Effect of row-like puncture at sternocleidomastoid on peripheral facial palsy at recovery stage / 中国针灸

OBJECTIVE@#To observe the effect of conventional acupuncture combined with row-like puncture at sternocleidomastoid on peripheral facial palsy at recovery stage.@*METHODS@#A total of 60 patients with peripheral facial palsy at recovery stage were randomized into an observation group and a control group, 30 cases in each one. Acupuncture was applied at affected Cuanzhu (BL 2), Yangbai (GB 14), Sibai (ST 2), Quanliao (SI 18), Jiache (ST 6), Dicang (ST 4), Hegu (LI 4), Taichong (LR 3) and Zusanli (ST 36) in the control group. On the basis of the treatment in the control group, row-like puncture was applied at sternocleidomastoid (1 needle was punctured at muscle origin and insertion respectively, 3 to 4 needles were row-like punctured at the connection line of muscle origin and insertion). The treatment was given once a day, 5 times were as one course, with 2-day interval, totally 4 courses were required in the both groups. The house-brackmann (H-B) facial nerve function grade, facial nerve function rating system-dynamic view rating scale score and facial disability index (FDI) scale score [including scores of FDI physical function (FDIp) and FDI social life function (FDIs)] before and after treatment were observed, and the clinical efficacy was evaluated in the two groups.@*RESULTS@#After treatment, the H-B facial nerve function grades were improved compared before treatment in the both groups (@*CONCLUSION@#Compared with conventional acupuncture, combination therapy with row-like puncture at sternocleidomastoid can improve the therapeutic effect of peripheral facial palsy at recovery stage.

Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy

BACKGROUND AND OBJECTIVES: We aimed to assess the clinical significance of dizziness associated with acute peripheral facial palsy (APFP). SUBJECTS AND METHODS: Medical records of patients who visited an otorhinolaryngology clinic at a university hospital and were admitted for treatment of APFP between 2014 and 2016 were thoroughly reviewed. RESULTS: In total, 15.3% (n=15) of patients had dizziness. Continuous, rotatory dizziness without exacerbating factors was most common and frequently accompanied by nausea/vomiting. Dizziness disappeared within 1 week during the hospitalization period. Patients with Ramsay Hunt syndrome (31.0%) had dizziness more frequently than those with Bell’s palsy (8.7%). In addition, higher hearing thresholds and pain around the ear was reported more often in dizzy patients (p < 0.05). Logistic regression analysis revealed that the initial House-Brackmann grade of facial paralysis was solely associated with final recovery, but dizziness was not associated with prognosis. CONCLUSIONS: Patients with APFP may have transient dizziness in the early stage, which may be more frequently accompanied by worse hearing thresholds and/or pain around the ear. However, these symptoms including dizziness seem to be unrelated to final prognosis.

Meta-analysis of the Clinical Efficacy of Contralateral Needling in Treating Acute-stage Peripheral Facial Paralysis / 上海针灸杂志

Objective To compare the clinical efficacy between contralateral needling and homolateral (the affected side) needling in treating acute-stage peripheral facial paralysis by using systematic evaluation. Method By computer and manual retrieval, literatures about clinical trials on contralateral needling in treating acute-stage peripheral facial paralysis published before March of 2017 were collected from China National Knowledge Infrastructure (CNKI), WanFang database, Vip database, China Biology Medicine disc (CBMdisc), Pubmed, Web of Science, EMbase and The Cochrane Library. By adopting the Cochrane systematic evaluation, the collected data underwent meta-analysis by using RevMen 5.3 software. Result A total of 276 articles were retrieved and 11 articles were finally recruited, including 761 patients with acute-stage facial paralysis, 394 cases treated by contralateral needling and 367 by homolateral needling. The meta-analysis showed that contralateral needling produced more significant effective rate and recovery rate than homolateral needling [effective rate: RR=1.06, 95％CI(1.01,1.11), Z=2.32, P=0.02; recovery rate:RR=1.53, 95％CI(1.31,1.78), Z=5.42, P<0.01]. Moreover, contralateral needling produced a better effect in improving facial nerve function, showing an advantage in ameliorating facial movement [HB: WMD=0.26, 95％CI(0.04,0.48), Z=2.34, P=0.02; FDIP: WMD=3.77, 95％CI(1.53,6.01), Z=3.30, P<0.01]. Conclusion Contralateral needling is worth applying in treating acute-stage peripheral facial paralysis. However, due to the small amount and unsatisfactoryquality of the recruited literatures in this systematic evaluation, multiple-centered randomized trials with high quality and large sample size are expected for further verification.

