Pathophysiology and Mechanism of Bell's Palsy ; Early Diagosis and Treatment.

贝尔麻痹的病理生理学和机制；

• 批准号: 13470360
• 负责人: SHINGO Murakami
• 金额: $ 7.87万
• 依托单位: Nagoya City University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-13470360/
• 关键词: Facial nerve paralysis; Bell's palsy; HSV-1; reactivation; PCR; ベル麻痺; 単純ヘルペスウイルス1型; 神経障害; 免疫操作; ウイルス感染細胞; ベル麻酔; リント症候群; 神経血流; 神経内圧

Evidence of herpes simplex type 1 as a cause of Bell's palsy has been more and more increasing in recent years. In the present study, we have demonstrated the mechanism and pathophysiology of facial nerve palsy caused by HSV-1 infection using animal model. Histopathologically, severe nerve swelling, inflammatory cell infiltration and vacuolar degeneration in the affected facial nerve. HSV-1 was infected not only Shwann cells but also nerve cell and astrocyte. Many kind of nerve fibers, intact, demyelinated, and degenerated, were intermingled in the facial nerve trunk. Electro physiological study has demonstrated that the time course of R1 latency in the blink reflex tests paralleled the recovery of the facial nerve paralysis well, whereas ENoG recovery tended to be delayed, compared to that of the paralysis ; these responses are usually seen in Bell's palsy. We also performed the detection of viral DNA from saliva of Bell's patient. HSV-1DNA was detected in 16% of the patients and VZV was from 9% of the patients. The effect of acyclovir-prednisone treatment was also evaluated retrospectively in 480 Bell's patients. The overall recovery rate was 95.7%. The rate in patients who started this treatment within 3 days after onset was 100%. These results suggest that early treatment is necessary for effective acyclovir-prednisone therapy in Bell's palsy.

近年来，单纯疱疹1型作为贝尔麻痹的原因的证据越来越多。在本研究中，我们证明了使用动物模型由HSV-1感染引起的面神经麻痹的机制和病理生理学。组织病理学，严重的神经肿胀，受影响的面神经的炎性细胞浸润和液泡变性。 HSV-1不仅被感染了Shwann细胞，还感染了神经细胞和星形胶质细胞。许多神经纤维完好无损，脱髓鞘和退化，都在面神经躯干中混合在一起。电生理研究表明，眨眼反射测试中R1潜伏期的时间过程与面部神经麻痹的恢复相似，而与瘫痪相比，Enog恢复往往会延迟。这些反应通常在贝尔的麻痹中看到。我们还从贝尔患者的唾液中进行了病毒DNA的检测。在16％的患者中检测到HSV-1DNA，VZV来自9％的患者。在480名贝尔的患者中，还回顾了阿苏克洛韦 - 普遍治疗的影响。总体回收率为95.7％。发作后3天内开始这种治疗的患者的率为100％。这些结果表明，早期治疗对于贝尔的麻痹中有效的阿西克洛韦 - 普遍治疗是必要的。

项目成果

Takahashi Hirotaka, et al.: "Mouse model of bell's palsy induced by reactivation of herpes simplex virus type1"Journal of Neuropathology and Experimental Neuropathology. 60(6). 621-627 (2001)

Takahashi Hirotaka 等人：“单纯疱疹病毒 1 型再激活诱导的贝尔氏麻痹小鼠模型”《神经病理学和实验神经病理学杂志》。

木口 淳, 山野耕嗣, 羽藤直人, 村上信五: "HSV-1による顔面神経麻痺モデルに関する研究-糖尿病モデルにおける検討-"Facial Nerve Research. 23. 71-73 (2003)

Jun Kiguchi、Koji Yamano、Naoto Hato、Shingo Murakami：“HSV-1 引起的面神经麻痹模型的研究 - 糖尿病模型的研究 -” 面神经研究 23. 71-73 (2003)。

村上信五: "ベル麻痺ハント症候群における最近の話題と診断治療の進歩"耳鼻咽喉科展望. 44. 448-456 (2001)

Shingo Murakami：“贝尔氏麻痹亨特综合征的诊断和治疗的最新主题和进展”《耳鼻喉科展望》44. 448-456 (2001)。

Wakisaka H, Hato N, Honda N, et al.: "Demyelination associated with HSV-1-induced facial paralysis^1"Experimental Neurology. 178. 68-79 (2002)

Wakisaka H、Hato N、Honda N 等人：“与 HSV-1 诱导的面瘫相关的脱髓鞘^1”实验神经学。

村上信五, 石田雄介: "顔面神経の移植法"JOHNS. 18・2. 271-273 (2002)

村上慎吾、石田佑介：“面部神经移植方法”JOHNS 18・273（2002）。