Cases Of Peripheral Facial Paralysis Research Articles

How much does clinical prediagnosis correlate with electrophysiological findings?: a retrospective study.

Electrodiagnostic testing (EDX) is important in the diagnosis and follow-up of neuropathic and myopathic diseases. This study aimed to demonstrate the compatibility between clinical prediagnosis and electrophysiological findings. EDX results from 2004 to 2020 at the physical medicine and rehabilitation (PM&R) clinic were screened. Tests with missing data, reevaluation studies, and cases of peripheral facial paralysis were excluded. The clinical prediagnosis and EDX results were recorded, and their compatibility was evaluated. A total of 2,153 tests were included in this study. The mean age was 49.0±13.9 years and 1,533 of them (71.2%) were female. The most frequently referred clinic was the PM&R clinic (90.0%). Numbness (73.6%) was the most common complaint, followed by pain (15.3%) and weakness (13.9%). The most common prediagnosis was entrapment neuropathy (55.3%), radiculopathy (16.1%), and polyneuropathy (15.7%). Carpal tunnel syndrome was the most frequently identified type of entrapment neuropathy (78.3%). Six hundred and seventy EDX results (31.1%) were within normal limits. While the EDX results were consistent with the prediagnosis in 1,328 patients (61.7%), a pathology different from the prediagnosis was detected in 155 patients (7.2%). In the discrepancy group, the most common pathologies were entrapment neuropathy (51.7%), polyneuropathy (17.3%), and radiculopathy (15.1%). The most common neuropathy type was carpal tunnel syndrome (79.3%). After adequate anamnesis and physical and neurological examinations, requesting further appropriate tests will increase the prediagnosis accuracy and prevent unnecessary expenditure of time and labor.

Bell's palsy in a seven-month-old twin infant: a case report

Idiopathic peripheral facial paralysis is a rare condition in the pediatric population under one year of age, characterized by paralysis of the structures innervated by the facial nerve. This report describes the first infant in Brazil to be diagnosed with this clinical condition. A 7-months-old twin infant presented with altered left oromotor control and a discrete incomplete closure of the left eyelid when blinking, although with normal tear production. Her primitive reflexes were present and the spontaneous movements of the four limbs were normal. An investigation for infectious etiology and a magnetic resonance imaging of the brain were performed and did not show any alterations. Thus, the diagnosis of Bell's palsy was assumed, and oral prednisone was prescribed for five days. The patient evolved with total resolution of the facial paralysis during the first two weeks after discharge. Most cases of peripheral facial paralysis in children are idiopathic, while the others are associated with infectious and/or traumatic etiologies. There are still no consistent data proving the benefit of the use of corticoid alone or in combination with antiviral drugs for the treatment of children under one year of age.

Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports.

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

Non-recovery animal model of severe facial paralysis induced by freezing the facial canal

ObjectiveSome cases of peripheral facial paralysis are resistant to treatment, thus, a non-recovery model of facial paralysis is needed to develop new treatment strategies for this condition. The purpose of the current study was to develop an animal model of which facial palsy was severe and prolonged. MethodsTen 8-week-old female Hartley guinea pigs weighing between 400 and 500 g were used for the animal model. The vertical segment of the facial canal was accessed via the otic bulla, without removing the bony wall of the facial canal. The canal was then frozen for 5 s using freeze spray. Facial movements, electroneurography (ENoG), histology, and changes in temperature were evaluated. ResultsAll animals exhibited complete facial paralysis immediately after the procedure and recovered gradually, however, not all of them had recovered completely 15 weeks after freezing. The ENoG values one week after freezing for all animals (10/10) were 0%. Histological examination one week after freezing revealed that most of the vertically placed myelinated nerve fibers which had been frozen were remarkably affected and denatured. The number of vertically placed myelinated nerve fibers increased 15 weeks after freezing, but the nerve fibers were smaller than normal nerve fibers and were distorted in shape. ConclusionComplete facial paralysis was induced in Hartley guinea pigs by freezing the facial canal. The behavioral, ENoG, and histopathological data suggest that the facial paralysis was severe and prolonged. This model may assist in developing novel treatment for severe facial palsy and facilitate basic research on facial nerve regeneration.

