Cases Of Facial Paralysis Research Articles

Recurrent Bilateral Facial Palsy Associated with Herpes Simplex Virus Infection

Bell's palsy is the most common cause of facial paralysis with a lifetime risk of one in 60 in general population. The exact pathophysiology is unknown, but it is suspected to be associated with viral infections such as herpes simplex virus (HSV). Recurrent facial palsy is a rare condition that can be caused by various factors but the cause remains unknown. We report a case of recurrent facial palsy who had antibodies of Lyme immunoglobulin G (IgG), HSV IgG, and IgM.

The utility and outcomes of the temporalis muscle flap for palate reconstruction after maxillectomy for malignancy

Back groundA common pedicled facial technique in head and neck reconstruction is the TMF It can be utilised to replace missing tissues in a variety of conditions, including oral deformities of the hard and soft palate.Aim of the study was to document the utility and outcomes with the reconstruction of the palate using TM flaps following Maxillectomy For maxillary sinus malignancies MethodologyThe study included 24 patients who were operated on for cancer maxilla and eligible for maxillectomy and reconstruction of the Palate using temporalis flap. Follow-up was planned for at least 12 months postoperative. Postoperative physical and speech therapy are initiated to help improve speech and swallow outcomes and to prevent trismus ResultsThe current study included 24 cases with Maxillary sinus cancer with a mean age of 42.34±4.67. The mean operative time was 5.4±1.22 hours with no reported intraoperative bleeding or injury of important structures .No cases of facial palsy or trismus were reported while partial flap loss was reported in one case where oronasal fistula was evident. The donor site complications were minimal where seroma occurred in two patients and alopecia , wound infection and dehiscence were reported in one case each. The donor site depression was evident in 25% of cases ConclusionTMF is an excellent option for the reconstruction of many craniofacial defects, it is easy to be harvested with good blood supply with minimal postoperative complications

Diagnosis and treatment of 68 cases of traumatic facial nerve paralysis

Objective:To summarize the clinical characteristics and therapeutic effect of traumatic facial nerve palsy. Methods:Sixty-eight cases of traumatic facial nerve palsy were retrospectively analyzed from January 2015 to May 2023. Results:The median course of disease was 33 days. The facial nerve function of the patients was grade HB-Ⅱin 2 cases, grade HB-Ⅲ in 4 cases, grade HB-Ⅳin 16 cases, grade HB-Ⅴ in 37 cases（38 ears）, and grade HB-Ⅵ in 9 cases. 42 cases occurred immediately after injury and 26 cases were delayed. CT examination of temporal bone revealed longitudinal fractures in 51 cases（52 ears） , transverse fractures in 6 cases and mixed fractures in 4 cases. No definite temporal bone fracture was found in the remaining 7 cases. The segments of facial nerve injury in 49 cases（50 ears） were geniculate ganglion and adjacent, in 7 cases were vertical segment, in 7 cases were horizontal segment, in 2 cases were horizontal segment and vertical segment; and the other 3 cases could not be evaluated. Conservative treatment with glucocorticoids was used in 23 ears and surgery was used in 46 ears. Patients were followed up 6-24 months after treatment, including 20 cases of grade HB-Ⅰ, 19 cases of grade HB-Ⅱ, 23 cases（24 ears） of grade HB-Ⅲ, 4 cases of grade HB-Ⅳ, and 1 case of grade HB-Ⅴ.One patient was lost to follow-up. After treatment, the facial nerve function of patients was significantly improved（P<0.05）, and there were significant differences between conservative treatment group and surgical treatment group in the course of facial nerve palsy, the ratio of facial palsy immediately after injury, the nerve function before treatment and the nerve function after treatment（P<0.05）. There were no significant differences in age, sex, hearing condition, temporal bone fracture, facial nerve injury segment and rate of favorable neurologic outcomes（P>0.05）. The comparison of patients with neurodegeneration rate>90% and ≤90% showed that the facial nerve function of patients with neurodegeneration rate>90% before treatment was significantly worse（P<0.05）, but there was no significant difference between the facial nerve function after treatment（P>0.05）. There was no significant difference in facial nerve function between middle fossa approach group and mastoid approach group（P>0.05）. Conclusion:Patients with traumatic facial nerve palsy should be evaluated individually. Patients with mild facial nerve palsy, low neurodegeneration rate and short course of disease can be treated conservatively and followed up closely. Patients with severe facial nerve palsy, high neurodegeneration rate and more than 6 weeks of disease can be actively considered surgery. Good prognosis can be obtained by correct evaluation and treatment.

