Effect of the staging comprehensive treatment with acupuncture-moxibustion on Bell's facial palsy in the acute stage / 中国针灸

OBJECTIVES@#To compare the clinical effect on Bell's facial palsy in the acute stage between the staging comprehensive treatment with acupuncture-moxibustion and western medication.@*METHODS@#Sixty patients with Bell's facial palsy in the acute stage were randomly divided into an observation group and a control group, with 30 cases in each one. The patients in the control group were administered orally with prednisone acetate tablets and methylcobalamin tablets until the 28th day of illness. In the observation group, the staging comprehensive treatment with acupuncture-moxibustion was adopted. On the affected side, Qianzheng (EX-HN 16), Yifeng (TE 17), Sibai (ST 2), Yangbai (GB 14), Jiache (ST 6), Dicang (ST 4) and Touwei (ST 8), etc. were stimulated. In the acute stage (Day 1 to 7 of illness), the routine acupuncture and the point-toward-point needle insertion were delivered, no any manipulation was exerted at acupoints, and the needles were retained for 30 min. In the subacute stage (Day 8 to 14 of illness), on the base of the treatment as the acute stage, the depth of needle insertion was adjusted at a part of acupoints and the even needling technique was operated by twisting needle. Besides, electroacupuncture (EA) was attached to Qianzheng (EX-HN 16) and Dicang (ST 4), with continuous wave of low intensity and high frequency, 100 Hz, for 20 min. In the recovery stage (Day 15 to 28 of illness), on the base of the treatment as the subacute stage, the heavy stimulation of acupuncture was given, in which, the sticking and lifting needle techniques were delivered after the needles were inserted from Sibai (ST 2) toward Dicang (ST 4), and from Dicang (ST 4) toward Jiache (ST 6), separately; warm needling was operated at Yifeng (TE 17), and EA changed to stimulate the acupoints with the intermittent wave of high intensity and low frequency, 2 Hz, for 30 min. Acupuncture-moxibustion was given once every other day until the end of the 28th day of illness. The level of House-Brackmann facial nerve function rating scale (H-B grade),the score of Sunnybrook facial nerve grading system (Sunnybrook), the score of facial disability index (FDI), the temperature difference in the infrared thermal imaging facial area and electromyogram (EMG) situation of the affected muscle group were observed before and after treatment in the two groups. Using musculoskeletal ultrasound,the facial nerve diameter was detected and the clinical effect was compared between the two groups.@*RESULTS@#After treatment, the level of H-B grade, Sunnybrook score, the scores of physical function and social life function in FDI were improved when compared with those before treatment in the patients of either group (P<0.01, P<0.05), and the results of these evaluations in the observation group were better than those of the control group (P<0.05). After treatment, the temperature difference of the frontal area, the eye area, the zygomatic area and the mouth corner was declined in comparison with that before treatment in the two groups (P<0.05), and the temperature difference in each area in the observation group was lower than that of the control group (P<0.05).The root mean square (RMS) of the frontal muscle group, the zygomatic muscle group and the orbicularis muscle group on the affected side increased in comparison with that before treatment in the two groups (P<0.01), and RMS of the observation group was higher than that of the control group (P<0.05) after treatment. Before treatment, the diameter of the facial nerve on the affected side was larger than that on the healthy side (P<0.01), and after treatment, the diameter on the affected side was reduced when compared with that before treatment in the two groups (P<0.01); the diameter of the facial nerve on the affected side in the observation group was smaller than that of the control group (P<0.05), while, the diameter on the affected side was larger when compared with the healthy side in the control group (P<0.05). The total effective rate of the observation group was 93.3% (28/30), higher than that of the control group (83.3% [25/30], P<0.05).@*CONCLUSIONS@#The staging comprehensive treatment with acupuncture-moxibustion is clearly effective on Bell's facial palsy in the acute stage, which affirms the effectiveness of acupuncture-moxibustion for the acute stage of Bell's facial palsy in comparison with conventional western medication.

Acupoint selection rules of staging, syndrome types, and symptoms of acupuncture for peripheral facial paralysis based on data mining / 中国针灸

OBJECTIVES@#To analyze and explore the acupoint selection rules of different staging, syndrome types, and symptoms of acupuncture for peripheral facial paralysis based on data mining.@*METHODS@#Literature regarding acupuncture for peripheral facial paralysis was retrieved in CNKI, VIP, Wanfang, SinoMed, and PubMed from January 1, 2012, to December 31, 2021. The Traditional Chinese Medicine Inheritance Assistant Platform (V 3.0), SPSS Modeler 18.0, and Cytoscape software were used to analyze the selection of acupoints based on staging, meridian distribution of acupoints, the selection of acupoints based on syndrome types, syndrome types based on staging, and symptom-based acupoint selection. Association rule analysis was performed for each stage and major syndrome types, and co-occurrence network diagrams were generated.@*RESULTS@#A total of 1 695 articles were included, involving 124 acupoints with a total frequency of 5 456 times. Among 1 080 articles related to staging-based acupoint selection, the acute stage had the highest acupoint use frequency (2 224 times) and number (88 acupoints). Among all stages, the acupoints of the stomach meridian of foot-yangming were most frequently used, with Dicang (ST 4)-Yangbai (GB 14) and Dicang (ST 4)-Jiache (ST 6) being the high-frequency acupoint pairs in each stage. The top four syndrome types in terms of acupoint usage frequency were wind-cold syndrome, wind-heat syndrome, qi-blood deficiency syndrome, and liver-gallbladder damp-heat syndrome. Among 521 articles combining staging with symptoms or syndrome types with symptoms for acupoint selection, the symptom "nasolabial groove becoming shallow or disappearing" had the highest frequency of occurrence. The symptoms with the highest acupoint usage frequency and number were "forehead wrinkles becoming shallow or disappearing" and "pain behind the ear" respectively.@*CONCLUSIONS@#Acupoint selection for peripheral facial paralysis primarily focuses on the yang meridians in each stage, supplemented by local acupoints and based on the pathological characteristics. Syndrome differentiation and treatment should be prioritized, combined with local acupoint selection. Clinical acupoint selection can be based on a combination of staging, syndrome types, and symptoms.

Application status and analysis of Fu's subcutaneous needling in the treatment of peripheral facial paralysis / 中国针灸

This paper summarizes the status of application and research of Fu's subcutaneous needling for peripheral facial paralysis, and the characteristics of different stages of peripheral facial paralysis treated with Fu's subcutaneous needling are analyzed from the aspects of intervention timing, protocol design, needle insertion point, sweeping and reperfusion activity, tube retaining time and acupuncture frequency. It is found that there are no norms and standards in sweeping and reperfusion, tube retention and acupuncture frequency in clinical application，and the exploration of staged treatment is insufficient in the research. In the future, it is necessary to form standardized operation to promote clinical promotion, and improve the research on treatment rules and mechanism according to the characteristics of disease stage.

WU Xu's experience of sequential therapy for peripheral facial paralysis / 中国针灸

The paper introduces professor WU Xu 's experience of sequential therapy for peripheral facial paralysis. The sequential therapy refers to a staging treatment, but not rigidly adheres to it. With this therapy, the acupuncture- moxibustion regimen is modified flexibly in line with the specific symptoms of illness. At the acute phase of peripheral facial paralysis, warm acupuncture at Wangu (GB 12) is predominated and electroacupuncture is not recommended at the acupoints on the face. At the recovery phase, warm acupuncture at Zusanli (ST 36) is the main therapy and electroacupuncture is applied to the acupoints on the face appropriately. Besides, for the intractable case, the tapping technique with plum-blossom needle or skin needle should be combined and exerted in the local affected region. At the sequelae phase, in order to shorten the duration of illness, depending on the different types of facial paralysis, i.e. stiffness type, spasmodic type and flaccid type, the corresponding needling techniques are provided, i.e. bloodletting and moxibustion, strong stimulation with contralateral acupuncture and the technique for promoting the governor vessel and warming up yang.

