ABSTRACT
[Objective] Peripheral facial paralysis with sequelae (PFPS) reduces the quality of life (QOL) of patients. However, not much information is available on acupuncture treatment (AT) for PFPS. We report a case of a patient with PFPS whose sequelae and QOL were successfully improved by a combination of medication, physical therapy (PT) and AT.[Case] A 42-year-old woman. Her chief complaint was facial tightness, facial asymmetry, and synkinesis.[History of present illness] Left paralysis developed in November X-1, and Bell's palsy was diagnosed. Yanagihara Score (YS) was 6 points. She received intravenous steroid treatment during hospitalization for 9 days after second week after onset. In addition, she was given facial nerve decompression on January 24, X. but there wasno change. Subsequently, she visited the Department of Otolaryngology-Head and Neck Surgery, The University of Tokyo on 24 April. Electroneurography was 4%, YS was16 points and synkinesis was found. AT was started from May 29, X. [Acupuncture treatment] We performed AT on muscle for facial expression for contractural reduction. Also, weinstructed self-care techniques such as massage, open-eyelid exercise, individual muscle strengthening exercise and matters that require attention in everyday life. AT was performed 19 times, once every one to two weeks.[Assessment and Progress] Measurements of YS, synkinesis, synkinetic potential (SP), Facial Clinimetric Evaluation Scale (FS) were evaluated at about 7 and 15 months after onset. YS (point) changed from 24 to 34, synkinesis changed from (++) to (+), SP did not change, FS (point) increased from 41 to 57.[Discussion and Conclusion] Treatment for PFPS is limited and reduces QOL. We added regular acupuncture treatment to medication and PT for PFPS. As a result, we were able to relieve sequelae, contributing to improvement in the quality of life. It is suggested that AT might have efficacy for PFPS.
ABSTRACT
[Introduction] We evaluated the efficacy of treatment and clinical characteristics of a patient with incomplete rotator cuff tear with a clinical presentation similar to that of frozen shoulder. It seems difficult to differentiate incomplete rotator cuff tear from frozen shoulder on physical findings alone since the former lacks the specific characteristics of rotator cuff tear. However, many patients with incomplete rotator cuff tears show a poor response to treatment due to mechanical disorders; thus, differentiation of incomplete rotator cuff tear from frozen shoulder may be demonstrated during the patient's clinical course.<BR>[Patient] In this patient, the joint range of motion improved in all directions, and the pain score also improved from 10 to 5, showing reduction of pain. However, the symptoms did not resolve smoothly; frequent remis-sions and exacerbations of symptoms were observed.<BR>[Discussion] We frequently encounter disorders diagnosed as periarthritis scapulohumeralis in daily clinical practice, and patients with such disorders usually respond well to treatment. However, we should realize that a variety of clinical conditions are involved in the disorders, and the clinical courses of patients should be followed closely during treatment.