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Facialispares

Senast uppdaterad: Senast reviderad:
Sakkunnig:
Definition:
Ansiktsförlamning beroende på en perifer eller central skada på nerven. En specialvariant med okänd orsak kallas Bells pares.
Förekomst:
Incidens är 15–30 fall per 100 000 individer och år.
Symtom:
Svårighet att sluta ögat, äta och tala. Kosmetiska problem tillkommer samt nedsatt livskvalitet. Insjuknandet är akut, oftast två till fyra dagar till maximal muskelsvaghet (ibland upp till sju dagar).
Kliniska fynd:
Perifer facialispares ger svaghet i pannans, ögats, näsans och munnens mimiska muskulatur på drabbad sida. Central facialispares ger svaghet i ansiktets ena halva förutom en normal rörlighet i pannan på drabbad sida. Paresens svårighetsgrad kan bedömas och följas med Sunnybrook-skalan .
Diagnos:
Typisk klinisk bild. Lumbalpunktion vid misstanke om neuroborrelios. CT/MR hjärna vid central pares.
Behandling:
Ögonskydd och prednisolon vi Bells pares. Antibiotika vid borrelios. Antivirusbehandling vid herpes zoster. 
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  • Malou Hultcrantz, professor och specialist i ÖNH-sjukdomar, Karolinska institutet
  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet