頻頻熬夜加班 睡醒臉歪嘴斜

記者蔡彰盛／竹市報導

一名36歲男性日前加班頻繁常熬夜，公司應酬多又常喝酒，一覺醒來發現右邊眼睛無法閉合，一直流眼淚；吃東西、喝水會從右邊嘴角流出來，照鏡子才發現左右臉不對稱，臉歪了一邊，診斷為周邊性顏面神經麻痺。

經過一星期的類固醇治療及顏面神經復健，逐漸恢復正常，眼睛可以閉合，臉也不歪了。

衛生署新竹醫院神經科醫師周秉箴說，顏面神經麻痺又可稱為貝爾氏麻痺，是不明原因的顏面神經麻痺，一般認為，跟病毒感染有密切關係，尤其是單純性?疹病毒及帶狀?疹病毒。通常會在勞累或是免疫力下降的狀況發生。

有的病人初期會感到患側的耳朵內或耳朵後會有輕微的疼痛，數天之後再出現同側的顏面肌肉無力的現象，大約2到3天會達到頂點。

此時病人會有嘴角歪斜、口水外流、眼睛閉不緊或流淚、食物卡在患側臉頰和牙齒之間的現象，有些病人會有同側味覺的喪失。

顏面神經傳導及眨眼反射檢查可以預測未來的復元情形及神經的受損程度。整體來說，70%患者可以完全恢復正常，平均要3星期的恢復時間，另有7%患者可能復發。

顏面神經麻痺很容易誤認為是中風，如果是中風的話，會有其他的症狀，例如手腳無力，看東西有複視現象，或是吞嚥困難等等。

目前在治療方面，建議症狀開始3天內，服用一星期的高劑量類固醇，可以加速顏面神經的復元。若是嚴重顏面神經麻痺的患者可以考慮類固醇加上抗病毒藥物一起治療，可能有較好的療效。由於眼睛無法閉緊，所以應做好眼睛的保護工作，可使用人工淚液或藥膏，避免因眼睛過度乾燥而產生的角膜潰瘍。另外要多休息，避免飲酒、熬夜或過度勞累。

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