Cervical approach for prestyloid parapharyngeal pleomorphic adenoma resection

ObjectiveTo describe the key points of cervical resection for prestyloid parapharyngeal pleomorphic adenoma and to discuss the role of modern imaging. ObservationRetrospective case series of 10 patients (4 women and 6 men, age 29–63 years) with prestyloid parapharyngeal pleomorphic adenoma with 2 to 8cm largest diameter on MRI, consecutively resected via a cervical approach between 2000 and 2020 in a French tertiary university referral care center. Seven patients had a minimum 10 years’ follow-up, and one was lost to follow-up before the fifth postoperative year. Peri- and postoperative complications comprised great auricular nerve transection without subsequent symptomatic neuroma (2 patients), associated transoral approach to free the upper pole of the adenoma (2 patients), capsule effraction (3 patients), and hematoma (1 patient). There were no cases of facial paresis or palsy, other cranial nerve impairment, trismus, auriculotemporal or first-bite syndrome. One of the three patients with capsule effraction showed local recurrence at month 17. ConclusionIn agreement with previous reports, the present case series confirmed the role of the cervical approach to resect prestyloid parapharyngeal pleomorphic adenoma, and hence the need to continue teaching it.

CLINICAL OUTCOME USING MODIFIED LATERAL TARSAL STRIP AND RESCESS LEVATOR IN PATIENTS WITH OCULAR PROBLEM DUE TO FACIAL NERVE PALSY

Introduction : Facial nerve palsy is a condition that affects various organ including the eyes. We report a case of facial nerve palsy with eye manifestations in one patient that requires immediate action to save the cornea.&#x0D; Case Illustration : A 63-year-old male presented to our OPC with the primary complaint of right eyelid inability to close since September 2021after brainstem tumor excision, which had worsened since May 2022. Visual acuity: 2 meters counting fingers; IOP: 11 mmHg. Anterior segment examination revealed lagophthalmos (8 mm) in the right eye, a pinch test result of 10mm (horizontal laxity), conjunctival hyperemia, conjunctivalization of the cornea, a fluorescein test result of 7 x 4 mm, and band keratopathy. The wrinkles on the patient's right face disappeared. There was numbness, and the smile was asymmetrical. Patient underwent right eye modified lateral tarsal strip and recesses levator 8mm. The patient's eyelids can close tightly almost symmetrically with the left eye and no ptosis after operations. One week after operation, patient feels more comfortable, and the conditionof the cornea has improved. The facial nerve is vulnerable to trauma because of its path from the brainstem through the temporal bone to the facial muscles. In conditions of irreversible facial nerve palsy, managements are focus to overcome the complications. Modified lateral tarsal strips and levator recesses are relatively simple and inexpensive techniques that can help to overcome lagophthalmos.&#x0D; Discussion : &#x0D; Conclusion : Ocular manifestations can occur in patients with facial nerve paresis. Modified lateral tarsal strips and recesses levator eyelids can help protect the cornea.

Prognostic Value of Electroneuronography in Severe Cases of Facial Palsy.

