摘要
目的增加对不典型RamsayHunt综合征的认识,提高诊治水平。方法分析3例不典型RamsayHunt综合征误诊误治原因。例1无面瘫,首先出现其他颅神经症状声嘶(左喉返神经麻痹)和左梨状窝积液(咽缩肌麻痹),第5天才于耳廓后方出现2粒疱疹。例2首先出现面瘫,面瘫后一周才于右侧颊粘膜部出现小疱疹。例3一侧剧烈头疼,2天后鼓膜轻微充血,5天后出现面瘫,一周后颈部才出现疱疹。结果例1误诊为下咽癌;例2误诊为Bell面瘫;例3误诊为脑血管疾病。结论疱疹延迟出现、异位疱疹、首先出现其他颅神经损害的症状,是造成不典型RamsayHunt综合征误诊甚至误治的原因。临床医生应加强对不典型RamsayHunt综合征的认识,注意鉴别诊断,提高诊疗水平。
Objective To analyze the reasons for misdiagnosis of Ramsay Hunt syndrome with non-typical symptoms so as to improve our skill of making a diagnosis and giving treatment.Methods We reported three cases with non-typical Ramsay Hunt syndrome and analyzed the reasons for misdiagnosis.First case without facial paralysis presented symptoms such as hoarseness and dysphagia (dysfunction in the IX and X cranial nerves) 5 days before emerging two vesicles on mastoid.Small vesicles emerged over the right buccal mucosa in the second patient a week after facial paralysis.The third case with severe headache presented tympanal membrane injection, facial paralysis and neck herpes in 2,5 and 7days, respectively .Results The first,second and third cases were misdiagnosed as hypopharyngeal cancer, Bell’s palsy and cerebrovascular disorder, respectively.Conclusion These non-typical symptoms such as herpes emerging after a delay, after cranial nerves dysfunction and ectopic herpes are main reasons leading to misdiagnosis of Ramsay Hunt syndrome.Physicians should differentiate them well.
出处
《中华耳科学杂志》
CSCD
2004年第3期200-202,共3页
Chinese Journal of Otology