Professor / 中国针灸

To summarize professor

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.

Bibliometric analysis of refractory facial paralysis based on CNKI database / 中国针灸

The current development situation and the hotspot of the relevant research on refractory facial paralysis are explored. The articles on refractory facial paralysis are retrieved from CNKI database. The bibliographic items co-occurrence matrix builder (BICOMB) 2.0 is adopted to extract and analyze statistically literature characteristics and generate the high-frequency keywords matrix. The graphical clustering toolkit (gCLUTO) 1.0 is used to cluster the high-frequency keywords. A total of 750 articles are included, mostly published in

O uso da kinesio taping no tratamento da paralisia facial pós-acidente vascular cerebral fase aguda / The use of kinesio taping in the treatment of the acute phase of post-stroke facial paralysis

RESUMO Objetivo comparar os resultados da reabilitação da paralisia facial pós-acidente vascular cerebral isquêmico na fase aguda, com e sem o uso da Kinesio Taping. Métodos estudo experimental caso e controle com 46 pacientes com paralisia facial pós-acidente vascular cerebral, distribuídos em dois grupos de forma randomizada, para a reabilitação da mímica facial: o grupo caso realizou terapia miofuncional orofacial e fez uso da Kinesio Taping nos músculos zigomáticos maior e menor e o grupo controle apenas terapia miofuncional orofacial. Para avaliação da paralisia facial, foi utilizada a escala de House e Brackmann e o protocolo de incompetência do movimento para as medições da face. Todos os participantes realizaram 12 dias de intervenção fonoaudiológica para a reabilitação da mímica facial. Para análise, considerou-se a incompetência do movimento por meio das medidas da face e o grau de comprometimento da paralisia facial e foi verificado se a idade poderia ter influenciado os resultados. Foram realizadas análises de associação e o nível de significância adotado foi de 5%. Resultados os dois grupos apresentaram melhora da assimetria facial após intervenção fonoaudiológica, a incompetência do movimento foi menor em todas as medidas da face e a melhora da gravidade da paralisia facial foi semelhante, sem diferença estatística entre os tratamentos. Conclusão tanto a terapia miofuncional orofacial exclusiva, como associada ao uso da Kinesio Taping, são estratégias terapêuticas que promovem melhora da paralisia facial pós-acidente vascular cerebral.

ABSTRACT Purpose To compare the results of treatment of facial paralysis after ischemic stroke in the acute phase with and without the use of Kinesio Taping. Methods Experimental case-control study with 46 patients with facial paralysis after stroke, randomly assigned to two groups for treatment of facial mimicry: the case group underwent orofacial myofunctional therapy and used Kinesio Taping on the zygomatic major and minor muscles while the control group only received orofacial myofunctional therapy. To assess facial paralysis, the House and Brackmann scale and the movement incompetence protocol were used for facial measurements. All participants underwent 12 days of treatment for facial mimicry. The analysis considered movement incompetence by means of the face measurements and the degree of impairment of facial paralysis, checking whether age might have influenced the results. Association analyses were performed and the significance level adopted was 5%. Results both groups showed an improvement in facial asymmetry after treatment, movement incompetence was lower in all facial measurements, and the improvement in the severity of facial paralysis was similar, with no statistical difference between treatments. Conclusion Both the exclusive orofacial myofunctional therapy and the one combined with Kinesio Taping are therapeutic strategies that promote improvement in post-stroke facial paralysis.

