Abordaje de La Paralisis de Bell Diagnostico y Tratamiento

 

69/9/:1:1

Ijhr`imgX`gXdiXpiridcscsX`gXJgddX`cikbhstcfhXyXtritiocgbth

. . Zgvcsti Oã`cfi Vcbgrkci. ^hd. ^hd. 0 Buo. >. Mubch :193, pp= iùhs y `gspuãs `g dhs >1 iùhs (7,). di ingftifcöb `gd kibkdch kgbcfudi`h y su fipifc`i` bgurhtröpcfi piri bgrvchsidrg`g`hr pgrcnãrcfhs @cfli fipifc`i` tiojcãb sg fhopirtg phr pirtg `g htrhs vcrus fhoh dh shb gd vcrus lgrpgs scopdg tcph : (LV^-:) y gd vcrus vircfgdi zöstgr  (^]^) dhs fuidgs gbtrib gb gd fugrph i trivãs `g di gxphscfcöb oufhfutébgi, fhb incbc`i` phr  dhs bgrvchs pgrcnãrcfhs y gstijdgfgb su prgsgbfci gb nhroi ditgbtg (9,>). Gd vcrus `gd lgrpgs zöstgr gs di sgkub`i cbngffcöb vcrid oés usuid ishfci`i fhb di pirédcscs nifcid pgrcnãrcfi. Htrhs ikgbtgs cbngffchshs cbfduygb gd vcrus Gpstgcb Jirr, gd vcrus `g di rujãhdi, gd fcthogkidhvcrus, gd i`gbhvcrus, vcrus `g di cbndugbzi J, vcrus fhxsifecg, di  pirhtc`ctcs, cbngffcöb rcfegttscid, rcfegttscid, y di glrdcflchscs (:). Vg li vcsth ub iuogbth `gd rcgskh i sunrcr pirédcscs `g Jgdd ishfci`i fhb gd gojirizh, di  prggfdiopsci krivg, di `cijgtgs, dis cbngffchbgs `gd trifth rgspcrithrch supgrchr y di lcpgrtgbscöb (:).

OIBCNGVPIFCHBGV FDÏBCFIV lttps=//rgvcstiog`cfiscbgrkci.fho/cb`gx.plp/ros/irtcfdg/`hwbdhi`/:0;/7;78cbdcbg?98cbdcbg?9

6/3

 

69/9/:1:1

Ijhr`imgX`gXdiXpiridcscsX`gXJgddX`cikbhstcfhXyXtritiocgbth

Dis oibcngstifchbgs fdïbcfis `g di pirédcscs `g Jgdd sg hrckcbib phr ubi fhbtriftcdc`i` ousfudir fhoprhogtc`i fhb `iùh `g dis nubfchbgs `gd fhbtrhd bgurid `gd bgrvch nifcid, qug  ddgvib i hfischbir ubi `gjcdc`i` ousfudir prhkrgscvi y pãr`c`i `g sgbscjcdc`i` gb ubi  lgocfiri fhb ubi ingftifcöb bgrvchsi fhopdgti h cbfhopdgti (96). Wsuidogbtg, sg pug`g hjsgrvir gb di lgocfiri ingfti`i ubi `csocbufcöb `g di nugrzi ousfudir fhoh `cncfudti` piri gdgvir di fgmi, shbrgïr h fhogr, cbfipifc`i` `g fgrrir gd hmh, gpcnhri g copg`cogbth id nrubfcr dhs dijchs i`goés `gd `gtgrchrh `gd lijdi phr di ingftifcöb gb di cbgrvifcöb ousfudir (7,90).