To examine the prognostic value of electroneuronography (ENoG) in predicting functional recovery in severe cases of acute facial palsy. Patients with severe degrees of facial palsy (initial House-Brackmann [HB] grades IV to VI) with available electrodiagnostic studies conducted 2-4 weeks after symptom onset were reviewed retrospectively. The patients were categorized into "good recovery" and "poor recovery" groups, with the former showing mild to no dysfunction (HB I to III) and the latter exhibiting moderate to severe dysfunction (HB IV to VI) on follow-up evaluation, 2 months after onset. ENoG amplitudes in four facial muscles (frontalis, nasalis, orbicularis oculi, and orbicularis oris), as well as age, sex, affected side, disease etiology, comorbidities, and laboratory findings, were compared between the two groups. Thirty-seven patients were included. Twenty-nine of the patients showed "good recovery," and eight showed "poor recovery" at 2 months after symptom onset. Univariate analysis yielded no significant difference in age, sex, affected side, disease etiology, comorbidities, and laboratory findings between the two groups. Preserved ENoG amplitudes (individual, average, and trimmed means) were significantly higher in the good recovery group than in the poor recovery group (p<0.005). Sex (p=0.038) and the ENoG of the nasalis muscle, acquired 2-4 weeks from symptom onset (p=0.004), showed significant differences in multivariate regression analysis. This study suggests that the female sex and lower ENoG of the nasalis muscle, acquired 2-4 weeks from symptom onset, have negative prognostic value for the 2-month functional outcome of severe facial palsy cases.

Comparison of mid-cheek tumors endoscopically assisted dissection between a single preauricular or transoral incision

Objective: To summarize the preliminary experience of endoscopically assisted mid-cheek benign tumor resection using a single preauricular or transoral incision and to evaluate its indications, advantages, and disadvantages. Methods: Thirty-six patients with benign mid-cheek tumors were prospectively enrolled, including 11 males and 25 females, aged (37.2±15.9) years and ranged from 11 to 65 years old. The patients were randomly divided into two groups: endoscope-assisted tumor dissections through a single preauricular incision (19 cases) or transoral incision (17 cases). Their surgical approaches were introduced, and the tumor long-axis length, incision length, operative time, estimated intraoperative bleeding, postoperative drainage amount and time, aesthetic satisfaction, perioperative complications, and follow-up were recorded and analyzed. Results: The difference between the tumor long-axis lengths in the preauricular group [(2.2±0.9) cm] and the transoral group [(2.1±0.7) cm] was not statistically significant (t=0.46, P=0.687), and all surgical procedures were completed as planned. There was no significant difference in the incision size (t=1.57, P=0.100) or operative time (t=0.44, P=0.736). Compared with the preauricular group [(30.8±8.7) ml], transoral incision [(23.6±8.9) ml] reduced intraoperative blood loss (t=2.97, P=0.006) and improved aesthetic pleasure (t=3.44, P=0.015). Two cases of earlobe numbness and one case of temporary facial palsy were observed in the preauricular group; two cases of postoperative effusion were noted in the transoral group, and no signs of nerve injury were detected. No tumor recurrence was found during the 1-54-month of follow-up. perioperative complications. Conclusions: Endoscopic-assisted preauricular or transoral incision for dissecting mid-cheek benign tumors provides excellent aesthetic and minimally invasive results, reducing complications and obtaining satisfactory aesthetic results.

Efficacy of S53P4 Bioactive Glass for the Secondary Obliteration of Chronically Discharging Radical Cavities.

