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Aktuelle Neurologie 2013; 40(01): 37-48
DOI: 10.1055/s-0032-1332848
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© Georg Thieme Verlag KG Stuttgart · New York

Periphere Fazialisparese

Bell’s Palsy
J. Schiefer
Oberarzt Abteilung Neurologie, Uniklinikum der RWTH Aachen
› Author Affiliations
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Publication History

Publication Date:
13 February 2013 (online)

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Lernziele

Umfassende Kenntnisse

  • des neuroanatomischen Aufbaus und Verlaufs des N. facialis

  • der verschiedenen Läsionsmuster und ihrer differenzialdiagnostischen Abgrenzung

  • des sinnvollen Einsatzes diagnostischer Methoden (Elektrophysiologie, Liquordiagnostik, Bildgebung)

  • der aktuellen therapeutischen Empfehlungen

 

  • Literatur

  • 1 Hirsch A. Friedreich, Nicolaus Anton. In: Allgemeine Deutsche Biographie (ADB). Band 7. Leipzig: Duncker & Humblot; 1878: 400-401
    Google Scholar
  • 2 Frühinsfeld J. Nicolaus Anton Friedreich. Erstbeschreiber der sogenannten rheumatischen Fazialisparese. Lebenslauf und Würzburg. Faksimile der deutschen Erstübersetzung. Medizinische Dissertation. Universität Würzburg; 1983
    Google Scholar
  • 3 Rowlands S, Hooper R, Hughes R et al. The epidemiology and treatment of Bell’s palsy in the UK. Eur J Neurol 2002; 9: 63-67
    CrossrefPubMedGoogle Scholar
  • 4 Hellebrand MC, Friebe-Hoffmann U, Bender HG et al. Das Mona-Lisa-Syndrom – die periphere Fazialisparese in der Schwangerschaft. Z Geburtsh Neonatol 2006; 210: 126-134
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Poeck K, Hacke W. Schädigungen der peripheren Nerven. In: Poeck K, Hacke W, Hrsg. Neurologie. 12.. Aufl. Berlin: Springer; 2006: 628
    Google Scholar
  • 6 Novy J, Michael P, Poncioni L et al. Isolated nuclear facial palsy, a rare variant of pure motor lacunar stroke. Clin Neurol Neurosurg 2008; 110: 420-421
    CrossrefPubMedGoogle Scholar
  • 7 Agarwal R, Manandhar L, Saluja P et al. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell’s palsy: a case report. J Med Case Reports 2011; 5: 287
    Google Scholar
  • 8 Hirose G, Furui K, Yoshioka A et al. Unilateral conjugate gaze palsy due to a lesion of the abducens nucleus. Clinical and neuroradiological correlations. J Clin Neuroophthalmol 1993; 13: 54-58
    PubMedGoogle Scholar
  • 9 Danchaivijitr C, Kennard C. Diplopia and eye movement disorders. J Neurol Neurosurg Psychiatry 2004; 75: iv24-31
    CrossrefPubMedGoogle Scholar
  • 10 Roh JK, Kim BK, Chung JM. Combined peripheral facial and abducens nerve palsy caused by caudal tegmental pontine infarction. Eur Neurol 1999; 41: 99-102
    CrossrefPubMedGoogle Scholar
  • 11 Heckmann JG, Doerr M, Lang CJ. Idiopathische periphere Fazialisparese. Gesichtsnerv im Streik. INFO Neurologie&Psychiatrie 2009; 11: 34-36
    PubMedGoogle Scholar
  • 12 Fisch U. Surgery of Bell’s palsy. Arch Otolaryngol 1981; 107: 1-11
    Google Scholar
  • 13 Eicher SA, Coker NJ, Alford BR et al. A comparative study of the fallopian canal and the meatal foramen and labyrinthine segment in jung children and adults. Arch Otolaryngol Head Neck Surg 1990; 116: 1030-1035
    CrossrefPubMedGoogle Scholar
  • 14 Wolf SR. Die idiopathische Fazialisparese. HNO 1998; 46: 786-798
