Study on Efficacy of Steroids and Acyclovir Treatment in Bells Palsy

Bells palsy is an idiopathic disease of the seventh cranial nerve. This is the most frequent cranial mononeuropathy with an annual incidence of 10 to 40 cases per 100,000 population with geographical variations. Aim: To assess the efficacy of Steroids and Acyclovir in the management of Bell’spalsy. Methods: All the patients with Bell's palsy, without clinical evidence of other cranial nerve damage or central nervous system diseases were included. Patients were divided into 4 groups, control, steroid alone, steroid with acyclovir and acyclovir alone. The study groups of patients were clinically tested in a periodic manner within twelve months at various intervals. The severity of the facial nerve involvement is assessed with House- Brackmann grading (HB) system. Results: In 101 patients, Majority of patients come under grade IV (43.6%) and next comes to grade V (31.7%). 86% of the percentage of patients improved in grade IV, and 68.8% of patients improved in grade V. None of the patients from grade VI showed improvement. Combination of Steroids and acyclovir is definitely useful when compared to the control group. The combination scores over the control group by 1.37 times which is statistically significant (P value= 0.031668). Conclusion: Steroids are safe and are probably effective in the management of bells palsy which improves the rate ofrecovery. Acyclovir in combination with prednisolone is safe and has a definite role in improving facial functional outcomes in patients with Bell’s palsy than using the drugalone.

Efficacy of Electro Acupuncture in Bell’s Palsy – A Clinical Interventional Pilot Trial in Indian Patients

Introduction: Bell’s palsy is an acute peripheral facial neuropathy and is the most common cause of lower motor neuron facial palsy. Various treatment modalities including steroids, physiotherapy, antivirals have been described. We aimed to study the efficacy of electroacupuncture to modify and improve the muscle paralyses. Material and methods: The first twenty patients who were willing for the study were selected. Fourteen sittings of thirty minutes each were done with one chun silver needles and stimulation was electrical and the intensity was adjusted for de qi feeling for the patients. House-Brackmann Classification of Facial Function was used to categorize the patients before and after treatment. Improvement in the score of more than 1 was termed significant relief. Results: Out of the twenty patients 17 had significant improvement of power and three had mild improvement. Three patients had minimal bleeding in a few points which stopped with simple pressure. Watering of the eye stopped in all the cases. The majority of patients were satisfied according to partha patient satisfaction score. Conclusion: To conclude, electroacupuncture has a significant role in early paralytic phase of Bells palsy without many side effects.

Paralisia de Bell subsequente a ritidoplastia / Bell’s palsy subsequent to rhytidectomy

A paralisia facial periférica é uma entidade que pode deixar sequelas estéticase funcionais importantes nos pacientes. De acordo com a literatura, a paralisia de Bell (PB) é a causa mais comum, representando de 50 a 80% dos casos. Porém deve ser considerada como diagnóstico de exclusão. Estima-se uma prevalência ligeiramente maior entre as mulheres e sua incidência é bimodal, com picos na terceira e oitava décadas de vida. A maioria dos pacientes evolui para a recuperação dentro de algumas semanas, embora seja comum uma piora do quadro nas primeiras 48 horas. O tratamento deve ser realizado no sentido de prevenir complicações e as condutas medicamentosas não estão consagradas. Como fatores de risco para a PB têm sido relatados hipertensão arterial, diabete mellitus, gravidez, puerpério e infecção pelo vírus herpes tipo I. Embora existam vários fatores de risco associados à PB, em relação à cirurgia de face-lifting existe apenas um caso relatado na literatura. Relato do Caso: No presente estudo, os autores descrevem o segundo caso de paralisia de Bell após a cirurgia de face-lifting.

