본문 바로가기
KERD
논문KCI 등재

Sunnybrook 척도를 이용한 특발성 안면신경 마비의 acyclovir 치료 효과 및 예후 분석

The Analysis of Treatment with Acyclovir and Prognostic Factors on Idiopathic Facial Mononeuropathy Using Sunnybrook Scale

이승환|이대희|김병조|박건우|고성범|김호정
대한신경과학회 (Korean Neurological Association)|2007.11|대한신경과학회지 (Journal of the Korean Neurological Association)|제25권 제4호|pp. 455-461

0

조회

0

다운로드

2

인용

0

참고문헌

주제분류신경과학

초록

Abstract

Background: Based on a recent study showing that the reactivation of HSV-1 may be one of the possible pathogenesis of idiopathic facial mononeuropathy, antiviral therapy has been suggested as a good treatment modality. However, the efficacy of antiviral therapy is still controversial. This argument may be caused by the absence of a reliable system of grading facial nerve paralysis. We performed this study to investigate the therapeutic effects of an antiviral agent and possible prognostic factors using the Sunnybrook scale. Methods: Patients with idiopathic facial mononeuropathy were divided as two groups according to the treatment regimens (Acyclovir & Steroid vs. Steroid only). Clinical efficacy was evaluated using the House-Brackmann grading system and Sunnybrook scale. Electrodiagnostic studies including the blink reflex, facial nerve conduction study, and facial nerve excitability test were performed. The clinical improvement rate between the two groups and the usefulness of the electrodiagnostic studies as prognostic factors were analyzed. Results: No significant differences of the clinical improvement rate was revealed with a 70% improvement rate for the Acyclovir treatment group and 84% for the steroid only group. Among electrodiagnostic studies, the compound muscle γaction potential (CMAP) amplitude (=0.637, p=0.000) and nerve excitability =0.688, γtest (p=0.000) on 2 weeks showed significant correlations to the final Sunnybrook score. There is good correlation between the two facial nerve grading systems. Conclusions: Acyclovir may not be effective in the recovery of idiopathic facial mononeuropathy. CMAP amplitude and nerve excitability tests on 2 weeks may provide valuable prognostic factors. The Sunnybrook scale may be useful as a facial grading system.

참고문헌 (19)

  1. "McCormick DP. Herpes-simplex virus as a cause of Bell's palsy. Lancet 1972", pp.937~939
  2. "Reactivation of herpes simplex virus type 1 in patients with Bell's palsy", 54, pp.162~166 (1998)
  3. "Bell's palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomized, controlled trial", 105, pp.371~378 (1996)
  4. "Efficacy of early treatment of Bell's palsy with oral acyclovir and prednisolone", 24, pp.948~951 (2003)
  5. "Peitersen E. The natural history of Bell's palsy. Am J Otol 1982", pp.107~111
  6. "Stalberg E. Electroneurography in the prognostication of Bell's palsy. Acta Otolaryngol 1981", pp.221~237
  7. "Benecke R. Investigation of unilateral facial weakness magnetic stimulation of the proximal facial nerve and of the face-associated motor cortex. J Neurol 1989", pp.102~107
  8. "Gil R. Idiopathic peripheral facial paralysis. Prognostic value of the combined study of the blink reflex with stimulation of the facial nerve. 91 cases. Neurophysiol Clin 1992", pp.465~473
  9. "Murray JA. The neurophysiological investigation of Bell's palsy and the predictive value of the blink reflex. Clin Otolaryngol Allied Sci 1988", pp.85~92
  10. "investigations on the localization and pathogenesis of meato-labyrinthine facial palsies. Schriftenr Neuro 1977", pp.1~164
  11. "Jongkees LB. On the Prognosis of Peripheral Facial Paralysis of Endotemporal Origin. Ann Otol Rhinol Laryngol 1963", pp.621~636
  12. "Development of a sensitive clinical facial grading system", 114, pp.380~386 (1996)
  13. "Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle", 124, pp.27~30 (1996)
  14. "Richardson AT. Value of nerve-excitability measurements in prognosis of facial palsy. Br Med J 1962", pp.7~10
  15. "Idiopathic facial paralysis: a randomized, prospective, and controlled study using single-dose prednisone versus acyclovir three times daily", 108, pp.573~575 (1998)
  16. "Martin Galan A. The incorporation of acyclovir into the treatment of peripheral paralysis. A study of 45 cases. Acta otorrinolaringol Esp 1992", pp.117~120
  17. "a randomized double blind controlled study of placebo versus prednisone. Laryngoscope 1993", pp.1326~1333
  18. "Devriese PP. Compression and ischaemia of the facial nerve. Acta oto-laryngol 1974", pp.108~118
  19. "Arnon R. Cellular immune response to peripheral nerve basic protein in idiopathic facial paralysis", pp.13~20

관련 논문AI추천

급성 벨마비에서 Acyclovir의 효과김태일, 서상일, 이동국대한임상신경생리학회 · Annals of Clinical Neurophysiology2001 · 제3권 제2호벨마비 및 이성대상포진 환자에서 예후인자로서의신경전도검사의 유용성여상원, 오현진, 이동호, 이동희, 이석은, 전범조, 홍성진대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2005 · 제48권 제10호말초성 안면신경마비의 예후인자로서 Electroneuronography(ENoG)의 유용성에 대한 연구서은비, 임진영, 주현아, 황충연대한한방안이비인후피부과학회 · 한방안이비인후피부과학회지2011 · 제24권 제3호벨마비의 급성기와 회복기에서 바이러스 항체역가의 변동김성제, 김지언, 김태일, 배준석, 서상일, 신임희, 이동국대한임상신경생리학회 · Annals of Clinical Neurophysiology2001 · 제3권 제1호안면신경 마비 환자의 임상 양상 분석과 전기진단학적 검사의 변화김동환, 김희상, 안경회, 윤동환대한재활의학회 · Annals of Rehabilitation Medicine2002 · 제26권 제4호급성 염증성 안면신경마비권기한, 이종대, 이호기, 장기홍, 조양선대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2011 · 제54권 제6호

이 간행물의 다른 논문 (20건)

두개내 동맥경화증이 뇌경색 이후의 장기 사망률에 미치는 영향김병건, 구자성, 권오현, 박종무, 배희준, 이정주, 장윤숙, 이준영, 강지훈pp. 462-468경동맥 폐색 질환의 관류 양상 : 관류 CT를 이용한 연구김준태, 박만석, 김병채, 김명규, 조기현, 최윤주, 이승한, 최성민pp. 469-474급성 어지럼증으로 대학병원 응급실을 방문한 환자에서 뇌자기공명영상의 진단적 유용성강사윤, 강지훈, 이정석, 최재철pp. 475-481야간 저산소증과 주관적 주간 졸음증이 폐쇄성 수면 무호흡증 환자의 인지기능 저하에 미치는 영향마은주, 황혜란, 하충건, 최성혜, 윤창호, 윤병남pp. 482-487습관적 코골이를 가지고 있는 환자들에서 주간졸리움의 빈도 및 관련 인자심은정, 황상희, 김준식, 이형, 조용원, 김희철, 이주화, 서영성, 안병훈pp. 488-493
원문 보기