Abstract
BackgroundAlthough many patients with facial paralysis have obtained benefits or completely recovered after acupuncture or electroacupuncture therapy, it is still difficult to list intuitive evidence besides evaluation using neurological function scales and a few electrophysiologic data. Hence, the aim of this study is to use more intuitive and reliable detection techniques such as facial nerve magnetic resonance imaging (MRI), nerve electromyography, and F waves to observe changes in the anatomic morphology of facial nerves and nerve conduction before and after applying acupuncture or electroacupuncture, and to verify their effectiveness by combining neurological function scales.Methods/DesignA total of 132 patients with Bell’s palsy (grades III and IV in the House-Brackmann [HB] Facial Nerve Grading System) will be randomly divided into electroacupuncture, manual acupuncture, non-acupuncture, and medicine control groups. All the patients will be given electroacupuncture treatment after the acute period, except for patients in the medicine control group. The acupuncture or electroacupuncture treatments will be performed every 2 days until the patients recover or withdraw from the study. The primary outcome is analysis based on facial nerve functional scales (HB scale and Sunnybrook facial grading system), and the secondary outcome is analysis based on MRI, nerve electromyography and F-wave detection. All the patients will undergo MRI within 3 days after Bell’s palsy onset for observation of the signal intensity and facial nerve swelling of the unaffected and affected sides. They will also undergo facial nerve electromyography and F-wave detection within 1 week after onset of Bell’s palsy. Nerve function will be evaluated using the HB scale and Sunnybrook facial grading system at each hospital visit for treatment until the end of the study. The MRI, nerve electromyography, and F-wave detection will be performed again at 1 month after the onset of Bell’s palsy.Trial registrationChinese Clinical Trials Register identifier: ChiCTR-IPR-14005730. Registered on 23 December 2014.
Highlights
Many patients with facial paralysis have obtained benefits or completely recovered after acupuncture or electroacupuncture therapy, it is still difficult to list intuitive evidence besides evaluation using neurological function scales and a few electrophysiologic data
The purpose of this study is to investigate the effects of electroacupuncture therapy starting from the acute stage of Bell’s palsy
It is recognized that prednisolone but not antiviral medicine shows significant short- and long-term positive treatment effects in patients with Bell’s palsy [24,25,26,27,28,29]
Summary
Many patients with facial paralysis have obtained benefits or completely recovered after acupuncture or electroacupuncture therapy, it is still difficult to list intuitive evidence besides evaluation using neurological function scales and a few electrophysiologic data. The detectable pathological changes of peripheral facial paralysis (including Bell’s palsy) are facial nerve edema and bioelectric conduction disorders. The former can be detected and evaluated using magnetic resonance imaging (MRI) [11,12,13,14,15], the latter using more sensitive neural electrophysiological methods [16]. There are beliefs that electroacupuncture stimulation is not appropriate for patients in the acute stage of Bell’s palsy and that it is more likely to aggravate facial nerve edema and bioelectric conduction disorders. The efficacy of electroacupuncture for treating Bell’s palsy starting from the acute stage is yet to be investigated
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