Present the results of the secondary obliteration of chronically discharging radical cavities using S53P4 bioactive glass (BAG). Retrospective cohort study. Single-center study. A single-center retrospective cohort study was conducted of all patients that underwent secondary obliteration of persistently draining radical cavities using S53P4 BAG between 2011 and 2022. Patients with middle ear cholesteatoma were excluded. The main outcome was postoperative otorrhea, as indicated by Merchant grading. In total, 97 patients were included. The median postoperative follow-up time was 3.9 years (range 0.5-10.4). Average time between the original canal wall down surgery and the secondary obliteration was 25.3 years (SD 11.7, range 2-66). At the most recent follow-up visit, a Merchant grade of 0 to 1 was observed in 95% of the cases. There were no cases of sensorineural hearing loss or facial palsy, one case developed a retro auricular skin defect and 1 patient developed CSF leakage. Minor complications were seen in 10 patients (10%). Ossicular chain reconstruction with a titanium prosthesis was performed in 42 cases, resulting in a median improvement of 11.2 dB in air conduction thresholds. In 9/42 cases (21%), closure of the postoperative air-bone gap to ≤20 dB was achieved. Twenty-five percent of cases could be discharged from out-patient visits. Revision of persistently draining radical cavities with BAG obliteration is feasible and results in a dry and safe ear in 95% of the patients, thereby enabling wearing of a conventional hearing aid. Out-patient visits could be ceased in 25% of the cases.

Facial Palsy After Multisystem Inflammatory Syndrome in Children

Abstract COVID-19 pandemic has affected the pediatric and adult populations in different ways. Although adults experience more respiratory disease, pediatric population has been struck by multisystem inflammatory syndrome in children. There have been multiple case reports of Bell’s palsy associated with acute COVID-19 infection. We present the first known case of unilateral facial palsy after multisystem inflammatory syndrome in children in a pediatric patient.

Comparison of Facial Palsy Cases before and during the Pandemic Coronavirus Disease-2019

Comparison of Facial Palsy Cases before and during the Pandemic Coronavirus Disease-2019

Transient Facial Nerve Palsy in Aviation.

INTRODUCTION: Facial nerve palsy has been observed sporadically by aviation medicine doctors in recent years. We present two case reports of patients with the rare condition of facial nerve palsy occurring during aviation, along with a review of the literature, an overview of the phenomenon and the described symptoms of the cases. PubMed® including Medline® was searched using the terms nerve palsy and aviation with no restriction. In addition, two new cases of recurrent nerve palsy are described.CASE REPORTS: We describe two case reports: A 20-yr-old woman reported recurrent transient left-sided facial nerve palsy with increased duration and intensity on four subsequent flights, and a 35-yr-old woman who reported a left-sided transient facial nerve palsy 20 min after ascent.DISCUSSION: Included in the systematic review were 17 studies. Only case report studies were found. Including the two cases of facial nerve palsy described in this article, the reviewed studies represent 23 cases of peer-reviewed facial baro-palsy in aviation (ages 10 to 62 yr old). Having baro-palsy symptoms during flight is a rare condition, and the mechanism is not well understood. Some typical characteristics and possible mechanisms are discussed. PE tube insertion of the tympanic membrane has been found to be an effective treatment; however, further studies are needed.Bloch SL, Hertz J, Klokker M. Transient facial nerve palsy in aviation. Aerosp Med Hum Perform. 2023; 94(5):404-408.

Clinical manifestations of neuroborreliosis in children – review of literature

Introduction: The most common tick-borne disease caused by the spirochete Borrelia burgdorferi is Lyme disease. It is characterized by a variety of disorders: dermatological, rheumatological, cardiological and neurological. Neuroborreliosis is defined as an involvement of the nervous system, and it is the second most common form of infection in children (10-15% of those infected).&#x0D; The aim of the study: To review the available materials and presentation of the current state of knowledge on the various manifestations of neuroborreliosis in children.&#x0D; Material and method: Databases such as PubMed and Google Scholar were searched. Literature was searched using the keywords: Lyme disease, neuroborreliosis, borreliosis, facial nerve paralysis, and pediatric population. The materials obtained in this way were analyzed in terms of compliance with the subject of the work.&#x0D; Results: Typical clinical manifestations of neuroborreliosis in children are facial nerve palsy and meningitis. Neuroborreliosis is the cause of 50% of all cases of bilateral facial nerve palsy in children. Multiple cranial and peripheral neuritis, myelitis, cerebral vasculitis and, consequently, the formation of intracranial aneurysms are less common manifestations of infection.&#x0D; Conclusions: The symptoms of neuroborreliosis are non-specific. This makes it difficult to make an accurate diagnosis. Even if no information on tick bite or erythema migrans has been obtained from the clinical history, neuroborreliosis should be considered in the differential diagnosis, especially in Lyme-endemic areas.

