両側同時性顔面神経麻痺の4症例

Four Cases of Bilateral Simultaneous Facial Palsy

I．はじめに

　両側性の顔面神経麻痺は各種の原因で起こることが知られているが，比較的稀な疾患である。その中でも両側同時期に起きてくるのはさらに稀である。我々は発症間隔が4日から15日までの両側同時性顔面神経麻痺の4症例を経験したので，文献的考察を加えて報告する。

　Four cases of bilateral simultaneous facial palsy had different causes such as Ramsay-Hunt syndrome, Bell's palsy, acute promyelocytic leukemia and metastatic cerebellopontine angle tumor.

　From these four cases the following points were concluded :

　1) In Ramsay-Hunt syndrome, palsy on the firstly involved side was severer than that of the secondly involved side. The first side was improved by decompression operation more than two months after onset.

　2) In Bell's palsy, against the other reports, the degree of palsy firstly involved side was not always severer than secondly side.

　3) In leukemia, the relapse of the leukemia was discovered by the facial palsy. And the palsy was cured by the treatment of leukemia.

　4) Metastatic adenocarcinoma in left cerebellopontine angle cause the facial palsy of not only the left side but also the right side which was previously misdiagnosed as Bell's palsy. The cause of the palsy of the right side turned out to be meningeal carcinomatosis.