The peripheral facial palsy is a disease that can leave significant aestheticaland functional sequelae in patients. According to medical literature, Bell’s palsy (BP) is the most common cause, representing from 50 to 80% of the cases. However, it must be considered as an exclusion diagnosis. A slightly higher prevalence is estimated in women and its incidence is bimodal with peaks in the third and eighth life decades. Most patients recover within weeks, though a worsening degree may be common in the first 48 hours. Treatment must be performed to prevent complications and the medical procedures are not universally accepted. The following have been mentioned as BP risk factors: arterial hypertension, mellitus diabetes, pregnancy, puerperium and infection caused by type I herpesvirus. Although there are several BP associated risk factors, regarding face-lifting surgery there is only one reported case in medical literature. Case Report: In the present study, the authors describe the second case of Bell’s palsy after face-lifting surgery.

Fisioterapia na paralisia facial periférica: estudo retrospectivo / Physical therapy in peripheral facial paralysis: retrospective study

A paralisia facial periférica requer tratamento especializado. A fisioterapia tem como objetivo restabelecer a mímica facial. O objetivo deste estudo foi descrever e analisar os resultados da fisioterapia para indivíduos com paralisia facial periférica. FORMA DE ESTUDO: Retrospectivo. MÉTODO: Foi realizado um estudo retrospectivo em um Hospital Universitário, com autorização do Serviço de Atendimento Médico e Estatístico, no período de 1999 a 2003. Os dados são apresentados em forma descritiva, com utilização de média e mediana para variáveis numéricas e freqüência para variáveis categóricas. RESULTADOS: Foram analisados 23 prontuários durante quatro anos. Foi identificado o predomínio do sexo feminino e a média de idade foi de 32,3 anos (DP±16,5); 14 casos idiopáticas e cinco traumáticas; 12, com comprometimento motor total e 11, parcial; nos 12 casos com avaliação final, sete evoluíram para recuperação parcial e cinco para total. A fisioterapia utilizada foi cinesioterapia e orientações. CONCLUSÃO: Neste estudo os indivíduos são similares a outras populações. Foram tratados com cinesioterapia, como sugerido pela literatura científica e evoluíram com recuperação.

Peripheral facial paralysis requires specialized treatment. Physical therapy aims at reestablishing facial movements. The aim of this study was to describe and to analyze physical therapy results for individuals with peripheral facial paralysis. STUDY DESIGN: Retrospective study. METHOD: A retrospective study was carried out at the University Hospital, authorized by the Statistics and Medical File Services, from 1999 to 2003. Data are presented in descriptive form with mean and median values for numeric variables and frequency for categorical variables. RESULTS: Twenty-three files were analyzed during four years. Females predominated and the average age was of 32.3 years (SD±16.5); 14 idiopathic and five trauma cases; 12 with total motor deficit and 11 with partial motor deficit; in the 12 cases that underwent final evaluation, seven had partial and five had total recovery. The physical therapy program used was kinesiotherapy and patient education. CONCLUSION: In this study, individuals were similar to individuals in other populations. They were treated with kinesiotherapy, as suggested by the scientific literature and recovered.

An appraisal of steroid therapy of bells palsy

Although a benign condition whose etiology has not been definitely established, pathology of the peripheral portion of the facial nerve (clinically called Bells Palsy) can be very disturbing because of the esthetic value of the integrity of the facial nerve. Because of its mild character, very little attention has been paid to the discovery of the etiology and consequently the treatment of the condition. In 1951, a report by Dr. Harold H. Rothendler in the "Journal of Nervous and Mental Diseases" indicated encouraging results of therapy on a purely empirical basis, with the use of steroids. Since then the authors have been following the advised regimen of therapy advocated by Dr. Rothendler. The present report studies a total of 43 cases of peripheral facial palsy (Bells Palsy, Ramsay-Hunt Syndrome) and the outcome of the therapy with Prednisolone, particularly Triamcinolone. Encouraging results have been obtained but the outcome of such therapy from these studies indicate that the higher the level of the lesion in the course of the facial nerve the slower is the recovery and the earlier therapy is instituted, the faster is the recovery. (Summary)