Advance in Facial Nerve Decompression for Facial Palsy Resulting from Zygomatic Fractures (review) / 中国康复理论与实践

@#The facial nerve is the longest nerve shaped the bone tube, which has many turnings and narrow path. About 7% to 10% of patients with temporal bone fracture have facial paralysis. Most of the patients showed loss of frontal lines, inability to close eyes, and deflection of the teeth. Facial nerve decompression has been an effective way to relieve the symptoms and restore facial nerve functions. However, the issue of surgical indications, timing of surgery, and scope of decompression still need further research.

Peripheral facial palsy in the past: contributions from Avicenna, Nicolaus Friedreich and Charles Bell / Paralisia facial periférica nos velhos tempos: as contribuições de Avicenna, Nicolaus Friedreich e Charles Bell

This study provides historical documents of peripheral facial palsy from Egypt, Greece and Rome, through the middle ages, and the renaissance, and into the last four centuries. We believe that the history of peripheral facial palsy parallels history of the human race itself. Emphasis is made on contributions by Avicenna and Nicolaus Friedreich. Controversies about the original clinical description by Charles Bell are also discussed.

Este estudo apresenta documentos de paralisia facial periférica nas artes plásticas no Egito antigo, Grécia e Roma, Idade Média, Renascimento e também dos últimos 4 séculos. Pensamos que a história da paralisia facial periférica acompanha a história da própria espécie humana. São apresentadas as contribuições de Avicenna e Nicolaus Friedreich, e são mostradas controvérsias sobre a descrição original de Charles Bell.

Peripheral Facial Palsy Associated With Ewing's Sarcoma

No abstract available.

A Case of Bell's Palsy with Narrowing of the Palpebral Fissure

Widened palpebral fissure has been regarded as one of the hallmarks of Bell's palsy. However, the palpebral fissure on the affected side may be narrower than that of the unaffected side. The narrowing of the palpebral fissure has been often thought as a sign caused by weakness of the levator palpebrae and Muller's muscles. However, weakness of the frontal muscle may cause drooping of the eyebrow, resulting in the narrowing of the palpebral fissure. We describe a patient of Bell's palsy with a narrowing of the palpebral fissure.

The Correlation between Peripheral Facial Neuropathy and Oropharyngeal Dysfunction

OBJECTIVE: To know the correlation between the grading of facial neuropathy by facial nerve conduction study (FNCS) and dysphagia severity by videofluoroscopic swallowing study (VFSS) in patients with acute peripheral facial palsy (PFP). METHOD: Twenty patients with acute PFP were recruited for this study. The causes of acute PFP were limited to idiopathic Bell's palsy and Ramsay-Hunt syndrome. The time interval from the onset of PFP to study of FNCS and VFSS was 10 to 14 days. The severity of PFP was graded according to House-Brackmann facial nerve grade (H-B FNG). Percent degeneration grade (PDG) was determined by FNCS. Baseline-to-peak amplitude of compound muscle action potentials in orbicularis oris muscle was used as an evaluation parameter. Oral transit time (OTT), pharyngeal transit time (PTT), pharyngeal delay time (PDT) and dysphagia limit were obtained by VFSS. RESULTS: There was a significant correlation between PDG and H-B FNG. The severity of oropharyngeal dysfunction was increased as the severity of the PDG increases. Delayed OTT, delayed PDT, and/or reduced dysphagia limit were revealed as a presentation of oropharyngeal dysfunction in acute PFP. CONCLUSION: The severity of PFP and oropharyngeal dysfunction were significantly correlated. And so we think that precise evaluation and adequate management of oropharyngeal dysfunction will be needed in acute PFP patients.

Incomplete AICA Syndrome Presented with Peripheral Facial Palsy; A Variant of Gasperini Syndrome

Acute infarcts of the anterior inferior cerebellar artery (AICA) territory are unusual. Furthermore incomplete AICA infarcts are perplexing because of its variations of vascular anatomy and inconsistent clinical features. We present a case with clinical features of AICA infarction, which consist of ipsilateral peripheral-type facial palsy, vertigo, and contralateral facial and upper limb sensory changes without motor weakness. The patient had hypertension and was a current smoker. The high signal intensity on inferior pontine tegmental area was found on MRI and the R2 interneuronal dysfunction was note on Blink reflex. The angiographic findings didn't show any focal vascular lesions, which is contrary to the pathogenesis of AICA infarction published previously. On the clinical ground, the present case reserves to attention in that patients with peripheral-type facial palsy should be properly evaluated and with thorough neurological examination and we could differentiate between the incomplete AICA infarcts such as Gasperini syndrome and Bell's palsy.