A Case of Bilateral Facial Nerve Palsy with Bilateral Cavitary Lung Nodules in a Young Adult

A Case of Bilateral Facial Nerve Palsy with Bilateral Cavitary Lung Nodules in a Young Adult

Incomplete Kawasaki Disease with Peripheral Facial Nerve Palsy and Lung Nodules: A Case Report and Literature Review

The diagnosis of Kawasaki disease (KD) is challenging and often delayed mainly in case of young infants and in presence of an incomplete disease and atypical features. Facial nerve palsy is one of the rare neurologic symptoms of KD, associated with a higher incidence of coronary arteries lesions and may be an indicator of a more severe disease. Here, we describe a case of lower motor neuron facial nerve palsy complicating KD and perform an extensive literature review to better characterize clinical features and treatment of patients with KD-associated facial nerve palsy. The patient was diagnosed at the sixth day of disease and presented extensive coronary artery lesions. A prompt treatment with intravenous immunoglobulins, aspirin and steroids obtained a good clinical and laboratory response, with resolution of facial nerve palsy and improvement of coronary lesions. The incidence of facial nerve palsy is 0.9-1.3%; it is often unilateral, transient, more frequent on the left and seemingly associated with coronary impairment. Our literature review showed coronary artery involvement in the majority of reported cases (27/35, 77%) of KD with facial nerve palsy. Unexplained facial nerve palsy in young children with a prolonged febrile illness should prompt consideration of echocardiography to exclude KD and start the appropriate treatment.

Facial nerve paralysis in nasopharyngeal carcinoma: a case report

Nasopharyngeal carcinoma (NPC) is cancer originating from the mucosal lining of nasopharynx, with the highest predilection in the fossa of Rosenmüller. One-fifth of NPC cases have cranial nerve complications. The location of Rosenmüller's fossa which is adjacent to foramen lacerum and middle base of the cranium allows the tumor to extend directly into the cranium and surrounding cranial nerves. This paper reported a case of facial nerve paralysis in NPC. A 55-year-old man came to the Ear-Nose-Throat (ENT) Clinic at Dr. Kariadi General Hospital, Semarang with complaints of facial pain on the right side, headache, a lump on the left neck, fullness in ears, and nosebleed. However, the patient did not complain of double vision. After a thorough history taking, physical examination, radiology, and histopathology tests, the patient was diagnosed with WHO 3 ECOG I T3N2M0 stage III NPC with House Brackmann III facial nerve paresis at the level of Mastoid segment. The patient was treated using chemotherapy treatment by an ENT specialist with a chemotherapy regimen of paclitaxel-cisplatin for 6 cycles. In conclusion, although rare, NPC can cause facial nerve paralysis.

Acute otitis media-related facial nerve palsy in a child: a case report and a literary review

BackgroundAcute otitis media has become a rare cause of facial palsy in children. A high index of suspicion is essential to achieve the diagnosis and to properly treat this condition to avoid permanent neurological sequelae.Case presentationA case of acute otitis media-related facial nerve palsy in an 18 months-old child is described and a review of the recent literature about the clinical presentation, diagnosis, and management of this condition is performed.ConclusionsFacial paralysis is an uncommon complication of acute otitis media that requires appropriate care. As highlighted in our report, the treatment of facial nerve palsy secondary to otitis media should be conservative, using antibiotics and corticosteroids. The role of antiviral is still a matter of debate. Myringotomy and a ventilation tube should be added when spontaneous perforation of the tympanic membrane is not present. More aggressive surgical approach should be considered only when there is no significant improvement.