Htrhs sïbthois qug sg oibcncgstib shb dhs `g ingftifcöb sgbsctcvi fhb `hdhr idrg`g`hr `g di oib`ïjudi y `gtrés `gd hï`h, tcbbctus, fgnidgi, pãr`c`i `gd kusth gb dhs `hs tgrfchs ibtgrchrgs `g di dgbkui g lcpgrsgbscjcdc`i` id shbc`h `gd di`h ingfti`h (7). Nrgfugbtgogbtg, dhs pifcgbtgs shdh tcgbgb ingftifcöb `gd sãptcoh pir fribgid, scb gojirkh, sg lib vcsth fishs `g htris bgurhpitïis fhbfhoctibtgs fhoh dis shb dis `gd trckãocbh fhbtriditgrid, kdhshnirïbkgh g lcphkdhsh (:). Gs cophrtibtg rgfidfir qug di pirédcscs `g Jgdd sg firiftgrczi phr ub cbcfch sýjcth prhkrgscvh `g ubh i `hs `ïis `g `gjcdc`i` nifcid tgbcgb`h ubi rgocscöb i dis `hs h trgs sgoibis `gd cbcfch `gd fui`rh fdïbcfh5 gb dhs `gsfirtir pifcgbtgspithdhkïi fhb gopghriocgbth h scb rgocscöb fdïbcfi i dhs fuitrh ogsgs sg vugdvg bgfgsirch tuohrid h `gbgrvifcöb (3,99). Qiri vidhrir gd fhoprhocsh y sgvgrc`i` `gd bgrvch nifcid gb di pirédcscs `g Jgdd sg utcdczi di Fdiscncfifcöb `g Lhusg Jrifeoibb ifgpti`i gb 93 Qirédcscs thtid

Ohvcocgbths oh`gri`hs i dckgrhs

Fcgrrg fhopdgth fhb gsnugrzh

Dckgri `gjcdc`i` fhb gd oéxcoh gsnugrzh

Qirgstgscis

Fcgrrg ccbbfhopdgth Jhfi5 iisscogtrïi iidd gsnugrzh

Qirédcscs

Fcgrrg cbfhopdgth Ohvcocgbths dckgrhs

Gxcstgbfci `g scbfcbgscis y/h iuogbth `gd thbh `g oýsfudhs nifcidgs

  

Vcb ohvcocgbth

Nugbtg. Qiyé I., Bivirrh Z., Fdcogbt C., Zg`hb`h O. Qirédcscs nifcid pgrcnãrcfi rgfurrgbtg y idtgrbibtg gb ub sgrvcfch `g Zglijcdctifcöb. Zglijcdctifcöb. :193.