A case of peripheral facial paralysis with sequelae combined with acupuncture treatment

A case of peripheral facial paralysis with sequelae combined with acupuncture treatment

A pediatric case of ramsay hunt syndrome.

Ramsay Hunt syndrome (RHS) is characterized by facial paralysis, inner ear dysfunction, periauricular pain, and herpetiform vesicles. The reported incidence in children is 2.7/100,000. The pathogenesis involves the reactivation of latent varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve. The recovery rate is better in children than in adults. This paper discusses a 12-year-old girl with a rare case of peripheral facial paralysis caused by RHS and reviews the literature.

Comparison on the therapeutic effect of acupuncture on 60 cases of peripheral facial paralysis at different stages

ObjectiveTo investigate the difference in the therapeutic effect of different methods in the treatment of peripheral facial paralysis (PFP) at different stages. MethodsSixty cases of PFP at different stages were divided into a treatment group and a control group according to the sequence for visit, and 30 patients were included in each group. The patients in the treatment group were treated by using drugs, acupuncture (shallow puncture and subexcite) and microwave therapy during the acute stage, and they were subjected to electroacupuncture (EA) (heavy stimulation and penetration needling), acupoint injection, electrotherapy and massage during the convalescence stage. In contrast, the patients in the control group were treated simply with drugs, and the therapeutic methods during the convalescence stage were the same to those for the treatment group, and the therapeutic effect of the two groups was observed after three treatment courses. ResultsThe total effective rate in the treatment group was 100.0% (30/30), the cured rate after one treatment course was 48.2% (13/27), the cured rate after two treatment courses was 44.4% (12/27), and the cured rate after three treatment courses was 7.4% (2/27). The total effective rate in the control group was 90.0% (27/30), the cured rate after one treatment course was 5.5% (1/18), the cured rate after two treatment courses was 27.8% (5/18), and the cured rate after three treatment courses was 66.7% (12/18). The therapeutic effect and the treatment courses for healing of the treatment group were significantly better than those in the control group (P<0.05). Conclusionthe therapeutic effect of different therapeutic methods on PFP is remarkable.

Clinical analysis of nine cases of congenital petrous apex cholesteatoma

To investigate the clinical symptoms, diagnosis and treatment of congenital petrous apex cholesteatoma. A retrospective review of clinical symptoms, image findings and effect of operation in nine patients with congenital petrous apex cholesteatoma were performed. two cases of congenital petrous apex cholesteatoma patients had peripheral facial paralysis, and progressively aggravated;four cases of peripheral facial paralysis were repeated, without hearing loss; three cases firstly appeared hearing loss, followed by paralysis. When hospitalized, nine cases of patients had peripheral facial paralysis and hearing loss. Seven patients were complicated with tinnitus, and four had vertigo. HRCT scans showed petrosal apex damage; MRI showed that petrosal apex was occupied;and the facial nerve electromyography and evoked potential examination showed moderate-severe neurogenic changes. All were treated by surgeries, among them, 8 cases were by middle fossa approach, 1 case was by middle cranial fossa-translabyrinth combined approach. Two cases whose labyrinthine segment of the facial nerve injured severely, were operated by end to end anastomosis; 3 cases with facial nerve compression thinning, were operated by facial nerve decompression; 4 cases were horizontal segment of facial nerve exposed and edema. None of them had recurrence in a follow-up of 6 to 32 months. 3 cases of peripheral facial paralysis were lessened in different degrees. Patients with congenital petrous apex cholesteatoma have peripheral facial paralysis in the early stage. Computed tomography scanning, magnetic resonance imaging and facial nerve imaging has important significance to clinical diagnosis, choosing the approach of operation and dealing with the facial nerve during operation.