    CrossrefPubMedGoogle Scholar
  • 15 Esslen E. Investigations on the localization and pathogenesis of meato-labyrinthine facial palsies. In: Esslen E, ed. The acute facial palsies. Berlin: Springer; 1977: 41
    CrossrefGoogle Scholar
  • 16 Marra CM. Bell’s palsy and HSV-1 infection. Muscle Nerve 1999; 22: 1476-1478
    CrossrefPubMedGoogle Scholar
  • 17 Gilden DH. Bell’s palsy. N Engl J Med 2004; 351: 1323-1331
    CrossrefPubMedGoogle Scholar
  • 18 Sweeney CJ, Gilden DH. Ramsay Hunt syndrome. J Neurol Neurosurg Psychiatry 2001; 71: 149-154
    CrossrefPubMedGoogle Scholar
  • 19 Tsai J, Cohrs RJ, Nagel MA et al. Reactivation of type 1 herpes simplex virus and varicella zoster virus in immunosuppressed patient with acute peripheral facial weakness. J Neurol Sci 2012; 313: 193-195
    CrossrefPubMedGoogle Scholar
  • 20 Lee HY, Kim MG, Park DC et al. Zoster sine herpete causing facial palsy. Am J Otolaryngol 2012; 3: 46
    PubMedGoogle Scholar
  • 21 Rana PV, Wadia RS. The Marin-Amat syndrome: an unusual facial synkinesia. J Neurol Neurosurg Psychiatry 1985; 48: 939-941
    CrossrefPubMedGoogle Scholar
  • 22 Peitersen E. The natural history of Bell’s palsy. Am J Otol 1982; 4: 107-111
    PubMedGoogle Scholar
  • 23 Peitersen E. Bell’s palsy: the spontaneous course of 2500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl 2002; 122: 4-30
    Google Scholar
  • 24 Monrad-Krohn GH. On the dissociation of voluntary and emotional innervations in facial paresis of central origin. Brain 1924; 47: 22-35
    CrossrefPubMedGoogle Scholar
  • 25 Hopf HC, Müller-Forell W, Hopf NJ. Localization of emotional and volitional facial paresis. Neurology 1992; 42: 1918-1923
    CrossrefPubMedGoogle Scholar
  • 26 Töpper R, Kosinski C, Mull M. Volitional type of facial palsy associated with pontine ischaemia. J Neurol Neurosurg Psychiatry 1995; 58: 732-734
    CrossrefPubMedGoogle Scholar
  • 27 Therapie der idiopathischen Fazialisparese (Bell’s palsy). Leitlinie der Deutschen Gesellschaft für Neurologie. AWMF-Leitlinien-Register; 030/013, 2011
    Google Scholar
  • 28 Rattay T, Dafotakis M, Eickhoff S, Sass C, Schiefer J. Die Rolle der cranialen Computertomographie bei der peripheren Fazialisparese. Abstract Jahrestagung DGN 2011. ISBN: 978-3-940017-80-2 ISSN Nr. 2192-9394
    Google Scholar
  • 29 Thömke F, Urban PP, Marx JJ et al. Seventh nerve palsies may be the only clinical signe of small pontine infarctions in diabetic and hypertensive patients. J Neurol 2002; 249: 1556-1562
    CrossrefPubMedGoogle Scholar
  • 30 Sartoretti-Schefer S, Brandle P, Wichmann W et al. Intensity of MR contrast enhancement does not correspond to clinical and electroneurographic findings in acute inflammatory facial nerve palsy. AJNR Am J Neuroradiol 1996; 17: 1229-1236
    PubMedGoogle Scholar
  • 31 Yetiser S, Kazakayas M, Altinok D et al. Magnetic resonance imaging of the intratemporal facial nerve in idiopathic peripheral facial palsy. Clin Imaging 2003; 27: 77-81
    CrossrefPubMedGoogle Scholar
  • 32 Song MH, Kim J, Jeon JH et al. Clinical significance of quantitative analysis of facial nerve enhancement on MRI in Bell’s palsy. Acta Otolaryngol 2008; 128: 1259-1265
    CrossrefPubMedGoogle Scholar
  • 33 Burmeister HP, Baltzer PA, Volk GF et al. Evaluation of the early phase of Bell’s palsy using 3 T MRI. Eur Arch Otorhinolaryngol 2011; 268: 1493-1500