@CIKBÖVPCFH Gd `cikböstcfh `g di pirédcscs `g Jgdd gs fdïbcfh (>). Gd oã`cfh `gjg cbfducr ubi lcsthrci fdïbcfi fhopdgti `gd pifcgbtg shjrg di gxphscfcöb i virchs vcrus (lgrpgs, vircfgdi, ^CL, gtf.) g cbvgstckir gd tcgoph `g cbcfch `g dhs sïbthois (9). Gd gxiogb nïscfh vidhri ohvcocgbths nifcidgs fhb rgspugsti i ör`gbgs `i`is phr gd gxpdhri`hr, sg gvidýi di prgsgbfci `gd ngböogbh `g Jgdd `gsfrcth fhoh ubi rhtifcöb lifci irrcji `gd kdhjh hfudir fuib`h dhs pifcgbtgs cbtgbtib fgrrir dhs hmhs, prgsgbtg gb gd ;7% `g di  phjdifcöb ingfti`i (9). I`cfchbidogbtg, sg shdcfcti id pifcgbtg gdgvir di nrgbtg, nrubfcr gd fgùh y dhs dijchs, ohstrir dhs `cgbtgs y tgbsir dhs tgmc`hs jdib`hs `gd fugddh th`h gsth jusfib`h di  pãr`c`i `g di nubfcöb `gd oýsfudh hrjcfudir `g dhs pérpi`hs, gsti sctuifcöb ingfti gd oibgmh i`gfui`h `g dis dékrcois, isï fhoh di pãr`c`i `gd thbh ousfudir nifcid, prhvhfib`h qug di fgmi mubth fhb di firi og`ci g cbngrchr sg cbfdcbgb, `ib`h i dhs pifcgbtgs di ipircgbfci `g ub gvgbth fgrgjrhvisfudir. fgrgjrhvisfudir. Vg tcgbg qug rgidczir ubi cbspgffcöb fuc`i`hsi `gd hï`h gxtgrbh, fibid iu`ctcvh y di ogojribi tcopébcfi piri c`gbtcncfir vgsïfudis h fhstris qug hrcgbtg i ubi cbngffcöb phr  lgrpgs zöstgr (:,99). Di fijgzi, di firi y gd fugddh sg cbspgffchbib piri `gtgftir fébfgr  futébgh, oisis y dgschbgs oiscvis `gbtrh `g di kdéb`udi pirötc`i. Gs prgfcsh rgidczir ub gxiogb bgurhdökcfh ocbufchsh, gviduib`h th`hs dhs pirgs fribgidgs, fhb gspgfcid itgbfcöb i di gxtgbscöb `g di `gjcdc`i` nifcid jusfib`h di ingftifcöb `g th`is dis riois cbvhdufri`is (99). Gd `cikböstcfh `g di cbngffchsis, pirédcscs `gcbndioithrcis Jgdd sg iphyi gb gd `gsfirtg bgurhdökcfis, hthdökcfis, h bghpdéscfis (99). `g phscjdgs fiusis Gs cophrtibtg rgfidfir qug dhs sïbthois ishfci`hs `g `cpdhpïi, `csnikci, gbtuogfcocgbth kgbucbh `g di firi h oirghs bh shb tïpcfhs `g di pirédcscs `g Jgdd, gb fiojch shb sïbthois `g lttps=//rgvcstiog`cfiscbgrkci.fho/cb`gx.plp/ros/irtcfdg/`hwbdhi`/:0;/7;78cbdcbg?98cbdcbg?9

7/3

 

69/9/:1:1

Ijhr`imgX`gXdiXpiridcscsX`gXJgddX`cikbhstcfhXyXtritiocgbth

 jib`gri rhmi qug bhs sukcgrg lifgr shspgflir shjrg htrhs `cikböstcfhs `cikböstcfhs (99). (99).



Vg pug`g rgidczir di hjtgbfcöb `g coékgbgs `gd fgrgjrh, lugsh tgophrid y kdéb`udi pirötc`i fhb thohkrinïi ixcid fhoputirczi`i (P ( PIF) utcdczib`h og`ch fhbtristg h rgshbibfci oikbãtcfi  bufdgir (ZOB) fhb ki`hdcbch yi sgi sc dhs sckbhs nïscfhs shb itïpcfhs, sg `i ubi prhkrgscöb `g  oés `g trgs sgoibis h sc bh liy ogmhrïi i dhs fuitrh ogsgs (:).

@CIKBÖVPCFH @CNGZGBFCID Gd `cikböstcfh `cngrgbfcid cbfduyg `cvgrsis pithdhkïis qug gb su gvhdufcöb fdïbcfi fursib fhb `gjcdc`i` `g dhs oýsfudhs nifcidgs (:). Vg fdiscncfib gb fiusis fhbkãbctis y i`qucrc`is (>). 9. Fhbkãbctis (9) • Oidnhroifchbgs Fhbkãbctis (Vïb`rhog `g Ohgjcus) :. I`qucrc`is (9) • Dgschbgs i bcvgd `g scstgoi bgrvchsh fgbtrid □ Puohrgs □ Gvgbths fgrgjrhvisfudirgs • Cbngffchsis □ Lgrpgs zöstgr  □ LC^ □ Htctcs og`ci `g Dyog □ Gbngrog`i` • Iuthcboubgs (9,:) □ Vïb`rhog Kucddicb Jirrg □ Virfhc`hscs □ Vïb`rhog `g Vmhkrgb □ Vïb`rhog Ogdegrshb - Zhsgbtlid • Priuoétcfis □ Nrifturi `gd lugsh tgophrid □ Fcrukïi □ Jirhtriuoi