Chinese medicinal herb therapy for the rehabilitation of peripheral facial palsy

Chinese medicinal herb therapy was adopted to treat 68 cases of peripheral facial paralysis. The treatment was conducted once daily, with 10 days being a therapeutic course. Following three courses of treatments, the results showed a reliable and rapid clinical therapeutic effect that 35 cases were cured, 17 cases experienced remarkable effect, and 9 cases had improvement and failure in 7 cases, with a total effective rate of 89.7%. And the patients whose disease duration was within 2 weeks, the effective rate was 97.6%, and for disease duration was over 2 weeks, the effective rate was 77.8%, indicating that the shorter the duration, the better the therapeutic effect was. Key words: Chinese medicinal herb therapy, peripheral facial paralysis, therapeutic effect.

Clinical observations of mind-regulating acupuncture in treating 100 cases of peripheral facial paralysis

Objective To investigate the clinical effect of mind-regulating acupuncture therapy on peripheral facial paralysis.

Clinical observation on 48 cases of peripheral facial paralysis treated by acupoint-penetrating acupuncture

In the treatment of 48 cases of peripheral facial paralysis by puncturing Yangbai (GB 14) toward Yuyao (Ex-HN 4), Dicang (ST 4) toward Jiache (ST 6), Xiaguan (ST 7) toward Jiache (ST 6), Sibai (ST 2) toward Quanliao (SI 18), Baihui (GV 20) toward Taiyang (Ex-HN 5), Yintang (Ex-HN 3) toward Shangen (Ex-HN), Cuanzhu (BL 2) toward Jingming (BL 1), and Hegu (LI 4) toward Laogong (PC 8) on the sick side, with other acupoints added in accordance with the symptoms, the results showed cure in 39 cases, remarkable effect in 7 cases, failure in 2 cases, and the curative rate in 81.2% and the effective rate in 95.8%.

Acupuncture and moxibustion treatment of 150 cases of peripheral facial paralysis in different stages

Moxibustion was used in predominance in acute stage. Shallow needling technique plus electric stimulation was used in the restoration stage. Comprehensive therapy of acupuncture and massage was used in the sequels stage. 21 cases were cured in the acute stage. 101 cases were cured in the restoration stage. 10 cases were cured in the sequels stage. The results indicate that the restoration stage is a key moment for treatment of peripheral facial paralysis.

Acupuncture treatment of 106 cases of peripheral facial paralysis in different stages

In the treatment of facial paralysis in the acute stage and restoration stage by shallow needling technique and penetrating needling technique respectively, totally 106 cases, the effective rate is respectively 98.6% and 83.9%, indicating that the curative rate is high if early treatment is given.

Paralysie faciale périphérique et infection par le VIH. A propos de 2 observations

Two cases of peripheral facial paralysis in subjects with HIV infection are reported. On the basis of these two cases and data from the literature, the clinical and paraclinical features of this facial nerve lesion are described. The various aetiological hypotheses put forward are discussed, but it is probable that the paralysis results from a direct effect of the virus on the nerve. HIV-associated peripheral facial paralysis may occur irrespective of the number of CD4 lymphocytes and does not seem to have a prognostic significance. However, it appears by preference in stages I, II and III and may then reveal the HIV infection.

末しょう性顔面神経麻ひにおける耳小骨筋反射

Since the stapedial muscle is an extraposed facial muscle, stapedial reflex should show a parallel change with that of the facial muscles.In the case of facial paralysis, stapedial reflex, like the Score Rating Method (May, 1975, Yanagihara, revised in 1977) and the Integrated EMG Method (Magi, 1980), reflects the degree of facial nerve damage.The stapedial reflex of an affected side induced by contralateral stimulation was compared with that of the unaffected side, and was expressed in a percentage, which we regarded as the degree of facial nerve damage.Three methods, namely the Score Rating Method, Integrated EMG Method and stapedial reflex were administered to 33 cases of peripheral facial paralysis. By applying the values measured in each method in a regression analysis, the onset of recovery and the termination date were determined.In the case of complete recovery, the stapedial reflex had late onset but its recovery rate was high and showed complete return. In the case of incomplete recovery, the stapedial reflex had late onset but it had a more rapid rate of recovery than that of the Score Rating method.The distribution of values of onset of stapedial reflex and the Score Rating method had a good correlation with that of the diameters of the fibers in the facial canal. The stapedial muscle is innervated by small fibers and stapedial reflex has a late onset, because in smaller fibers, injury is severer and recovery tends to be stagnated.

