地域基幹病院における中枢性を含めた顔面神経麻痺の５年間374例の検討

Abstract

Acute onset of peripheral facial nerve palsy necessitates a prompt evaluation and treatment by otorhinolaryngologists.Generally, most patients are of the opinion that treatment of facial palsy is in the domain of otolaryngology. Although several reports on cases of peripheral facial nerve palsy are available, few reports on cases of central facial nerve palsy exist. In this study, we elucidated the etiological background of patients with types of facial nerve palsy, such as peripheral and central facial nerve palsy, at Aizawa Hospital, a regional core hospital in Japan. We conducted a retrospective chart review of 374 patients with peripheral and central facial nerve palsies who visited our hospital from January 2016 to December 2020. Out of the 374 patients, 258(69%) , 108(29%) , and eight(2%)patients had peripheral, central, and unknown facial nerve palsies, respectively. The most prevalent causes of peripheral and central facial nerve palsies were Bell's palsy(211 out of 258 patients, 81%)and cerebral infarction(72 out of 108 patients, 67%) , respectively. On the one hand, patients who visited the emergency department for initial medical care accounted for 40% of patients with peripheral facial nerve palsy and 73% of patients with central facial nerve palsy. On the other hand, only 16% of patients with peripheral facial nerve palsy visited the otolaryngology department. Patients with facial palsy, irrespective of the type, visited the emergency department more frequently than the otorhinolaryngology department. For an appropriate workup and treatment of patients with peripheral facial nerve palsy at the otorhinolaryngology department, co-operation with other medical departments is necessary.