Effect of warm acupuncture at Yifeng (TE 17) on facial paralysis with periauricular pain during pregnancy / 中国针灸

OBJECTIVE@#To compare the curative effect between the warm acupuncture at Yifeng (TE 17) combined with conventional acupuncture and TDP plus conventional acupuncture on facial paralysis with periauricular pain during pregnancy.@*METHODS@#A total of 68 patients were randomized into an observation group (36 cases, 3 cases dropped off) and a control group (32 cases, 1 case dropped off). First week, TDP light was used on the affected side in the control group, and warm acupuncture at Yinfeng (TE 17) on the affected side was used in the observation group, both once a day. From the second week, both groups were given acupuncture at Chengjiang (CV 24) and the affected side of Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Yingxiang (LI 20), Dicang (ST 4), etc. and electroacupuncture (continuous wave, 2 Hz in frequency) was connected at Cuanzhu (BL 2) and Taiyang (EX-HN 5), Jiache (ST 6) and Dicang (ST 4). Both treatments were given every other day for 4 weeks totally. The visual analogue scale (VAS) score of the periauricular pain degree before treatment and after 1 week of treatment, the House-Brackmann (H-B) facial nerve function grading scale and facial disability index (FDI) score before treatment and after 2, 4 weeks of treatment were compared between the two groups.@*RESULTS@#After 1 week of treatment, the VAS scores of both groups decreased (@*CONCLUSION@#Warm acupuncture at Yinfeng (TE 17) combined with conventional acupuncture can effectively improve the periauricular pain and facial nerve function in patients of facial paralysis with periauricular pain during pregnancy, and the curative effect is better than TDP plus conventional acupuncture.

Parálisis facial periférica. Incidencia y etiología / Peripheral facial paralysis. Incidence and etiology / Paralísia facial periferal. Incidência e etiologia

INTRODUCCIÓN: La parálisis facial periférica implica una disfunción del VII par. Predomina la forma idiopática o de Bell. Su tratamiento se basa en el uso de corticoides y en las demás causas depende de la patología de base. El presente estudio describe la incidencia, la etiología y el grado de afectación de la parálisis facial en la población del Hospital de Clínicas José de San Martín. MÉTODO: Revisión de historias clínicas de pacientes que concurrieron a la guardia del Servicio de Otorrinolaringología entre enero de 2013 y septiembre de 2017, y revisión bibliográfica...

INTRODUCTION: Peripheral facial paralysis implies a dysfunction of the seventh pair. The idiopathic or Bell form predominates. Its treatment is based on the use of corticosteroids; and in the other causes depends on the underlying pathology. The present study describes the incidence, etiology and degree of involvement of facial paralysis in the population of the Hospital de Clínicas José de San Martín. METHOD: Review of medical records of patients who attended the otorhinolaryngology service ward between january 2013 and september 2017, and literature review…

INTRODUÇÃO: A paralisia facial periférica implica uma disfunção do sétimo par. Predomina a forma idiopática ou de Bell. O seu tratamento baseia-se no uso de corticosteróides; e nas outras causas depende da patologia subjacente. O presente estudo descreve a incidência, etiologia e grau de envolvimento da paralisia facial na população do Hospital de Clínicas José de San Martín. MÉTODO: Revisão dos registros médicos de pacientes atendidos na sala de atendimento de Otorrinolaringologia entre janeiro de 2013 e setembro de 2017 e revisão da literatura...

Electroestimulación muscular selectiva utilizada en el tratamiento kinésico de pacientes con parálisis facial periférica aguda y crónica / Selective muscular electrostimulation used in the kinetic treatment of patients with acute and chronic peripheral facial paralysis

Se presentan dos casos de pacientes con parálisis facial periférica aguda y crónica respectivamente, en los que se utilizó el mismo tratamiento kinésico basado en electroestimulación muscular selectiva combinado con masoterapia y reeducación de músculos faciales. Ambos pacientes recuperaron las funciones básicas de oclusión básica de ojos y boca como así también mímica y simetría facial. En el caso del paciente con parálisis facial aguda, se obtuvieron resultados funcionales en menor número de sesiones. El inicio precoz del tratamiento kinésico podría ser considerado como un factor que favorecería la pronta recuperación del paciente. No se registraron efectos no esperados con el uso de corrientes eléctricas para la recuperación del trofismo de los músculos faciales

