儿童EB病毒致面神经炎7例临床分析

Clinical analysis of facial neuritis caused by Epstein-Barr virus in 7 children

目的 研究爱泼斯坦-巴尔(Epstein-Barr,EB)病毒感染引起面神经炎的临床特点,提高对EB病毒致病多样性的认识。方法 收集2014年1月—2018年12月于苏州大学附属儿童医院住院的7例EB病毒所致面神经炎病例,分析其发病情况、临床表现、实验室检查、治疗和预后。结果 7例患儿,发病年龄为5岁以下5例,5~10岁1例,10岁3个月1例;均为周围性面神经炎;病灶为左侧5例,右侧2例。3例患儿在传染性单核细胞增多症发病急性期起病,2例患儿发病前半个月内有呼吸道感染病史,1例患儿1个月内有结膜炎病史,1例起病前无明显感染史。发病症状均以口角歪斜,一侧额纹变浅或者消失,鼻唇沟变浅为主。7例患儿头颅脊髓MRI均未见异常。7例患儿均经糖皮质激素治疗,并辅助维生素B6、赖氨酸肌醇维生素B12、维生素B1、五维葡钙等营养支持。随访3个月发现,大部分患儿2周左右恢复正常,最长3个月完全恢复。结论 EB病毒可以引起面神经炎,预后多良好,应早期治疗,可以恢复较快,应重视EB病毒引起的神经损伤。

Objective To analyze the clinical characteristics of facial neuritis caused by Epstein-Barr(EB)virus infection and to improve the understanding of the pathogenic diversity of EB virus.Methods Seven cases of facial neuritis caused by EB virus hospitalized in Children's Hospital of Soochow University from January 2014 to December 2018 were collected.The incidence,clinical manifestations,laboratory examinations,treatment and prognosis were analyzed.Results Among the 7 cases,5 cases were under 5 years old,one case aged 5 to 10 years,one case aged 10 years and 3 months.All of them were peripheral facial neuritis,5 cases of facial neuritis occurred on the left side of the face and 2 cases occurred on the right side of the face.The onset of facial neuritis in three children was at the acute stage of infectious mononucleosis,two cases had a history of respiratory tract infection within half a month before facial neuritis onset,one case had a history of conjunctivitis within one month,and one case had no history of obvious infection before onset.The symptoms were askew at the mouth angle,shallow or disappeared forehead lines on one side,and shallow nasolabial sulcus.There were no abnormalities on the images of MRI scanning for craniospinal cord in 7 cases.Seven cases were treated with glucocorticoid and supplemented with nutritional support of vitamin B6,lysine inosite and vitamin B 12,vitamin B 1 and Five Vitamins and Calcium Gluconate.Follow-up of 3 months showed that most diseased children recovered in about 2 weeks and the longest time for complete recovery was 3 months.Conclusion EB virus can cause facial neuritis,the prognosis is good.It should be treated early and recovered more quickly.We should pay attention to the nerve damage caused by EB virus.