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首页> 外文期刊>Journal of Neurology Research >Pontine Infarct Camouflaged as Bell’s Palsy
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Pontine Infarct Camouflaged as Bell’s Palsy

机译：庞廷梗塞伪装成贝尔的麻痹

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Facial palsy is a neurological disorder triggered by dysfunction of the seventh cranial nerve, categorized as either central, between the cerebral cortex and brainstem nuclei, or peripheral, between the brainstem nuclei and peripheral organs. Central lesions cause impairment of the contralateral lower facial musculature with associated sparing of the forehead and ocular muscles. Conversely, peripheral lesions produce ipsilateral whole-sided facial hemiplegia including both forehead and ocular muscles. Facial palsy is diagnosed clinically, while imaging studies and additional subsidiary testing (e.g. electromyography, nerve conduction studies), serologies, and rarely biopsy can assist in confirming or refuting the working diagnosis. The differential diagnosis comprises Bell’s palsy (idiopathic), HIV infection, Ramsey Hunt syndrome, Lyme, sarcoidosis, amyloidosis, acoustic neuroma, parotid gland tumor, temporal bone biopsy, otitis media, Guillain-Barre syndrome, and brainstem infarct. Facial palsy is branded as Bell’s palsy if one of the aforementioned etiologies is not identified as the root cause. Herein, we report the case of a 58-year-old male, who presented with left facial weakness involving both the upper and lower face, posterior circulation symptoms in the setting of hypertensive emergency. Initial magnetic resonance imaging (MRI) was unrevealing for any acute process, however given lack of improvement repeat imaging was ordered. The patient was ultimately confirmed to have an acute versus subacute pontine infarct where the seventh and eighth cranial nerve exits at the cerebellopontine angle. Ancillary laboratory studies were non-contributory. Subsequently, the patient’s symptoms continued to improve, blood pressure control was achieved, and was consequently discharged on goal-directed medical therapy.
机译：面神经麻痹是由第七个颅神经功能障碍引发的神经系统疾病，其分类为大脑皮层和脑干核之间的中央或脑干核和外周器官之间的中央。中枢病变会导致对侧下面部肌肉组织受损，并伴有额头和眼肌的稀疏。相反，周围的病变会引起同侧的全脸偏瘫，包括前额和眼肌。临床诊断为面神经麻痹，而影像学检查和其他辅助检查（例如肌电图检查，神经传导检查），血清学检查和极少的活检可以帮助确认或驳回工作诊断。鉴别诊断包括贝尔麻痹（特发性），HIV感染，Ramsey Hunt综合征，莱姆，结节病，淀粉样变性，听神经瘤，腮腺肿瘤，颞骨活检，中耳炎，格林巴利综合征和脑干梗塞。如果上述病因之一未被确定为根本原因，则面神经麻痹被称为“贝尔氏麻痹”。本文中，我们报道了一名58岁男性的情况，该男性在高血压急症中表现出左面部无力，涉及上，下面部，后循环症状。最初的磁共振成像（MRI）在任何急性过程中都没有显露，但是由于缺乏改善，因此需要重复成像。最终证实该患者患有急性与亚急性桥脑梗塞，其中第七和第八颅神经以小脑桥脑角伸出。辅助实验室研究是无贡献的。随后，患者的症状持续改善，血压得到控制，因此接受了针对性药物治疗。

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