Comparação da eficácia entre a toxina onabotulínica A com a abobotulínica A, na equivalência de 1: 3, para o tratamento da assimetria na paralisia facial de longa duração / Comparison of the efficacy of the 1:3 onabotulinumtoxinA:abobotulinumtoxinA ratio for the treatment of asymmetry after long-term facial paralysis

A aplicação de toxina botulínica A no lado não paralisado (LNP) é feita para tratar a assimetria resultante da paralisia facial (PF). As unidades de toxina onabotulinica A (Ona) e toxina abobotulinica A (Abo) não são equivalentes. Comparou-se a taxa de conversão de 1:3 em pacientes com PF. Cinquenta e cinco pacientes (idade entre 16 e 67 anos, 43 mulheres), com PF de longa duração foram tratados de forma aleatória com a aplicação de Ona (n = 25) ou Abo (n = 30) no LNP. Efeitos adversos, simetria facial, satisfação subjetiva e Índice de Incapacidade Facial (IIF) foram avaliados após 1 e 6 meses. Os resultados mostraram que a incidência de efeitos adversos foi maior com Abo (93,3% vs. 64,0%, p = 0,007). Avaliação Clínica do LNP diminuiu após 1 mês e aumentou novamente aos 6 meses, sem diferenças entre os grupos. A nota do lado paralisado (LP) foi menor no grupo Ona antes do tratamento, mas semelhante em ambos os grupos depois do tratamento. A nota do LP aumentou depois de 1 mês, e aos 6 meses foi ainda maior que a nota de prétratamento em ambos os grupos. A avaliação subjetiva melhorou em todos os momentos em comparação com a nota do pré-tratamento e diferiu entre os dois grupos apenas em 1 mês, quando o grupo Abo ficou um pouco mais paralisado. Índice de Função Física (IFF) e Índice de Bem-Estar Social (IBES), subescalas do Índice de Incapacidade Facial (IFF), entre os dois grupos não foram diferentes. Concluímos que ambas as toxinas reduziram a assimetria de forma eficiente em pacientes com FP. Os efeitos adversos foram maiores com Abo na equivalência de 1:3.

Botulinum toxin A injection into the nonparalyzed side (NPS) is used to treat asymmetry resulting from facial palsy (FP). OnabotulinumtoxinA (ONA) and abobotulinumtoxinA (ABO) units are not equivalent. We compared the conversion ratio of 1:3 in patients with FP. Fifty-five patients (aged 16-67 years, 43 women) with long-standing FP were randomly treated with either ONA (n = 25) or ABO (n = 30) injections into the NPS. Adverse effects, facial symmetry, subjective satisfaction, and Facial Disability Index (FDI) were assessed after 1 and 6 months. The results showed that the incidence of adverse effects was higher with ABO (93.3% vs. 64.0%, p = 0.007). Clinical scores of the NPS decreased after 1 month and increased again at 6 months, with no betweengroup differences. Scores of the paralyzed side were lower in the ONA group before treatment, but similar in both groups thereafter. The paralyzed side scores increased after 1 month, and at 6 months were still higher than the pretreatment scores in both groups. Subjective assessment improved at all time points compared to pretreatment score and differed between the two groups only at 1 month, when the ABO group was a bit too paralyzed. The Physical Function and Social/Well-Being Function subscales of the FDI did not differ between the two groups. We conclude that both toxins efficiently reduced asymmetry in patients with FP. Adverse effects were higher with ABO at an equivalence ratio of 1:3.

Paralisia facial periférica e gestação: abordagem e tratamento / Facial palsy and pregnancy: management and treatment

OBJETIVO: Comparar o grau da paralisia facial periférica de gestantes e puérperas no momento da admissão e na alta e avaliar outros fatores associados. MÉTODOS: Estudo retrospectivo, transversal, com análise dos prontuários de gestantes e puérperas atendidas no ambulatório de paralisia facial, em um período de 12 meses, com aplicação de protocolo padronizado de avaliação das pacientes e da escala de House-Brackmann na primeira consulta e na data da alta. RESULTADOS: Foram identificadas 6 pacientes, com média de idade de 22,6 anos. Cinco casos foram classificados com estadiamento IV e um com II na escala de House-Brackmann, sendo que duas eram puérperas e quatro gestantes. Todas evoluíram com melhora na escala de House-Brackmann. CONCLUSÃO: A paralisia de Bell tem bom prognóstico mesmo em gestantes e puérperas, sendo importante realizar tratamento adequado para diminuir as sequelas neste grupo apontado como mais susceptível à paralisia facial periférica.

