-type facial palsy is Bell's palsy (54%), followed respectively by herpes zoster otitis (Ramsay-Hunt syndrome) (20%), traumatic palsy (12%), and others (4%). A 71-year-old man presented with left peripheral-type facial palsy (House-Brackmann classification IV), left sudden deafness, vertigo, and wide-based gait. Brain magnetic resonance imaging demonstrated left pontine and cerebellar infarctions. The National Institutes of Health Stroke Scale was 4. Isolated pontine infarction rarely presents with isolated peripheral-type facial palsy. The case's unilateral peripheral-type facial palsy was complicated with ipsilateral sudden deafness, vertigo and other cerebellar signs; it was therefore attributable to a brainstem lesion rather than Bell's palsy, the common cause of peripheral-type facial palsy.

並列關鍵字

facial palsy ； sudden deafness ； pontine infarction ； cerebellar infarction