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Authors
Advisor(s)
Abstract(s)
A paralisia facial periférica manifesta-se com uma fraqueza ou perda total da
mímica facial. Para além disso, alterações do paladar, salivação, lacrimejo e sensibilidade
ao som também podem estar presentes na clínica. A sua causa mais comum é a paralisia
de Bell. A recorrência da paralisia facial periférica é uma patologia rara, que, no entanto,
possui um vasto quadro de possíveis etiologias. Infelizmente, atualmente não existem
muitos dados/relatos sobre a paralisia facial periférica recorrente, bem como orientações
sobre a avaliação clínica e exames auxiliares de diagnóstico que devem ser realizados
nessa situação.
Com esta monografia, pretende-se reunir informação sobre as diferentes
etiologias que podem cursar com paralisia facial periférica recorrente, focando-se nos
sintomas, exames complementares de diagnóstico e tratamentos possíveis.
Para a realização desta dissertação, recorreu-se maioritariamente ao motor de
pesquisa PubMed para a recolha de artigos relevantes. Para além da Pubmed, utilizaramse livros e outros motores de pesquisa, como o Google Scholar e Elsevier, de forma a
complementar a informação analisada.
Através da análise dos case reports e estudos apresentados, em conjunto com a
teoria estudada, verificou-se que a realização de uma boa história clínica, incluindo
uma avaliação por aparelhos e sistemas, e um exame objetivo detalhado é fundamental
na abordagem de um doente com paralisia facial periférica recorrente. Para além disso,
é essencial a realização de uma investigação mais exaustiva com recurso a exames
complementares de diagnóstico, nomeadamente exames imagiológicos, estudo analítico
completo (incluindo o perfil autoimune; função renal, hepática e tiroideia) e despiste
serológico de infeções bacterianas e víricas a nível sérico e do líquido cefalorraquidiano,
de forma a clarificar a etiologia da causa recorrente da paralisia facial periférica.
É também possível constatar que a grande maioria dos primeiros episódios da
paralisia facial foram mal interpretados como sendo Paralisia de Bell. Desta forma, é
necessário que os profissionais de saúde tenham um elevado índice de suspeição para
certas etiologias perante uma paralisia facial periférica recorrente, pois só assim poderão
fazer um estudo adequado e um diagnóstico assertivo, de forma a proporcionar o correto
tratamento da patologia.
Peripheral facial palsy manifests itself with weakness or total loss of facial mimic. In addition, changes in taste, salivation, lacrimation and sensitivity to sound may also be present in the clinic. It’s most common cause is Bell's palsy. The recurrence of peripheral facial palsy is a rare pathology, however it has a wide range of possible etiologies. Unfortunately, there are currently not many data/reports on recurrent peripheral facial palsy, as well as guidelines on the clinical evaluation and auxiliary diagnostic exams that should be performed in this situation. The aim of this monograph is to gather information on the different etiologies that can occur with recurrent peripheral facial palsy, focusing on symptoms, complementary diagnostic exams and possible treatments. For this dissertation, the PubMed search engine was used as the main source of relevant articles. In addition to PubMed, books and other search engines, such as Google Scholar and Elsevier, were used to complement the information analyzed. By analyzing the case reports and studies presented, together with the studied theory, it was found that a good clinical history, including an assessment by systems, and a detailed physical examination are fundamental when approaching a patient with recurrent peripheral facial palsy. Besides that, it is important to carry out a more exhaustive investigation using complementary diagnostic exams, namely imaging exams, a complete analytical study (including the autoimmune profile; renal, hepatic and thyroid function) and serological screening for bacterial and viral infections in the serum and cerebrospinal fluid, with the aim of clarifying the etiology of the recurrent cause of peripheral facial palsy. It can also be seen that the vast majority of first episodes of facial palsy were misinterpreted as Bell's palsy. Thus, it is necessary for health professionals to have a high suspicion for certain etiologies when faced with recurrent peripheral facial palsy, because only then it will be possible to make an appropriate study and an assertive diagnosis, in order to make a correct treatment for the pathology.
Peripheral facial palsy manifests itself with weakness or total loss of facial mimic. In addition, changes in taste, salivation, lacrimation and sensitivity to sound may also be present in the clinic. It’s most common cause is Bell's palsy. The recurrence of peripheral facial palsy is a rare pathology, however it has a wide range of possible etiologies. Unfortunately, there are currently not many data/reports on recurrent peripheral facial palsy, as well as guidelines on the clinical evaluation and auxiliary diagnostic exams that should be performed in this situation. The aim of this monograph is to gather information on the different etiologies that can occur with recurrent peripheral facial palsy, focusing on symptoms, complementary diagnostic exams and possible treatments. For this dissertation, the PubMed search engine was used as the main source of relevant articles. In addition to PubMed, books and other search engines, such as Google Scholar and Elsevier, were used to complement the information analyzed. By analyzing the case reports and studies presented, together with the studied theory, it was found that a good clinical history, including an assessment by systems, and a detailed physical examination are fundamental when approaching a patient with recurrent peripheral facial palsy. Besides that, it is important to carry out a more exhaustive investigation using complementary diagnostic exams, namely imaging exams, a complete analytical study (including the autoimmune profile; renal, hepatic and thyroid function) and serological screening for bacterial and viral infections in the serum and cerebrospinal fluid, with the aim of clarifying the etiology of the recurrent cause of peripheral facial palsy. It can also be seen that the vast majority of first episodes of facial palsy were misinterpreted as Bell's palsy. Thus, it is necessary for health professionals to have a high suspicion for certain etiologies when faced with recurrent peripheral facial palsy, because only then it will be possible to make an appropriate study and an assertive diagnosis, in order to make a correct treatment for the pathology.
Description
Keywords
Nervo Facial Paralisia Facial Paralisia Facial Periférica Paralisia Facial Periférica Recorrente