소아에서 벨 마비의 발생빈도, 임상적 특징 및 예후에 대한 연구 = Incidence, clinical features and prognosis of Bell's palsy in children

다국어 초록 (Multilingual Abstract)

Purpose : Bell's palsy is defined as an idiopathic facial nerve paralysis of sudden onset. In spite of intensive clinical and experimental investigation, there is still uncertainty in the incidence, etiology, and preferred mode of treatment in children. The objective of this study was to analyze clinical outcome and prognosis of children with Bell' palsy.
Methods : We analyzed 61 cases of Bell's palsy diagnosed at the Department of Wonkwang University Hospital from January 1998 to July 2006. The inclusion criteria were any children with acute isolated unilateral lower motor neuron type of facial nerve palsy. The clinical findings and investigations were reviewed including age, sex, affected site, seasonal incidence and result of steroid treatment. Chi-square and Fisher's exact test was used to compare clinical outcome between duration of complete recovery and age.
Results : There was no difference in incidence according to sex or age. Incidence was higher in summer and winter. There was no difference in complete recovery rate and duration between steroid treated group and control group. In the group of children younger than 6 years, duration of complete recovery was shorter than older children.
Conclusion : We found increasing the incidence of Bell's palsy in summer and winter. Children younger than 6 years had shorter duration in complete recovery.

국문 초록 (Abstract)

목 적 : 벨 마비(Bell's palsy)는 특별한 원인이나 외상없이 얼굴 근육의 움직임을 지배하는 제7번 뇌신경에 이상이 생겨 안면운동이 마비되는 질환으로, 70-80%는 수일 또는 수 주일에 걸쳐 완전히 회복되나 일부는 후유증을 남긴다. 우리나라에서 소아의 벨 마비의 임상적 고찰에 대한 보고서가 부족한 상황이다. 이에 본원에서는 소아에서 나타난 벨 마비의 임상 양상과 나이에 따른 예후를 알아보고자 본 연구를 시행하였다.
방 법 : 1998년 1월부터 2006년 7월까지 원광대학병원에 안면마비를 주소로 내원한 15세 이하의 소아 61명을 대상으로 남녀 비율, 좌우 비율, 계절별 발생빈도, 치료 기간, 나이에 따른 완치율 등을 후향 적으로 분석하였다.
결 과 : 총 61명 중 남아는 31명, 여아는 30명으로 차이는 없었으며 좌우 병변 부위의 비율은 1:1.44 로 우측이 우세하였다. 월별에 따른 발병 빈도는 3개월(12월, 1월, 2월)에 22(36.0%)명으로 다른 월보다 높은 발병률을 보였다. 스테로이드 치료에 따른 완치 정도 및 완전 회복기간에 있어 유의한 차이는 없었다. 하지만 6세 미만에서 6세 이상에 비하여 완전 회복 기간이 4주 미만인 경우가 유의하게 많았다.
결 론 : 본 연구에서 소아 벨 마비의 발병빈도는 겨울에 높았고 예후는 나이가 어릴수록 좋았다.

참고문헌 (Reference)

1 Harbert I, "Wetterlage und Haufigkeit von idiopathischen Fazialisparesen, Vestibularisusfallen, Meniere-Anfallen und Horsturzen" 66 : 249-250, 1987

2 Harney M, "Treatment conteoversies in Bell's palsy" 96 : 197-198, 2003

3 Rowlands S, "The epidemiology and treatment of Bell's palsy in the UK" 9 : 63-67, 2002

4 Williamson IG, "The clinical problem of Bell's palsy:is treatment with steroid effective" 46 : 743-747, 1996

5 Gregg G, "Some observations on Bell's palsy in Belfast during the period 1949 to 1958" 42 : 602-608, 1961

6 Salman MS, "Should children with Bell's palsy be treated with corticosteoids" 16 : 565-568, 2001

7 De Diego Jl, "Seasonal patterns of idiopathic facial paralysis: a 16-year study" 120 : 269-271, 1999

8 Chen W.C, "Prognosis of Bell's palsy in children- analysis of 29 case" 27 : 504-508, 2005

9 Mair I.W.S, "Peripheral facial palsy in subarctic Norway" 77 : 1974

10 Katusic SK, "Incidence, clinical features and prognosis in Bell's palsy, Rochester, Minnesota" 20 : 622-627, 1986

11 Yanagihara N, "Incidence of Bell's palsy" 137 : 3-4, 1988

12 Brandenburg NA, "Incidence and risk factors for Bell's palsy in Laredo, Texas" 12 : 313-325, 1993

13 Melotte G, "Idiopathic paralysis of the facial nerve" 187 : 349-353, 1961

14 Tovi F, "Epidermiological aspects of idiopathic periperal facial paralysis" 2 : 228-232, 1986

15 May M, "Differential diagnosis of facial nerve palsy" 24 : 613-645, 1991

16 Ding HC, "Biologic effects of freezing on tissues of the macillofacial region" 43 : 778-781, 1985

17 Adour KK, "Bell's palsy treatment with acyclovir and Prednisone alone: a double-blind randomized, controlled trial" 105 : 371-378, 1996

18 Murakami S, "Bell's palsy and herpes simplex virus; identification of viral DNA in endoneurial fluid and muscle" 124 : 27-30, 1996

19 Devriese PP, "Atmospheric Pressure and Idiopathic Facial Paralysis(Bell's palsy)" 48 : 672-673, 1977

20 Siwula JM, "Acute onset of facial palsy associated with Lyme disease in a 6 year-old child" 24 : 572-574, 2002

21 Kazemi B, "A survey of idiopathic facial palsy(Bell's palsy) in sourthen Iran" 7 : 436-440, 1977