Bell麻痺及びRamsay-Hunt症候群の統計的観察

臨床像の検討と鑑別診断について

抄録

Based upon observations on clinical pictures of 98 patients with Bell's palsy or RamsayHunt's syndrome, the following results were obtained.
1) Bell's palsy was frequently found in children under 3 years of age, while no Ramsay-Hunt'ssyndrome was found.
2) As to sex-difference, males were more frequently suffered from Ramsay-Hunt's syndrome.
3) Periauricular pain, in a broad sense, was noticed in about 90% of cases with RamsayHunt's syndrome, and it seemed to be diagnostic of the disease.
4) The clinical pictures of Ramsay-Hunt's syndrome were various, and atypical types were noticed more frequently than typical ones.
5) Occurrence of each of three major manifestations Ramsay-Hunt's syndrome was about 80%.
6) The diagnosis of geniculate herpes zoster should carefully be made, because the clinical findings varied according to the clinical stages, and the clinical course was not always typical.
7) Of VIIIth nerve involvement, cochlear symptoms (tinnitus and hearing loss) were often found independently. Vestibular symptoms without cochlear signs were seldom found.
8) The primary lesion of Ramsay-Hunt's syndrome was considered to be the geniculate ganglion or the vestibulocochlear ganglion.
9) At least, one third of Bell's palsy were actually considered to be of atypical Ramsay-Hunt's syndrome.
10) Some cases with clinical diagnosis of sudden deafness or cochlear neuronitis could possibly be of atypical Ramsay-Hunt's syndrome.
11) Differential diagnosis of Bell's palsy from Ramsay-Hunt's syndrome should be made by careful taking of the patients' history and the physical examinations. Especially the existence of geniculate herpes zoster and hearing loss should carefully be confirmed.