{"id":8128,"date":"2018-07-11T11:03:53","date_gmt":"2018-07-11T11:03:53","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=8128"},"modified":"2018-07-11T11:03:53","modified_gmt":"2018-07-11T11:03:53","slug":"paralizia-faciala-periferica-la-copii","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/paralizia-faciala-periferica-la-copii\/","title":{"rendered":"Paralizia facial\u0103 periferic\u0103 la copii"},"content":{"rendered":"

\n\"\"<\/a>Autor:
\nDr. Gabriela
\nVI\u0218A,
\nmedic primar
\nneurolog, Aria
\nClinic, Sibiu<\/p>\n

\n

Paralizia facial\u0103 periferic\u0103 se manifest\u0103 prin apari\u0163ia\u00a0unei sl\u0103biciuni musculare la nivelul hemife\u0163ei\u00a0\u2013 unilateral sau bilateral, de obicei cu debut\u00a0brusc. Ap\u0103rut\u0103 \u00een perioada copil\u0103riei, poate pune<\/em>
\nimportante probleme de diagnostic \u015fi tratament.<\/em><\/p>\n

Nervul facial are originea \u00een punte \u0219i pe parcursul s\u0103u periferic\u00a0emite ramuri care asigur\u0103 inerva\u021bia glandelor lacrimale,\u00a0a mu\u0219chiului stapedius din urechea intern\u0103, a\u00a0tegumentului urechii externe, a glandelor salivare sublinguale\u00a0\u0219i submandibulare, a celor dou\u0103 treimi anterioare ale limbii \u0219i a\u00a0mu\u0219chilor mimicii. Asimetria facial\u0103 secundar\u0103 afect\u0103rii fibrelor\u00a0periferice ale nervului facial are cauze diverse, poate fi congenital\u0103\u00a0sau dob\u00e2ndit\u0103. \u00cen aproximativ 50% din cazuri nu se poate\u00a0stabili cauza paraliziei, fiind vorba de paralizia Bell (idiopatic\u0103).\u00a0Paralizia nervului facial congenital\u0103 poate ap\u0103rea \u00een cadrul unor\u00a0malforma\u021bii ale sistemului nervos, \u00een boli genetice \u0219i traumatisme\u00a0legate de na\u0219tere.<\/p>\n

\n\u00cen r\u00e2ndul cauzelor dob\u00e2ndite g\u0103sim infec\u021biile, bolile inflamatorii,\u00a0neoplaziile, traumatismele. Cele mai frecvente infec\u021bii asociate \u00a0cu paralizia facial\u0103 periferic\u0103 sunt determinate de virusul varicelozosterian\u00a0(forma Ramsay-Hunt), virusul herpetic, virusul Epstein-Barr, Haemophilus influenzae, boala Lyme, TBC, citomegalovirus,\u00a0HIV, etc. Paralizia facial\u0103 periferic\u0103 poate fi o complica\u021bie a unei \u00a0otite sau otomastoidite, meningite sau a altor boli inflamatorii sistemice.<\/p>\n

\nSchwanoamele nervului VII, hemangioamele localizate \u00een\u00a0apropierea nervului, rabdomiosarcoamele, leucemia, tumorile de\u00a0gland\u0103 parotid\u0103 pot determina simptome care se \u00eencadreaz\u0103 \u00een
\nparalizia periferic\u0103 de nerv facial.Traumatismele \u00een zona capului\/\u00a0fe\u021bei pot leza nervul facial prin strivirea oaselor fe\u021bei sau fracturi\u00a0ale bazei craniului. \u00cen cursul interven\u021biilor chirurgicale pe glanda
\nparotid\u0103, urechea medie sau mastoid\u0103 se pot produce leziuni ale\u00a0nervului. Cele mai \u00eent\u00e2lnite forme la copil sunt paralizia Bell \u0219i paralizia\u00a0cauzat\u0103 de infec\u021bii.<\/p>\n

\nAfectarea ramurilor periferice ale nervului facial determin\u0103 sl\u0103biciune\u00a0muscular\u0103 la nivelul jum\u0103t\u0103\u021bii fe\u021bei corespunz\u0103toare, at\u00e2t\u00a0\u00een partea superioar\u0103, c\u00e2t \u0219i inferioar\u0103. Rezult\u0103 afectarea mi\u0219c\u0103rilor
\nla acest nivel cu deficit de \u00eenchidere a ochiului, cu devierea comisurii\u00a0bucale spre partea s\u0103n\u0103toas\u0103, c\u0103derea comisurii pe partea afectat\u0103, \u0219tergerea pliurilor cutanate la nivelul frun\u021bii \u0219i obrazului, sc\u0103derea\u00a0secre\u021biei lacrimale \u0219i salivare, pot ap\u0103rea dureri \u00een regiunea\u00a0retroauricular\u0103, tulbur\u0103ri de gust, tulbur\u0103ri de auz.<\/p>\n