    Google Scholar
  • 34 Kohler A, Chofflon M, Sztajzel R et al. Cerebrospinal fluid in acute peripheral facial palsy. J Neurol 1999; 246: 165-169
    CrossrefPubMedGoogle Scholar
  • 35 Birkmann C, Bamborschke S, Halber M et al. Bell’s palsy: electrodiagnostics are not indicative of cerebrospinal fluid abnormalities. Ann Otol Rhinol Laryngol 2001; 110: 581-584
    PubMedGoogle Scholar
  • 36 Hato N, Yamada H, Kohno H et al. Valaciclovir and prednisolone treatment for Bell’s palsy: a multicenter, randomized, placebo-controlled study. Otol Neurotol 2007; 28: 408-413
    CrossrefPubMedGoogle Scholar
  • 37 Rimpiläinen I, Karma P, Laranne J et al. Magnetic facial nerve stimulation in Bell’s palsy. Acta Otolaryngol 1992; 112: 311-316
    PubMedGoogle Scholar
  • 38 Rimipiläinen I, Eskola H, Laippala P et al. Prognostication of Bell’s palsy using transcranial magnetic stimulation. Acta Otolaryngol Suppl 1997; 529: 111-115
    PubMedGoogle Scholar
  • 39 Takemoto N, Horii A, Sakata Y et al. Prognostic factors of peripheral facial palsy: multivariate analysis followed by receiver operating characteristic and Kaplan-Meier analyses. Otol Neurotol 2011; 32: 1031-1036
    CrossrefPubMedGoogle Scholar
  • 40 Mamolie B. Zur Prognoseerstellung peripherer Fazialisparesen unter besonderer Berücksichtigung der Elektroneurographie. Wien Klin Wschr 1976; 53: 3-28
    PubMedGoogle Scholar
  • 41 Hopf HC. Topodiagnostic value of brain stem reflexes. Muscle Nerve 2004; 17: 475-484
    PubMedGoogle Scholar
  • 42 Angerer M, Pfadenhauer K, Stöhr M. Prognosis of facial palsy in Borrelia burgdorferi meningopolyradiculitis. J Neurol 1993; 240: 319-321
    CrossrefPubMedGoogle Scholar
  • 43 Devriese PP, Moesker WH. The natural history of facial paralysis in herpes zoster. Clin Otolaryngol 1988; 13: 289-298
    CrossrefPubMedGoogle Scholar
  • 44 Teixeira LJ, Soares BGDO, Vieira VP. Physical therapy for Bell’s palsy (idiopathic facial paralysis) (Protocol). Cochrane Database Syst Rev 2006; 4 CD006283
    PubMedGoogle Scholar
  • 45 Teixera LJ, Valbuza JS, Prado GF. Physical therapy for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2011; 12 CD006283
    PubMedGoogle Scholar
  • 46 He L, Zhou D, Wu B et al. Acupuncture for Bell’s palsy. Cochrane Database Syst Rev 2004; 1 CD002914
    PubMedGoogle Scholar
  • 47 Kim JI, Lee MS, Choi TY et al. Acupuncture for Bell’s palsy: a systematic review and metaanalysis. Chin J Integr Med 2012; 18: 48-55
    CrossrefPubMedGoogle Scholar
  • 48 Cumberworth A, Mabvuure NT, Norris JM et al. Is acupuncture beneficial in the treatment of Bell’s palsy? Best Evidence Topic (BET). Int J Surg 2012; 10: 310-312
    CrossrefPubMedGoogle Scholar
  • 49 Dalla Toffola E, Tinelli C, Lozza A et al. Choosing the best rehabilitation treatment for Bell’s palsy. Eur J Phys Rehabil Med 2012; 48: 635-642
    PubMedGoogle Scholar
  • 50 Cao H, Li X, Liu J. An updated review of the efficacy of cupping therapy. PLoS ONE 2012; 7: e31793
    CrossrefPubMedGoogle Scholar
  • 51 Chang CY, Cass SP. Management of facial nerve injury due to temporal bone trauma. Am J Otol 1999; 20: 96-114
    CrossrefPubMedGoogle Scholar
  • 52 Berghaus A, Strieth S. Diagnostik, Therapie und Rehabilitation bei peripheren Fazialisparesen. MMW-Fortschr Med 2009; 36: 40-44
    PubMedGoogle Scholar