PURPOSE: To compare the degree of peripheral facial palsy of pregnant women and puerperae at admission and at discharge and to evaluate related factors. METHODS: Retrospective, cross-sectional study, with analysis of medical records of pregnant and postpartum women with facial palsy, over a period of 12 months, with application of a standardized protocol for patient evaluation and of the House-Brackmann scale on the occasion of the first visit and at discharge. RESULTS: Six patients were identified, mean age of 22.6 years. Five cases were classified as stage IV and one as stage II on the House-Brackmann scale, being two of them puerperae and four pregnant. All showed improvement on the House-Brackmann scale. CONCLUSION: The Bell's palsy has a good prognosis even in pregnant and postpartum women, being important to perform the correct treatment to reduce the sequelae in this group identified as more susceptible to peripheral facial palsy.

Utilização de fio de polipropileno de autossustentação de tripla convergência para a correção do desvio de hemiface causada por lesão do nervo facial / Use of triple-convergence polypropylene thread for the aesthetic correction of partial facial paralysis caused by the facial nerve injury

OBJETIVO: Avaliar a utilização do fio de polipropileno de autossustentação de tripla convergência para a correção do desvio de hemiface que se apresenta como sequela tardia da paralisia facial periférica. MÉTODOS: Realizou-se um estudo retrospectivo e observacional em 34 indivíduos portadores de paralisia facial tardia. Utilizou-se fio de polipropileno de tripla convergência para a correção do desvio da hemiface paralisada. Trata-se de fio monofilamentar, sintético, transparente e inabsorvível que possui garras que tracionam os tecidos ptosados mantendo-os na posição correta, em simetria com o lado são. Os resultados foram avaliados através de análise subjetiva, quanto ao grau de satisfação dos pacientes, submetidos a um questionário próprio. RESULTADOS: Analisou-se 34 pacientes, 73,52% deles relataram grande melhora, 20,58% relataram melhora moderada e 5,88%, uma melhora leve; encontrou-se um alto índice de satisfação, 94,1%. Dois pacientes apresentaram extrusão parcial do fio. Nenhum paciente desenvolveu infecção. CONCLUSÃO: O emprego do fio de polipropileno de autossustentação de tripla convergência para a correção do desvio da hemiface, consequente à paralisia facial, ocasionou acentuada melhora da assimetria facial e a recuperação da autoestima dos pacientes.

OBJECTIVE: To evaluate the use of self-sustaining triple-convergence polypropylene thread for correction of hemiface deviation presenting as late result of facial paralysis. METHODS: We conducted a retrospective, observational study with 34 subjects with late facial paralysis. We used a triple-convergence polypropylene thread to correct the deviation of the paralyzed hemiface. It is a monofilament, synthetic, transparent and unabsorbable thread that has hooks that exert traction in the ptotic tissues, keeping them in the correct position, in symmetry with the healthy side. The results were evaluated by subjective analysis, with assessment of patient satisfaction with a proper questionnaire. RESULTS: We analyzed 34 patients, 73.52% of them reported great improvement, 20.58% moderate improvement and 5.88%, slight improvement; we found a high satisfaction rate of 94.1%. Two patients had partial extrusion of the wire. No patient developed infection. CONCLUSION: The use of triple-convergence polypropylene thread to correct the deviation of hemiface consequent to facial palsy markedly improved facial asymmetry and recovery of patients' self-esteem.