\n\u00cen cadrul tratamentului, un rol important \u00eel are \u00eengrijirea ocular\u0103\u00a0prin utilizarea de lacrimi artificiale sau unguente cu rol protector\u00a0\u00eempotriva usc\u0103rii corneei. \u00cen formele severe de lagoftalmie se
\npoate face sutura pleoapelor. Studiile efectuate la adul\u021bi recunosc\u00a0eficien\u021ba utiliz\u0103rii corticoterapiei \u00een tratamentul paraliziei Bell. \u0218i \u00een\u00a0cazul copiilor se recomand\u0103 utilizarea acestui tratament \u00een primele\u00a0zile de la debut (\u00een primele 3-7 zile). Cu c\u00e2t tratamenul este ini\u021biat\u00a0mai devreme, cu at\u00e2t viteza refacerii este mai mare.<\/p>\n

\nTratamentul antiviral este recomandat la copii doar c\u00e2nd se\u00a0asociaz\u0103 \u0219i vezicule la nivelul tegumentelor inervate de nervul facial\u00a0(\u00een forma Ramsay-Hunt). \u00cen paralizia de origine traumatic\u0103 se
\npoate face sutura nervului sau chiar transplant de nerv. Tehnicile\u00a0de recuperare \u2013 fizioterapie gr\u0103besc \u0219i ele procesul de recuperare.<\/p>\n

\nComplica\u021biile de tipul hemispasmului facial se pot trata cu toxin\u0103\u00a0botulinic\u0103. \u00cen cazurile determinate de tumori, neoplazii, inflama\u021bii\u00a0sistemice tratamentul va viza boala de baz\u0103. \u00cen cazurile de paralizie\u00a0Bell evolu\u021bia este bun\u0103: 85% din cazuri au recuperare complet\u0103, \u00een\u00a0aproximativ 10% din cazuri pot r\u0103m\u00e2ne mici tulbur\u0103ri de mi\u0219care
\nla nivelul fe\u021bei, iar \u00een 5% din cazuri deficitul r\u0103m\u00e2ne permanent. \u00a0Studiile arat\u0103 un grad de recuperare complet\u0103 \u0219i rapid\u0103 mai mare\u00a0\u00een r\u00e2ndul copiilor comparativ cu adul\u021bii. Un alt factor bun de prognostic\u00a0este severitatea deficitului motor la debut \u2013 formele u\u0219oare\u00a0prezint\u0103 remisia simptomelor mai rapid.<\/p>\n

\n\u00cen aproximativ 5% din cazuri, refacerea poate fi asociat\u0103 cu\u00a0dezvoltarea de sincinezii, contracturi, spasme \u00een teritoriul afectat,\u00a0prin refacerea defectuoas\u0103 a nervului. Poate induce \u0219i probleme
\nemo\u021bionale c\u00e2nd se suprapune adolescen\u021bei, datorit\u0103 afect\u0103rii aspectului\u00a0estetic. Recunoa\u0219terea rapid\u0103 \u0219i stabilirea corect\u0103 a etiologiei\u00a0ajut\u0103 la ini\u021bierea rapid\u0103 a tratamentului \u0219i asigur\u0103 un prognostic\u00a0bun cu recuperare rapid\u0103 \u0219i complet\u0103. Este important\u0103 prezentarea\u00a0la medic de la apari\u021bia primelor semne de boal\u0103.
\nParalizia facial\u0103 periferic\u0103 se manifest\u0103 prin apari\u0163ia\u00a0unei sl\u0103biciuni musculare la nivelul hemife\u0163ei\u00a0\u2013 unilateral sau bilateral, de obicei cu debut\u00a0brusc. Ap\u0103rut\u0103 \u00een perioada copil\u0103riei, poate pune
\nimportante probleme de diagnostic \u015fi tratament.<\/p>\n

\nSibiu, \u0218os. Alba Iulia, nr. 100, facebook\/Aria Clinic, www.aria.com.ro
\nProgram: Luni-Vineri 08:00-20:00, Program\u0103ri la tel: 0269 22 77 72 sau 0269 22 77 73<\/p>\n","protected":false},"excerpt":{"rendered":"

Autor: Dr. Gabriela VI\u0218A, medic primar neurolog, Aria Clinic, Sibiu Paralizia facial\u0103 periferic\u0103 se manifest\u0103 prin apari\u0163ia\u00a0unei sl\u0103biciuni musculare la nivelul hemife\u0163ei\u00a0\u2013 unilateral sau bilateral, de obicei cu debut\u00a0brusc. Ap\u0103rut\u0103 […]<\/p>\n","protected":false},"author":4,"featured_media":8131,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[277],"tags":[],"class_list":["post-8128","post","type-post","status-publish","format-standard","has-post-thumbnail","category-neurologie"],"yoast_head":"\nParalizia facial\u0103 periferic\u0103 la copii - Jurmed - Medici<\/title>\n<meta name=\"description\" content=\"Paralizia facial\u0103 periferic\u0103 la copii e manifest\u0103 prin apari\u0163ia\u00a0unei sl\u0103biciuni musculare la nivelul hemife\u0163ei\u00a0\u2013 unilateral sau bilateral.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/paralizia-faciala-periferica-la-copii\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Paralizia facial\u0103 periferic\u0103 la copii - 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