创伤继发的双侧面部无力伴感觉异常（BFP）：一例病例报告

文献信息

中文摘要

背景： BFP，即双侧面部无力伴感觉异常，是吉兰-巴雷综合征（GBS）的一种罕见变异型。本文详细描述了一例继发于头部创伤的BFP患者的诊断和治疗过程，以强调其重要性。
病例： 一名47岁男性在车祸后出现双侧周围性面瘫、听力丧失及双下肢感觉障碍。最初考虑颞骨骨折为面瘫的病因。我们给予患者糖皮质激素治疗，但无效，遂考虑计划行面神经减压手术。然而，在创伤后第12天发现腱反射减弱，随后进行了脑脊液（CSF）检测和抗神经节苷脂抗体检测。根据病史和实验室检查，患者被诊断为BFP，即GBS的一种罕见变异型。对患者进行了血浆置换治疗。在六个月随访时，除听力丧失外，其他症状几乎均已恢复正常。
结论： 本文报告了一例继发于头部创伤的BFP病例。我们强调，对于创伤后双侧面神经麻痹的患者，全面的神经系统检查对于准确诊断和避免不必要的药物或手术至关重要。

英文摘要

BACKGROUND: BFP, bifacial weakness with paresthesias is a rare variant of Guillain-Barré syndrome (GBS). Here, we detail the diagnosis and treatment process of a patient with BFP secondary to head trauma to highlight its importance.
CASE: A 47-year-old man presented with bilateral peripheral facial paralysis, hearing loss, and sensory impairment in both lower limbs following a car accident. Temporal bone fracture was first considered as the cause of facial palsy. We gave glucocorticoid therapy to the patient, but it was ineffective, facial nerve decompression surgery was planned as a consideration. However, diminished tendon reflexes was noted on the 12th day post-trauma, then cerebrospinal fluid (CSF) testing and anti-ganglioside antibodies were performed. Based on the medical history and Laboratory testing, the patient was diagnosed with BFP, a rare variant of GBS. Plasma exchange therapy was performed on the patient. At six-month follow-up, except for hearing loss, the other symptoms had almost returned to normal.
CONCLUSION: In this article, we report a case of BFP secondary to head trauma. We emphasize that in patients with post-traumatic bilateral facial nerve paralysis, a comprehensive neurological examination is essential for accurate diagnosis and to avoid unnecessary medications or surgery.