末しょう性顔面神経麻ひに対するメチコバール｀Ｒ´の効果について 回帰直線を用いて

Rating paralysis score (YANAGIHARA, 1976) is an excellent psychometric method for clinician to estimate degree of facial paralysis. In addition to this, integrated EMG method proposed by YAGI, et al. (1979) also gives an additional electromyographic information of affected facial muscles. When we use both paralysis score and integ. EMG, we can easily follow recovery process of facial paralysis expressed as increase of score and percentage of integ. EMG. Both increases are almost linear to daily recovery of paralysis, and could be plotted in semilogarithmic paper as a linear line. By applying regression analysis to this, it is possible to calculate and determine slope and constant of following equation:Y=Blogx-AY: score x: day B: slope A: constantIn equation, slope means speed of recovery such as recovery become rapid when it is high.In 29 cases of peripheral facial paralysis, the effect of methycobalgroup (12 cases) and steroid group (17 cases) was compaired after calculation of each regression line in all cases. As to slope, methycobal group and steroid group were 80.07, 92.21 respectively and showed no significant difference statistically.This means that methycobal has same effect as steroid on treatment of facial paralysis.

Two Cases of Peripheral Facial Paralysis Associated with Varicella

Facial paralysis caused by chickinpox are rare. Two cases of facial paralysis associated with varicella were described.First case, a 5-year-old girl, complained of immobility of right facial muscle on Feb. 6, 1979. Three days later, she developed typical varicella. Laboratory studies revealed no abnormalities except for an elevated anti varicella-zoster virus (VZV) antibody levels in the serum. Anti VZV antibody titers were measured by immune adherence hemagglutination test (IAHA). The serum IAHA titers for VZV were 1:128 (Feb. 14) and 1:128 (March 5). Complete recovery occured five weeks after the onset.Second case, a 5-year-old boy, had a skin rash and diagnosed as varicella on April 5, 1979. On May 17, he noticed a weakness of the right facial muscle. No other neurological abnormalities were observed. About two weeks later, mumps occured. The serum IAHA titers for VZV were 1:64 (May 23) and 1:128 (June 18) and the mumps virus antibody titers were 1:<2 (May 23) and 1:64 (June 18). The facial palsy completely recovered after six weeks.

Neurinoma of the Facial Nerve

This paper deals with 2 cases of peripheral facial paralysis, due to intratemporal facial neuroma of tympanic (case No. 2) and vertical (case No. 1) segments of the Fallopian canal. The authors present a literature review of the intratemporal facial neuromas with special reference to clinical-surgical and differential diagnostic aspects. It is difficult to detect a Schwannoma of the facial nerve during a peripheral facial paralysis; radiological studies of the mastoid and Fallopian canal are essential for this diagnosis. Treatment of neurinomas of the VIIth nerve is always surgical, the authors emphasize the necessity of an 'en masse' tumor-nerve removal and the use of a nerve graft.

Speichelchemische Untersuchungen der Glandula submandibularis bei peripheren Fazialisparesen

The chemistry of the saliva produced by the submaxillary glands after pilocarpin stimulation has been investigated in normal cases and cases of peripheral facial paralysis.

Electro-diagnosis in peripheral facial nerve paralysis

In this series 84 cases of peripheral facial paralysis of different aetiologies and degrees were studied by electro-diagnostic tests i.e., R.D., Conduction studies and E.M.G. Reaction of degene ration was studied in 64 cases while conduction studies and E.M.G. were carried out in 80 cases each.