PZIPIOCGBPH Oibgmh gb gd pgrch`h iku`h Gd tritiocgbth iku`h sg firiftgrczi phr gd ush `g ub fcfdh fhrth `g fhrtcfhgstgrhc`gs y sg  pug`g vidhrir gd i`cfchbir og`cfiogbths ibtcvcridgs phr di phscjcdc`i` `g gtchdhkïi vcrid lgrpgs scopdg gb dhs gpcsh`chs iku`hs sgvgrhs (97). Vg rgfhocgb`i cbcfcir gd fcfdh gb dis  prcogris ;: lhris `gd cbcfch `g di gbngrog`i` yi qug gb tãrocbhs `g sgvgrc`i` y rgfupgrifcöb gs frufcid gd tcgoph (9:). Vg sukcgrg gd fhrtcfhgstgrhc`g prg`bcshbi gb `hscs `g >1 ok i /3

 

69/9/:1:1

Ijhr`imgX`gXdiXpiridcscsX`gXJgddX`cikbhstcfhXyXtritiocgbth

`g 9111 ok i`ocbcstri`i trgs vgfgs id `ïi vïi hrid phr ubi sgoibi y fhoh sgkub`i hpfcöb Ifcfdhvcr gb `hscs `g 011 ok fcbfh vgfgs id `ïi vïi hrid phr `cgz `ïis (6,97). Bh sg ifhbsgmi  suocbcstrir gd néroifh ibtcvcrid fhoh ohbhtgripci phr su jimi gngftcvc`i` (;). 

I`goés, gb fish `g prgsgbtir `hdhr sg pug`gb rgfgtir ibidkãscfhs fhoh ispcrcbi,  ifgtiocbhnãb h cjuprhngbh (7). I`cfchbidogbtg, sg `gjg copdgogbtir di prhtgffcöb hfudir fhb gd ush `g khtis irtcncfcidgs gb su prgsgbtifcöb dïquc`i, kgd h phoi`i fi`i lhri ocgbtris sg gbfugbtrg `gspcgrth y gd ush `g  phoi`is fhb visgdcbi h ifgctg ocbgrid `uribtg su sugùh, gs bgfgsirch di prgsfrcpfcöb `g dgbtgs `g prhtgffcöb. Vg pug`g fhdhfir pirflgs gb lhris `g sugùh scb i`lgrcr di fcbti `crgftiogbtg gb gd pérpi`h phr gd rcgskh `g dgscöb i di förbgi (97). Gb ub gstu`ch `g jimi fidc`i` sg ipdcfö gd ush `g désgr `g jimi phtgbfci ohstrib`h sgr ubi idtgrbitcvi gb fishs dgvgs (C-CC Lhusg Jrifeoibb) phr su iffcöb ibtccbndioithrci y gngfth ibtcg`goithsh (). Dhs pifcgbtgs fhb sgfugdis pgroibgbtgs `gsirrhddib ingftifcöb i bcvgd gohfchbid y jimi iuthgstcoi, gsth phr ub copifth `crgfth gb su fidc`i` `g vc`i, phr dh qug gs cophrtibtg jrcb`ir  shdufchbgs y id ocsoh tcgoph ijhr`img pscfhdökcfh (;).

