疱疹顿挫型面瘫同亨特综合征一样，由水痘-带状疱疹病毒（varicella-zoster virus VZV）感染面神经所致，多为潜伏在膝状神经节的VZV病毒再次复活感染。表现为急性周围性面瘫，耳、舌、咽等部位的剧烈疼痛，伴有眩晕、听力下降等症状，但不出现疱疹，所以在临床中常常被误诊为贝尔面瘫。而其不论是病因、发病机制还是治疗及愈后方面与贝尔面瘫都不同，临床中常常耽误治疗，影响患者的愈后。本文就疱疹顿挫性面瘫在临床特征、发病机制、诊断、治疗及愈后等方面的进展做一综述，以引起耳鼻咽喉科医师对此类疾病的关注。%Zoster sine herpete (ZSH) facial palsy is caused by the varicella-zoster virus (VZV), similar to Ramsay Hunt syndrome. Latent VZV infection is reactivated in the geniculate ganglion, causing acute peripheral facial palsy, severe pain in the ear, tongue, pharynx and other regions of head and neck. Vertigo and hearing loss can be part of the process. However, facial palsies caused by VZV are not always accompanied by vesicular eruption, and these cases are referred to as zoster sine herpete (ZSH). Distinguishing ZSH from Bell palsy is difficult, and ZSH is often clinically diagnosed as Bell pal-sy. However, the etiology, pathogenesis, treatment and prognosis are quite different. So facial palsy in ZSH is often misdiag-nosed and adequate treatment delayed, leading to poor prognosis. In this paper, we elaborate on the clinical features, patho-genesis, diagnosis, treatment and prognosis of ZSH associated facial palsy, in order to bring it to the attention of Otorhinolar-yngologist.
展开▼
