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Ano: 2012  Vol. 16   Num. Suppl. 1  - May - (109º)
DOI: 10.7162/S1809-977720120S1PC-007
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Seção: XXXIX CONVENTUS SOCIETAS ORL LATINA - Poster
Texto Text in English
PARALISIS FACIAL PERIFERICA POST INFECCION VIRAL EN PACIENTE LACTANTE MENOR, REPORTE DE CASO
PERIPHERIC FACIAL PARALYSIS POST - VIRAL INFECTION IN A BREASTFEEDING - LESS PATIENT, CASE REPORT
Author(s):
Liu Ta, Martínez Thelma, Doldan Diego, Morínigo José, Cardozo Nestor, Vicenty Álvaro
Resumo:

Objetivo: Describir el manejo de la paralisis facial periferica post infeccion viral en paciente lactante menor Relato clínico: Se presenta un paciente de 23 dias de vida, sexo masculino con 7 días de evolución de paresia de rama mandibular del facial izquierda, con manifestacion de desvio de comisura labial hacia la derecha exacerbado 24 h. previo a la consulta con oclusion incompleta del ojo izquierdo. Niega convulsiones, vómitos, diarreas, traumatismo, fiebre 48 h. previo al ingreso. Este cuadro es concomitante a cuadro de bronquiolitis. Al examen físico se constata Fascies: en reposo asimétrica a expensas de limitación en el cierre ocular izquierdo y desvio de la comisura labial a la derecha, con borramiento del surconasogeniano izquierda ; tono musculares disminuidos en reposo; al llanto, poca movilidad de las cejas y frente. Limitacíon enel cierre ocular derecha. Desvio de la comisura labial a la derecha sin alteración de la movilidad de la lengua ni del velo del paladar. Se investiga infección por STORCH. Se plantea diagnostico de paralisis facial periferica post infeccion viral vs idiopatica House Brackmann Grado 3, se inicia Aciclovir 40mg/kp/d y Prednisona 2mg/kp/d, Lagrimas Artificiales, Fisioterapia, Parche ocular. Con buena evolución en controles posteriores. Conclusión: Ante una afectacion del nervio facial en un paciente lactante menor, el diagnostico atribuible a una infeccion viral y/o idiopatica debe ser por descarte, consecuentemente se deben buscar antecedentes, patologias infecciosas o autoinmunes asociadas, malformaciones congenitas y patologia de oido.

Abstract:

OBJECTIVE: To describe the management of facial paralysis after viral infection in a patient who is breastfeeding less. Clinical report: a patient is 23 days old, male, with 7 days of evolution of paralysis of the jaw of the left cheek, with manifestation of deviation of labial commissure on the right side that exceeded 24 hours prior consultation with incomplete occlusion of the left eye. Denies convulsions, vomiting, diarrhea, trauma, fever 48 hours before go to the hospital. This table is concomitant to the bronchiolitis. On physical examination was found Fascies: asymmetrical resting at the expense limitation in closing the left eye and deviation of the right lip commissure, and blurring of the left nasolabial folds, decreased muscle tone at rest, tears, low mobility of the eyebrows and forehead. Limitation on closing the right eye. Deviation from the right corner of the lips without changing the mobility of the tongue or soft palate. Investigates infection for STORCH. It is considered diagnosis of facial paralysis after viral infection vs. idiopathic House Brackmann Grade 3, begins Acyclovir Prednisone 40mg/kp/day 2mg/kp/day, Artificial Tears, physiotherapy, eye swab (eye patch). With proper controls in subsequent developments. CONCLUSION: Given an affectation of the facial nerve in a patient who is breastfeeding less, diagnosis is attributed to a viral infection and / or idiopathic must be a discard, therefore we must seek antecedents, infectious or autoimmune pathologies associated congenital bad formations and abnormal hearing.

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