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| 題 名 | 一病例報告:周邊型顏面麻痺和第3期高血壓=Peripheral-type Facial Palsy and Stage 3 Hypertension: A Case Report |
|---|---|
| 作 者 | 陳建志; 張馨丰; 陳登郎; | 書刊名 | 臺灣家庭醫學雜誌 |
| 卷 期 | 24:2 2014.06[民103.06] |
| 頁 次 | 頁99-106 |
| 分類號 | 416.844、416.844 |
| 關鍵詞 | 周邊型顏面麻痺; 貝爾氏麻痺; 橋腦出血; 高血壓; Bell's palsy; Hypertension; Peripheral-type facial palsy; Pontine hemorrhage; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 一54歲男性,有吸菸之習慣,具高血壓之病史,因右側顏面肌肉無力1日而就診。來診時高血壓為193/129 mmHg,再確認後為207/130 mmHg。理學檢查顯示右側周邊型顏面麻痺(House-Brackmann面神經分級第4級),尚無其他神經學病症或徵候。然而,腦部電腦斷層顯示右側橋腦有一低密度的區域,磁振造影證實僅是血管旁空間,但是,梯度迴訊時序T2*權重影像顯示右側上橋腦有陳舊性的出血。本個案之週邊型顏面麻痺傾向是貝爾氏麻痺所致或與第3級高血壓有關。貝爾氏麻痺是國內顏面麻痺最常見的原因,但在診治時,需注意患者是否同時具有心血管疾病或是腦出血的風險因子,不要忽略相關的風險告知或密切追蹤。 |
| 英文摘要 | A 54-year-old male smoker with hypertension presented with right-sided facial muscle weakness for one day. At emergency, his blood pressure values were respectively 193/129 mmHg and 207/130 mmHg at initital and re-measurement. Physical examination showed right peripheral-type facial palsy (House-Brackmann Facial Nerve Grading IV) with no presence of other neurologic focal symptoms or signs. However, brain computed tomography identified in the right pons a hypodense lesion, which was later confirmed to be a perivascular space (Virchow-Robin space) as indicated by the magnetic resonance image. Gradient echo T2* weighted image, on the other hand, showed the trace of remote hemorrhage in the right upper pons. Based on the examination results, the right peripheral-type facial palsy appeared to be either attributable to Bell's palsy or associated with stage 3 hypertension. Although Bell's palsy contributes to most facial palsies in Taiwan, a potential brain organic lesion should be considered if a patient has any risk factor of cardiovascular disease or brain hemorrhage; the patient needs to be duly informed of related risks and follow-up shold be initiated withhout hesitation. |
本系統中英文摘要資訊取自各篇刊載內容。