ABSTRACT
@#Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on central facial paralysis after ischemic stroke. Methods From June, 2020 to June, 2021, 54 patients with central facial palsy after ischemic stroke who were hospitalized in the Rehabilitation Department of Xuzhou Central Hospital were randomly divided into control group (n = 27) and experimental group (n = 27). Both groups were given conventional rehabilitation treatment, including medication and facial muscle rehabilitation training. The experimental group was treated with 5 Hz rTMS on the affected primary motor cortex, and the control group was treated with the same parameters of sham stimulation at the same site. Before treatment and four weeks after treatment, the House-Brackmann Grading System 2.0 (HBGS-2), the Sunnybrook Facial Grading System, the horizontal distance difference between the bilateral mouth corners to the lower center of the philtrum at rest, the horizontal distance difference between the bilateral mouth corners to the intersection of the mandibular central incisor when showing the teeth at the best effort and the angle of the tongue midline deviating from the facial midline when the tongue was stretched out were used to evaluate the facial nerve function of the patient. Results One case dropped down in each group. Before treatment, there was no significant difference in the scores of HBGS-2 and Sunnybrook Facial Grading System, the horizontal distance difference between the bilateral mouth corners to the lower center of the philtrum at rest, the horizontal distance difference between the bilateral mouth corners to the intersection of the mandibular central incisor when showing the teeth at the best effort, and the angle of the tongue midline deviating from the facial midline when the tongue was stretched out between two groups (P > 0.05). After treatment, all the indexes significantly improved in both groups (|t| > 8.987, P < 0.001), and were better in the experimental group than in the control group (t > 2.939, P < 0.01). Conclusion 5 Hz rTMS on the affected primary motor cortex is effective on the facial nerve function of patients with central facial palsy after ischemic stroke.
ABSTRACT
Objective:To observe the clinical efficacy of Kinesio Taping guided therapy on facial paralysis and salivation after stroke. Methods:From January to July, 2018, 30 patients with central facial palsy were randomly divided into control group (n = 15) and observation group (n = 15). The control group accepted ice stimulation, facial massage, facial muscle function training and low-frequency electrical stimulation, while the observation group accepted Kinesio Taping of "Y" or "O" shape alternately during massage and facial muscle function training, and kept taping for a day if possible. They were assessed with Teacher Drooling Scale (TDS), House-Brackmann (H-B) Scale and Facial Nerve Function Scale before and four weeks after treatment. Results:Both groups improved in the scores of TDS, H-B Scale and Facial Nerve Function Scale after treatment (Z > 2.460, t > 4.971, P < 0.05), and improved more in the observation group than in the control group (Z > 2.817, t > 4.964, P < 0.01). Conclusion:Kinesio Taping guided therapy is effective on central facial paralysis and salivation after stroke.
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Objective:To observe the clinical efficacy of Kinesio Taping guided therapy on facial paralysis and salivation after stroke. Methods:From January to July, 2018, 30 patients with central facial palsy were randomly divided into control group (n = 15) and observation group (n = 15). The control group accepted ice stimulation, facial massage, facial muscle function training and low-frequency electrical stimulation, while the observation group accepted Kinesio Taping of "Y" or "O" shape alternately during massage and facial muscle function training, and kept taping for a day if possible. They were assessed with Teacher Drooling Scale (TDS), House-Brackmann (H-B) Scale and Facial Nerve Function Scale before and four weeks after treatment. Results:Both groups improved in the scores of TDS, H-B Scale and Facial Nerve Function Scale after treatment (Z > 2.460, t > 4.971, P < 0.05), and improved more in the observation group than in the control group (Z > 2.817, t > 4.964, P < 0.01). Conclusion:Kinesio Taping guided therapy is effective on central facial paralysis and salivation after stroke.
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Objective To observe the efficacy of acupuncture at Hegu (LI4) in treating central facial palsy due to cerebral ischemia, and to explore the dose-effect correlation and the optimal acupuncture protocol.Method Totally 150 patients with central facial palsy due to ischemic stroke were randomized into four groups to receive acupuncture at Hegu with different stimulation parameters plus the conventional integrated Chinese and Western medicine (group A, B, C, D) according to the acupuncture time and direction, and a control group (group E) only to receive the conventional Chinese and Western medicine treatment. The treatment lasted 14 d. The House-Brackmann facial nerve grading system, Toronto Facial Grading System and facial palsy grading scale were adopted as the evaluation indexes.Result After intervention, the scores of the three indexes were all significantly increased in the five groups (P<0.05), and the inter-group comparisons showed significant differences in comparing the improvement rate (P<0.05).Conclusion The study shows that acupuncture at Hegu is effective in treating central facial palsy due to cerebral ischemia, and with the inverse insertion of the needle and manipulation for 5 min at Hegu should be the optimal protocol regarding the improvement of the symptom score and effective rate.
ABSTRACT
According to the anatomical pathways of the corticobulbar tract, it is known that the responsible lesion site of central facial palsy is at the level of the midpons or the more rostral portion. In rare cases, central facial palsy is found in medullary lesions. We report two cases of medullary infarctions which presented as central facial palsy. These cases suggested that the hypothesis that part of the pathway of the facial corticobulbar fibers descend ipsilaterally to the lower medulla before decussating and ascending contralaterally to the facial nucleus.