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莱姆病(Lyme disease,LD)是70年代末发现的一种普遍存在于林区和山区的自然疫源性蜱媒传染病。常可导致皮肤、心脏、神经和关节多系统病变,尤以神经系统症状错综复杂且易误诊误治。现将我们5年来发现的8例以面神经麻痹为首发表现的莱姆病报告如下。 临床资料 男6例,女2例,年龄21～45岁。均生活在疫区,常被蜱叮咬。发病时间最短2周、最长10个月。单侧面瘫6例,双侧面瘫2例。临床上以患侧或双侧额纹消失,眼睑闭合不全,鼻唇沟浅,口角歪斜或流涎等周围性面瘫为主要表现,伴程度不同的头痛、头昏、眩晕、失眠多梦和易激惹等神经精神症状。常规实验室检查、EEG、CT及TCD均正常。间接免疫荧光抗体IFA.抗LD螺旋体抗体效价均≥1:128阳性,钩体显凝试验和梅毒USR反应均为阴
Lyme disease (LD) is a natural foci of tick-borne diseases commonly found in forests and mountains in the late 1970s. Often can lead to skin, heart, nerve and joint multiple system lesions, especially in the complex nervous system symptoms and easy misdiagnosis and mistreatment. Now we 5 years found in 8 cases of facial nerve paralysis as the first manifestation of Lyme disease are reported below. Clinical data of 6 males and 2 females, aged 21 to 45 years old. All live in the affected area, often tick tick bites. The shortest onset time of 2 weeks, up to 10 months. 6 cases of unilateral paralysis, bilateral facial paralysis in 2 cases. Clinically, ipsilateral or bilateral frontal veins disappear, incomplete eyelid closure, nasolabial fold shallow, skewed mouth or saliva and other peripheral facial paralysis as the main performance, with varying degrees of headache, dizziness, dizziness, insomnia and irritability and irritability Provoke other neuropsychiatric symptoms. Routine laboratory tests, EEG, CT and TCD were normal. Indirect immunofluorescence antibody IFA anti-LD spirochete antibody titers ≥ 1: 128 positive, hook body coagulation test and syphilis USR reaction were negative