Quantitative proteomic analysis of cerebrospinal fluid from patients with idiopathic facial nerve palsy.

Idiopathic facial palsy (IFP) accounts for over 60% of peripheral facial palsy (FP) cases. The cause of IFP remains to be determined. Possible etiologies are nerve swelling due to inflammation and/or viral infection. In this study, we applied an integrative mass spectrometry approach to identify possibly altered protein patterns in the cerebrospinal fluid (CSF) of IFP patients. We obtained CSF samples from 34 patients with FP. In four patients, varicella-zoster virus was the cause (VZV-FP). Among the 30 patients diagnosed with IFP, 17 had normal CSF parameters, five had slightly elevated CSF cell counts and normal or elevated CSF protein, and eight had normal CSF cell counts but elevated CSF protein. Five patients with primary headache served as controls. All samples were tested for viral pathogens by PCR and subjected to liquid chromatography tandem mass spectrometry and bioinformatics analysis and multiplex cytokine/chemokine arrays. All CSF samples, except those from VZV-FP patients, were negative for all tested pathogens. The protein composition of CSF samples from IFP patients with normal CSF was comparable to controls. IFP patients with elevated CSF protein showed dysregulated proteins involved in inflammatory pathways, findings which were similar to those in VZV-FP patients. Multiplex analysis revealed similarly elevated cytokine levels in the CSF of IFP patients with elevated CSF protein and VZV-FP. Our study revealed a subgroup of IFP patients with elevated CSF protein that showed upregulated inflammatory pathways, suggesting an inflammatory/infectious cause. However, no evidence for an inflammatory cause was found in IFP patients with normal CSF.

Gamma Knife radiosurgery - 12 years of experience in a high-complexity center of a middle-income country.

Gamma Knife radiosurgery (GKR) is a technique that consists of the release of a high dose of ionizing radiation onto a therapeutic target, which has been previously delimited. This technique was described by Lars Leksell and Borje Larsson in 1951. In Colombia, there is only one GKR unit functioning machine nowadays. The objective of this study is to describe the institutional experience of a single institution with Gamma Knife Perfexion over 12 years. We conducted a retrospective observational study. A total of 1906 medical records, taken from the period between May 4, 2010, and May 4, 2022, were included in the study. Descriptive analysis was performed through STATA 17 as statistic tool. Measures of central tendency were calculated depending on the distribution of the continuous data and proportions were taken into account in the case of qualitative variables. A total of 1906 procedures were performed. Patients from 1 year to 99 years old were treated, with a median age of 51 years. The most frequent diagnoses were meningioma (20.8%), arteriovenous malformation (AVM) (17%), vestibular schwannoma (15.6%), metastases (9.81%), and trigeminal neuralgia (9.12%). At 3-year posttreatment, in meningiomas, tumor size stability was observed in 57.3%, size decrease in 36%, and disappearance in 1.3%. In AVM, complete obliteration of the lesion was described in 36.8% and a decrease in size in 52.6%. Intracranial hemorrhage occurred in 5.2% during the follow-up period and 3.5% of all treated patients required a new procedure due to residual malformation. In vestibular schwannomas, tumor size remained stable in 62.2% and decreased in 28.8%. No new cases of facial paralysis after the procedure were described. At 1-year posttreatment, in metastasis, the size of the lesions remained stable in 40% of the patients, decreased in 47.5%, and disappeared in 2.5%. In trigeminal neuralgia, 88.4% of patients had pain relief and recurrences occurred in 16.6%. Acute complications were generally uncommon, the main ones being headache, pain at frame fixation points, and nausea. Our experience suggests that GKR is a noninvasive procedure with a broad spectrum of clinical applications, low frequency of complications, feasible, with good enough control size of tumor and vascular lesions in images, and good clinical results in the medium and long term.