FHBFDWVCÖB Di pirédcscs `g Jgdd gs ub sïb`rhog bgurhousfudir nrgfugbtg tibth gb lhojrgs fhoh gb oumgrgs fhb ingftifcöb nifcid ohthri y sgbsctcvi ubcditgrid y sýjcti `gd bgrvch nifcid gd fuid bh `gjg pisir `gsipgrfcjc`h phr gd oã`cfh yi qug gsth pug`g cbfc`cr gb gd kri`h `g rgfupgrifcöb qug tgb`ré gd pifcgbtg. Gb di iftuidc`i` sg `gsfhbhfg su gtchdhkïi gspgfïncfi, scb gojirkh, sg shspgfli qug su prcbfcpid ikgbtg fiusid gs vcrid phr dh qug su oibgmh vi `crckc`h gb gsg sgbtc`h. `cikböstcfh sg jisi ubi gb di ingffcöb scbthoithdhkïi qug prgsgbti pifcgbtg,Gdy ub nïscfh gb gdGdqug sg gvc`gbfcg `gd sãptcoh pir gdfribgid. ushgxiogb `g gdgogbths fhopdgogbtirchs, fhoh, phr gmgopdh, dis coékgbgs `cikböstcfis PIF y ZOB vib `crckc`is i `gsfirtir pithdhkïis fhb firiftgrïstcfis fdïbcfis scocdirgs. Zgidczir ub prhbth `cikböstcfh gs nub`iogbtid gb gd ohogbth `gd ijhr`img `g di pirédcscs `g Jgdd, gd fuid `gjg sgr gb ub dipsh ogbhr `g ;: lhris. Vg rgfhocgb`i utcdczir `g tritiocgbth gd ibtccbndioithrch gstgrhc`gh  prg`bcshbi, i`goés sg `gjg vidhrir su fhojcbifcöb fhb ibtcvcridgs mubth i di ipdcfifcöb `g  prhtgffcöb hfudir, jusfib`h prgvgbcr sgfugdis piri hjtgbgr ub prhböstcfh nivhrijdg piri gd  pifcgbtg, gb fish `g rgshdufcöb cbfhopdgti `g dhs sïbthois fhb prgsgbtifcöb `g sgfugdis fhoh lcpgrthbcfc`i`, iscogtrïi nifcid y scbfcbgscis sg prhphbg gd ush `g tgripci nïscfi piri di rgg`ufifcöb ousfudir o usfudir..

ZGNGZGBFCIV 9.^ielirci E, ^ielirci E. Jgdd°s Qidsy. Nifcid Qdist Vurk Fdcb Bhrtl IO. :19>5 :0(9)= 9-91. lttp=//`x.`hc.hrk/91.919>/m.nsf.:197.1 oirzh :193_. @csphbcjdg gb= lttps=//www ngiturgs-ib`-`cikbhscs-cb-i`udts8 sgirfl?piridcscs%:1`g%:1jgdd&shurfg?sgirflXrgsudt&sgdgftg`Pctdg?:~971&usikgXtypg?`gniudt&`cspdiyXribe?: 6. [idjiuo J, Zi`i K. ¸Gs ýtcd ikrgkir ibtcvcridgs i dhs fhrtcfhc`gs gb di pirédcscs `g Jgdd gb i`udths8. Og`wivg. :1975 97(:)= g>::>. lttps=//`hc=91.7;/og`wivg.:197.>::> 0. Vébflgz O, Fitifhdï M, Gflib`ïi F, ]ipiti M. Gviduifcöb `gd ïb`cfg fdïbcfh `g nubfcöb `gd bgrvch nifcid gb pifcgbtgs fhb pirédcscs `g Jgdd. Zgv Fhd Og` Ncs Zglij. :19>5 :>(:)= 977-9>9. @csphbcjdg gb= lttp=//www lttp=//www.rgvcstifonr.hr .rgvcstifonr.hrk/cb`gx.plp/rfonr/irtcfdg/vcgw/ k/cb`gx.plp/rfonr/irtcfdg/vcgw/9>6 9>6 lttps=//rgvcstiog`cfiscbgrkci.fho/cb`gx.plp/ros/irtcfdg/`hwbdhi`/:0;/7;78cbdcbg?98cbdcbg?9

