牛某,男,35岁,今年2月份患急性病毒性结膜炎.经对症治疗后好转。一个月后展起出现口角向右歪斜、流涎、左眼不能闭合.第五天,出现右眼闭合不全,全面部不能活动,流涎,进食时双侧颊部残留食物,但不反呛。查体:BP16.9/10.6KPa,神清语明。双眼球结膜明显充血。双侧角膜反射消失,Bell 氏征阳性。双侧额纹消失,眼裂变大,蹙眉、闭目、示齿、鼓腮等动作均差。双侧鼻唇沟变浅,口角下垂,伸舌居中。无感觉障碍,共济运动正常。四肢肌力、肌张力均正常,腱反射对称存在,未引出病理反射。辅助检查:腰穿,初压19.6KPa,潘氏试验(±)WBC18×10~6/L,蛋白质0.6g/L,葡糖糖3.4mmol/L。血、尿常规,血沉,血糖及肝功均正常。经用激素、神经营养剂治疗,一周后面瘫开始恢复,双眼闭合有改善,右嘴 Cattle, male, 35 years old, suffering from acute viral conjunctivitis in February this year after the symptomatic treatment improved. One month after the onset of the mouth tilt to the right, salivation, left eye can not close the fifth day, the right eye closed incomplete, all can not move, salivation, eating both cheeks left food, but not anti-choke. Physical examination: BP16.9 / 10.6KPa, clear statement. Eyes conjunctiva obvious congestion. Bilateral corneal reflex disappeared, Bell’s sign positive. Loss of bilateral forehead, eye fission, eyebrows, eyes closed, showing teeth, drums and other movements are poor cheeks. Bilateral nasolabial fold shallow, drooping mouth, stretch tongue center. No sense of disorder, the Masonic movement is normal. Limb muscle strength, muscle tone are normal, tendon reflex symmetry exists, did not lead to pathological reflex. Auxiliary examination: lumbar puncture, initial pressure 19.6KPa, Pan test (±) WBC18 × 10 ~ 6 / L, protein 0.6g / L, glucose sugar 3.4mmol / L. Blood, urine, ESR, blood glucose and liver function are normal. After treatment with hormones and neurotrophic agents, facial paralysis began to recover after one week, improvement of both eyes closed, right mouth