Recurrent facial palsy: Characteristics of ipsilateral and alternative palsies of 104 cases

ObjectiveRecurrent facial palsy is relatively rare and its clinical details of recurrent facial palsy are not well known. We analyzed recurrent facial palsy cases and clarified its characteristics, especially the difference between ipsilateral and alternative palsies. The analysis aimed to obtain information about recurrent facial palsy that would be useful for delivering explanations to patients and help improve recurrent facial palsy treatments based on the etiology. MethodsWe picked up data from the chart and analyzed the clinical characteristics of patients with recurrent facial palsy from 1243 facial palsy patients (Bell's palsy, VZV-related palsy (Ramsay Hunt syndrome and zoster sine herpete [ZSH])) between 2006 and 2020. ResultsRecurrent facial palsy was observed in 104 of 1243 patients (8.4%). There were 35 cases (34%) of ipsilateral palsy and 69 cases (66%) of alternative palsy. The mean age at the onset of the first palsy was 38.9 years old in the ipsilateral group and 48.4 years old in the alternative group, and a significant difference was observed between them. The number of recurrences ranged from 1 to 4. Among the ipsilateral group, 6 patients experienced more than second recurrence. In two cases, the condition failed to resolve after the second recurrence. A serological examination confirmed that 4 cases had recurrent VZV-related palsy (both the first and second palsies were VZV-related) and all of them initially had ZSH: no cases had Hunt syndrome as the first palsy. ConclusionsThe VZV-specific immunity obtained with ZSH might be insufficient to suppress VZV reactivation, and VZV vaccination should be recommended for ZSH patients to prevent further recurrence of VZV-related facial palsy. More than 2 ipsilateral recurrent episodes may be a risk factor for incomplete recovery.

Neural mechanisms underlying peripheral facial nerve palsy: A protocol for systematic review and meta-analysis of neuroimaging studies

Peripheral facial nerve palsy is a general term used to describe diseases that cause lower motor neuron lesions in the facial nerve. The most common cause of peripheral facial nerve palsy is idiopathic Bell's palsy (BP), accounting for 60% to 70% of all peripheral facial nerve palsy cases. Idiopathic BP is found in various medical conditions, such as ischemia, viral infection, and neuroinflammation; however, the specific pathophysiology remains unclear. Neuroimaging techniques help understand the neural mechanisms underlying various neurological disorders. In recent years, several studies have applied functional neuroimaging to investigate alterations of brain function in BP patients. However, the results have been inconsistent due to differences in methodology and quality. Moreover, systematic reviews of studies on functional neuroimaging for BP are insufficient. Therefore, the present study aims to verify the neural mechanisms of brain alterations and draw conclusions about the functional reorganization in patients with BP. This review includes all suitable studies published on or before October 31, 2022. A thorough search will be conducted using the following databases: MEDLINE, Cochrane Library, Excerpta Medica Database (EMBASE), China Knowledge Resource Integrated Database (CNKI), Korean Medical database (KMBASE), Korean Studies Information Service System (KISS). Clinical studies of BP using functional neuroimaging will be selected. We will apply a coordinate-based meta-analysis because most individual neuroimaging studies provide their results as coordinates in the standard space. The primary outcomes will include the types of functional neuroimaging methods and alterations of brain function in BP patients. The secondary outcomes will include the information about clinical measurement of the disease. Study selection, data extraction, and risk of bias assessment will be conducted. If possible, heterogeneity tests, data synthesis, and subgroup analyses will be conducted. The study will analyze the alterations in brain activity and worsening of clinical symptoms caused by idiopathic BP. The aim of this study is to investigate functional reorganization of brain alterations in patients with BP. This review will improve the understanding of the neural mechanisms of BP based on the most recent publications through extensive data retrieval. If sufficient data are collected, a sensitivity analysis is performed to verify the robustness of the conclusions.