Viabilidade do uso do óleo essencial da Alpinia zerumbet, Zingiberaceae, na otimização do tratamento fisioterapêutico em paralisia cerebral espástica / Feasibility of using essential oil of Alpinia zerumbet, Zingiberaceae, the optimization of physical therapy in spastic cerebral palsy

Objetivo: O objetivo deste estudo foi avaliar a viabilidade do óleo essencial da Alpinia zerumbet associado ao tratamento fisioterapêutico da paralisia cerebral. Métodos: O estudo foi prospectivo, analítico e clínico do tipo II, aleatório por grupos em períodos específicos. A amostra, N = 24, de crianças com paralisia cerebral foi dividida em quatro grupos: dois grupos de cinesioterapia tratado com óleo essencial e seu controle, por via dérmica, na dose de 0,5 kg ml/10 kg, e dois grupos de cinesioterapia, tratado com óleo essencial e seu controle, por via inalatória, na dose 0,05 ml/10 kg/5 ml de soro fisiológico por 15 minutos. A espasticidade muscular e as atividades funcionais estáticas e dinâmicas foram mensuradas pelo protocolo de Durigon (2004). Os testes t-Student e ANOVA foram utilizados para a significância de 95%. Resultados: Os grupos tratados com óleo essencial apresentaram resultados significativos na avaliação do tônus muscular e na função estática e dinâmica. Conclusão: O óleo essencial associado à cinesioterapia modula o tônus muscular, possibilitando ganho funcional. As crianças tratadas de forma dermal apresentaram melhor resultado em relação às que inalaram o óleo essencial.

Objective: The objective of this study was to evaluate the feasibility of the essential oil of Alpinia zerumbet associated with physical therapy for cerebral palsy. Methods: The study was a prospective, clinical analytical type II, random by groups in specific periods. The sample, N = 24, were children with cerebral palsy was divided into four groups: groups of exercise treated with essential oil and its control and dermal administration of 0.5 kg ml/10 kg and two groups of kinesiotherapy treated with essential oil and its control by inhalation at a dose of 0.05 ml/10 kg/5 ml saline for 15 minutes. Muscle spasticity and the static and dynamic functional activities were measured by protocol Durigon (2004). The Student t-tests and ANOVA were used for the 95% significance. Results: The groups treated with essential oil showed significant results in the assessment of muscle tone and function static and dynamic. Conclusion: The essential oil associated with the kinesiotherapy modulates the tone making it functional gain. Children treated in such a way that showed best results for dermal which inhaled the essential oil.

Recuperación de paralisis facial idiopática: ¿prednisolona o prednisolona/aciclovir? / Recovery in idiopathic facial palsy prednisone alone or prednisone/acyclovir combined therapy?

En la literatura hay discrepancia acerca del tratamiento de la parálisis facial idiopática. No existe suficiente evidencia que soporte la asociación de un antiviral con corticoide sistémico; sin embargo, su uso es frecuente en la práctica clínica justificado por la posible etiología viral. Objetivo: describir la frecuencia de recuperación completa en quienes reciben prednisolona o prednisolona/aciclovir. Métodos: estudio de cohorte histórica identificando los casos de parálisis facial periférica diagnosticados entre enero 2005 y enero 2009 mediante registros del servicio de otorrinolaringología. Se describe la clasificación de la parálisis al momento del diagnóstico con escala de House Brackman. Resultados: se analizaron 106 casos, 59 mujeres (55,7%) y 47 hombres (44,3%), con edad promedio 36.9 años (DE 16.7). Al ingreso el 47,2% de los pacientes presentaron parálisis grado III. Recibieron prednisolona 32 (30,2%) y prednisolona-aciclovir 74 (69,8%). La recuperación completa (House Brackman I) se documentó en 23 (71,9%) con prednisolona y 52 (70,2%) con prednisolona/aciclovir. El seguimiento mediano fue 39 días. En ambos grupos la frecuencia de mejoría fue mayor en quienes ingresaron con grados II y III. Conclusión: la tasa de mejoría es superior a la descrita con el uso de placebo, pero por debajo de lo esperado con prednisolona a tres meses. La frecuencia de recuperación completa fue similar en ambos grupos. Los datos no son comparables con otras publicaciones por el corto tiempo de seguimiento.

