소아청소년기 벨 마비 환자들의 임상 특징과 진료 형태에 관한 단일 기관 연구
Clinical Features and Practices of Bell Palsy of Children and Adolescent in a Single Center
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목적: 벨 마비는 뚜렷한 원인과 동반 질환이 없이 급성으로 발생하는 안면 신경 질환이다. 성인보다 발생 빈도가 낮지만, 소아청소년기에도 자주 볼 수 있는 질환이다. 그러나, 소아청소년 환자들의 벨 마비에 대한 임상 관찰 연구가 많지 않고, 예후가 좋아 대부분 빨리 회복을 하므로, 외래 추적에 대한 자료도 미비하다. 이에 저자들은 소아청소년기에 발생한 벨 마비에 대한 임상 특징과 진료 형태를 알아보고자 하였다. 방법: 2006년 9월부터 2017년 6월까지 대구가톨릭대학교병원 소아청소년과에서 벨 마비로 진단된 환자 70명의 의무기록을 후향적으로 조사하였다. 선정기준은 첫 발생인 경우로 하였다. 결과: 총 70명 환자 중 남자 35명, 여자 35명이었고, 나이의 중앙값은 102개월이었다. 계절별 발생률은 차이가 없었다. 내원 시점까지 마비가 지속한 기간은 중앙값 3일이었다. 최초 증상은 귀통증 14%, 안면 마비 83%, 안구통 1%, 이상 미각 1%이었다. 49%에서 바이러스성감염 질환이 선행하였다. 치료는 스테로이드 단독 26%, 스테로이드와아시클로버 병합요법은 74%이었다. 한방 치료를 병합한 경우는 14% 이었다. 4주 이상 추적 관찰된 환자의 49명 중 완전 회복은 44명(90%)이었고, 이들의 평가 시기에 따른 회복률은 마비 발생 4주째68%, 3개월 91%, 10개월 100%였다. 재발률은 4%였다. 결론: 소아청소년기 벨 마비 환자의 예후는 양호하며, 마비 발생 4 주 이내 68%, 10개월까지 100%에서 완전 회복을 보였다.
Abstract
Purpose: Bell palsy is an idiopathic peripheral facial nerve paralysis of sudden onset. Though the incidence in children is relatively lower than adult population, it is not uncommon. Because of its’ relative rarity and good prognosis, there have been few studies about clinical features and courses of Bell palsy in pediatric population. The aim of our study was to report the clinical characteristics and practices of Bell palsy in children and adolescent in a single center. Methods: We reviewed medical records of 70 patients diagnosed as Bell palsy in Daegu Catholic University Medical Center from September 2006 to June 2017 retrospectively. We included only first episode. Results: Of the 70 patients, 35 was male, 35 was females. Median age was 102 months. There was no seasonal difference. Median duration of palsy was 3 days. The first symptoms were auricular pain (14%), facial palsy (83%), eye pain (1%), and dysguesia (1%). Preceding viral infection was present in 49% of patients. 26% of patients were treated with steroid alone, and 74% of cases were treated with steroid plus acyclovir. Oriental medicine was accompanied in 14% of patients. Among 49 patients who were followed over 4 weeks, 44(90%) had complete recovery. The recovery rates were 68% (4 weeks), 91% (3months), and 100% (10 months). Recurrent rate was 4%. Conclusion: The prognosis of Bell palsy in pediatric population was good, and recovery rates were 68% within 4 weeks, and 100% by 10 months after palsy onset.
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