RESUMO
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.
RESUMO
OBJECT: The goals of radiosurgery include preservation of neurological function and prevention of tumor growth. We document the results of gamma-knife radio-surgery for vestibular schwannoma. METHOD AND OBJECT: Eighty-two patients underwent stereotactic radiosurgery for an vestibular schwannoma from October, 1994 to December, 2000. Sixty-five of these patients were followed up for radiological and clinical evaluation. As pregamma-knife modality, surgical resection were done in 23 patients,and V-P shunt in 2 patients. Initial symptoms were headache(n=45), dizziness(n=16), tinnitus(n=17). While normal facial function(House-Brackmann grade 1) was present in 48 patients(73.8%), other patients showed grade 2 function in 8, grade 3 function in 7,and grade 4 function in 2. The Gardner/Robertson scale was used to code hearing function. Male to female ratio was 1:3. Mean tumor volume was 7.98cm3. Mean dose delivered to the tumor margin was 14.2Gy,and mean maximal dose was 28.3Gy. RESULTS: Mean follow-up duration of 19.9 months. Thirty-five showed decrease(53.8%) in size, 19 patients(29.2%) stationary, 3(4.6%) initial decrease follow up increase, 5(7.6%) initial increase follow up decrease,and 59 patients (90.8%) were well controlled. Two patients experienced transient facial neuropathy, one transient trigeminal neuropathy, and one transient hearing deterioration. After gamma-knife radiosurgery, ventriculoperitoneal shunt was done in 4 patients. CONCLUSIONS: Gamma-knife radiosurgery can be used to treat postoperative residual tumors as well as in patients with concomitant medical problems in patients with preserved hearing function. Gamma-knife radiosurgery is safe and effective method to treat small, medium sized(less than 3cm in extracanalicular diameter), intracanalicular vestibular schwannoma, associated with low rate of cranial neuropathy.