There is discrepancy in literature regarding the treatment of idiopathic facial palsy. Insufficient evidence is available supporting combined therapy with anti-viral drugs and systemic corticosteroids; however, this regime is frequently used in clinical practice justified by probable viral etiology. Objective: to describe frequency of full recovery in patients who received prednisolone alone or prednisolone/acyclovir combined therapy. Methods: this is a historic cohort trial identifying the cases of peripheral facial palsy diagnosed between January 2005 and January 2009 by a review of otolaryngology records. Palsy was classified at admission using the House-Brackmann grading scale. Results: 106 cases were studied, 59 females (55.7%) and 47 males (44.3%), with a mean age of 36.9 years (SD 16.7). At admission, 47.2% presented grade III palsy. Prednisolone was administered to 32 (30.2%) and 74 (69.8%) received prednisolone-acyclovir. Complete recovery (House-Brackmann Grade I) was documented in 23 (71.9%) prednisolone-treated-patients and in 52 (70.2%) prednisolone/acyclovir-treated-patients. Mean follow-up was 39 days. The improvement profile in both groups was better in patients with grades II and III palsy at admission. Conclusion: improvement is greater to that described for a placebo, but less than expected for a 3-month administration of prednisolone. The rate of complete recovery was similar in both groups. Data cannot be compared with other publications due to the short follow-up period in this trial.

Parálisis facial periférica / Peripheral facial palsy

La parálisis facial periférica (PFP) es una patología frecuente que habitualmente es unilateral, que genera deformidad estética facial y alteraciones funcionales. Se describe la anatomía del nervio facial (NF) en sus segmentos supranuclear, nuclear e infranuclear; describiendo con mejor definición surelación en el hueso temporal. Se hace una breve mención de la fisiopatología de PFP y de los grados de lesión: neuropraxia, axonotmesis y neurotmesis. Especial énfasis se da al diagnóstico en la PFP. Se mencionan las pruebas de topodiagnóstico: Test de Shirmer, Test del Reflejo Estapedial y Test de Blatt con Gustometría que brindan la posibilidad de ubicar topográficamente el lugar de la lesión en el NF Asimismo, se describen las pruebas electrodiagnósticas: Prueba de Excitabilidad del Nervio; - Prueba de Excitabilidad Máxima; - Electroneuronografía y - Electromiografía, todas pruebas que brindan un pronóstico en la evolución de la PFP Se hace mención de las principales causas de PFP vinculándolo a los diferentes segmentos del NF Por último, se plantean las opciones terapéuticas en la PFP, tanto el tratamiento médico donde tiene importante presencia la cortico terapia y el tratamiento quirúrgico, que sobre todo en las causales traumáticas tiene su indicación.

Peripheral facial palsy (PFP) is a common disease, that usually presents as an unilateral form, with facial esthetic deformity, and functional changes. The article describes the anatomy of the facial nerve ( FN), the intranuclear, nuclear and supranuclearsegments, and its relation with the temporal bone. A brief mention of the pathophysiology lesions of the PFP and the type od neurological damage : neuropraxya, axonotmesys and neurotmesys. A special emphasize in the diagnosis of PFP is made and the topodiagnosis tests : Shirmer tests, Estapedial Reflex tests, and Blatt tests with tastemeter, that makes possible to locate topographically the injury zone in the facial nerve. A description is made of the electrodiagnosis tests: Nerve excitabillity test - Maximum excitabillity test - Electroneuronography and eletromiography. All these tests can provide a prognostic information of the PFP. Is mention the underlying explanation of the PFP, associated with the different facial nerve segments. At last, is represented the therapeutic options of the PFP, medical treatment where the corticotherapy is important, and the surgical treatment, specially at the traumatic causes is indicated.