  • 53 Holland NJ, Weiner GM. Recent developments in Bell’s palsy. Br Med J 2004; 329: 553-557
    CrossrefPubMedGoogle Scholar
  • 54 Grogan PM, Gronseth GS. Practice parameter: Steroids, acyclovir, and surgery for Bell’s palsy (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001; 56: 830-836
    CrossrefPubMedGoogle Scholar
  • 55 McAllister K, Walker D, Donnan PT et al. Surgical interventions for early management of Bell’s palsy. Cochrane Database Syst Rev 2011; 2 CD007468
    PubMedGoogle Scholar
  • 56 Smouha E, Toh E, Barry M et al. Surgical treatment of Bell’s palsy: current attitudes. Laryngoscope 2011; 121: 1965-1970
    PubMedGoogle Scholar
  • 57 Kaylie DM, Hogan MJ, Delashaw JB et al. A meta-analysis comparing outcomes of microsurgery and gamma knife radiosurgery. Laryngoscope 2000; 110: 1850-1856
    CrossrefPubMedGoogle Scholar
  • 58 Berghaus A, Neumann K, Schrom T. The platinum chain – a new upper-lid implant for facial palsy. Arch Facial Plast Surg 2003; 5: 166-170
    CrossrefPubMedGoogle Scholar
  • 59 Sokolovsky M, Paez MD, di Masi G et al. Bell’s palsy and partial hypoglossal to facial nerve transfer: case presentation and literature review. Surg Neurol Int 2012; 3: 46
    CrossrefPubMedGoogle Scholar
  • 60 Wutzler P, Gross G, Doerr HW. Antivirale Therapie des Zoster. Dtsch Ärztebl 2003; 100: A858-A860
    PubMedGoogle Scholar
  • 61 Wiener A, Touloei K, Glick BP. A novel long-term therapy of facila synkinesis with botulinum neurotoxin type A and fillers. J Clin Aesthet Dermatol 2011; 4: 45-49
    PubMedGoogle Scholar
  • 62 Filipo R, Spahiu I, Covelli E et al. Botulinum toxin in the treatment of facial synkinesis and hyperkinesis. Laryngoscope 2012; 122: 266-270
    CrossrefPubMedGoogle Scholar
  • 63 Shafshak TS, Essa AY, Bakey FA. The possible contributing factors for the success of steroid therapy in Bell’s palsy: a clinical and electrophysiological study. J Laryngol Otol 1994; 108: 940-943
    PubMedGoogle Scholar
  • 64 Sullivan FM, Swan IR, Donnan PT et al. Early treatment with prednisolone or aciclovir in Bell’s palsy. N Engl J Med 2007; 357: 1598-1607
    CrossrefPubMedGoogle Scholar
  • 65 Axelsson S, Berg T, Jonsson L et al. Prednisolone in Bell’s palsy related to treatment start and age. Otol Neurotol 2011; 32: 141-146
    CrossrefPubMedGoogle Scholar
  • 66 Engström M, Berg T, Stjernquist-Desatnik A et al. Prednisolone and valaciclovir in Bell’s palsy: a randomised, double-blind placebo-controlled, multicentre trial. The Lancet Neurology 2008; 7: 993-1000
    CrossrefPubMedGoogle Scholar
  • 67 Sara A, Thomas B, Lars J et al. Bell’s palsy – the effect of prednisolone and/or valaciclovir versus placebo in relation to baseline severity in a randomised controlled trial. Clin Otolaryngol 2012; 37: 283-290
    CrossrefPubMedGoogle Scholar
  • 68 De Almeida JR, Al Khabori M, Guyatt GH et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis. JAMA 2009; 302: 985-993
    CrossrefPubMedGoogle Scholar
  • 69 Gilden DH, Tyler KL. Bell’s palsy – is glucocorticoid treatment enough?. N Engl J Med 2007; 357: 1653-1655
    CrossrefPubMedGoogle Scholar
  • 70 Van der Veen EL, Rovers MM, de Ru JA et al. A small effect of adding antiviral agents in treating patients with severe Bell palsy. Otolaryngol Head Neck Surg 2012; 146: 353-357
    CrossrefPubMedGoogle Scholar