1-06&sfrcpt?sfcXirttgxt&t  pc`?V97>1-06&sfrcpt?sfcXirttgxt&tdbk?pt dbk?pt >. Gvcsthb P, Frhxshb K, Egbbg`y Q, Li`dhfe P, Ercslbib I. Jgdd–s pidsy= igtchdhky, fdcbcfid ngiturgs ib`  oudtc`csfcpdcbiry firg. M Bgurhd Bgurhsurk Qsyflcitry. :1975 (9:)= 967>-96>9. lttp=//`hc=91.996>/mbbp-:190-6137>6 

;. Lhddib` M, Jgrbstgcb M. Jgdd–s pidsy. JOM Fdcb Gvc`. :1905 :190= 9:10. 7. @csphbcjdg gb= lttp=//sfcgdh.sd`.fu/sfcgdh.plp8 sfrcpt?sfcXirttgxt&pc`?V91:3-6193:197119:11110 3. Édvirgz F, Ohri B, Khbzédgz Z. Qirédcscs nifcid pgrcnãrcfi= Gbnhqug `gs`g di og`cfcbi Nïscfi y rglijcdctifcöb gb Fhsti Zcfi. Zgvcsti Oã`cfi `g Fhsti Zcfi y Fgbtrhioãrcfi. :1975 ;:(>97)= :03-:77. @csphbcjdg gb= lttp=//www.og`ckriplcf.fho/fkc-jcb/bgw/rgsuogb.fkc8C@IZPCFWDH?>>131 lttp=//www.og`ckriplcf.fho/fkc-jcb/bgw/rgsuogb.fkc8C@IZ PCFWDH?>>131 91. Qiyé I, Bivirrh Z, Fdcogbt C, Zg`hb`h O. Qirédcscs nifcid pgrcnãrcfi rgfurrgbtg y idtgrbibtg gb ub sgrvcfch `g Zglijcdctifcöb. Zglijcdctifcöb. :1935 76(9)= >1->0. lttps=//`hc.hrk/91.919>/m.rl.:19.119 99. Qlib B, Qibczzi J, [iddwhre J. I kgbgrid priftcfg ipprhifl th Jgdd–s pidsy. Iustridcib Niocdy Qlyscfcib. :19>5 07(99)= ;30-;3;. @csphbcjdg gb= lttps=//www.rifkp.hrk.iu/inp/:19>/bhvgojgr/i-kgbgrid-priftcfg-ipprhifl-th jgdd%G:%(9)= 06-0;. @csphbcjdg gb= lttp=//rgvcstis.ubbg.g`u.ir/cb`gx.plp/rgo/irtcfdg/vcgw/:0:< 90. Jgbïtgz V, @ibcddi V, Prhbfhsh G, Ohyi I, Oilb M. Oibgmh cbtgkrid `g di pirédcscs nifcid. Zgv. Og`. Fdcb. Fhb`g. :19>5 :;(9)= ::-:/m.rofdf.:19>.19.110 97. Zhbtlid O. Jgdd–s pidsy= Prgitogbt ib` prhkbhscs cb i`udts UCbtgrbgt_. [idtlio= Wpth`itg5 :193 Ufhbsudti`h gd 9; oirzh :193_. @csphbcjdg gb= lttps=//www.upth`itg.fho/fhbtgbts/jgdds-pidsy-trgitogbt-ib`-prhkbhscs-cb i`udts8 sgirfl?piridcscs%:1`g%:1jgdd&shurfg?sgirflXrgsudt&sgdgftg`Pctdg?9~971&usikgXtypg?`gniudt&`cspdiyXribe?9 9>. Inrisltglniri F, Inrisltglniri E. Fhrrgffcöb `g di shbrcsi fhb thxcbi jhtudïbcfi gb ub pifcgbtg fhb pirédcscs nifcid. Zgv. Nif. Og`. :1975 7