Neurocysticercosis (NCC), a parasitic infection of the central nervous system caused by Taenia solium larvae, is a leading cause of acquired epilepsy in endemic regions. This case describes a 40-year-old male who presented with chronic headache, dizziness, and a recent seizure episode. He had no prior history of systemic illness, tuberculosis, or neurological disorders. Magnetic Resonance Imaging (MRI) of the brain revealed multiple ring-enhancing lesions with an eccentric scolex in the cerebral and cerebellar hemispheres, accompanied by surrounding edema, confirming the diagnosis of neurocysticercosis. Additional lesions in extraocular, facial, and tongue muscles were consistent with myocysticercosis, an uncommon but clinically significant manifestation that may mimic inflammatory or neoplastic processes.Spinal imaging demonstrated degenerative changes, including diffuse cervical disc bulges at multiple levels (C3–C7) and lumbar disc pathology at L4–L5, causing anterior thecal sac indentation but without cord compression or myelomalacia. While the spinal findings were incidental, they were clinically relevant as contributors to chronic pain and potential neurological deficits.The coexistence of disseminated neurocysticercosis with muscular involvement and early degenerative spinal disease highlights the importance of comprehensive evaluation in patients presenting with seizures and persistent headache. Treatment included albendazole-based antiparasitic therapy, corticosteroids to reduce perilesional edema, antiepileptic medications, and conservative management for disc disease.This case underscores the role of MRI in identifying pathognomonic features of cysticercosis, emphasizes the need for systemic evaluation, and demonstrates the significance of recognizing coexisting pathologies for tailored multidisciplinary management.

Virtual Reality (VR) technology has progressively expanded its influence from entertainment to critical domains including education, medical rehabilitation, and professional skill development. Consequently, User Experience (UX) has emerged as a decisive factor influencing the efficacy of VR applications. Conventional UX evaluation techniques, which predominantly utilize subjective surveys and heuristic reviews, struggle to capture dynamic user responses during immersive sessions. This paper examines the application of Artificial Intelligence (AI), specifically Machine Learning (ML) and Deep Learning (DL) techniques, to predict and improve UX in VR environments through real-time analysis of multi-sensor data. By synthesizing behavioral cues, physiological signals, and system performance indicators such as gaze patterns, motion kinetics, electroencephalography (EEG), and facial muscle movements. AI-driven models facilitate instantaneous assessment of engagement, cognitive effort, and simulator sickness. This research evaluates the merging of diverse data sources for UX interpretation, contrasts the predictive performance of various AI architectures, including neural networks, random forests, and support vector machines, and considers the creation of context-aware VR systems. The ultimate objective is to narrow the divide between data-centric AI methodologies and human-VR interaction, fostering the advancement of more adaptive and user-oriented virtual spaces.

ObjectivesThis study aimed to determine the preferred timing and measurement sites for electroneuronography (ENoG) to predict early recovery from acute peripheral facial paralysis.MethodsWe retrospectively evaluated 42 patients with acute peripheral facial paralysis who received standard treatment with oral corticosteroids. The severity of facial paralysis was assessed at the initial visit and after 1 month using the House–Brackmann grading system. Patients were classified into recovery and non-recovery groups according to changes in the grade. ENoG was performed at the initial visit and after 2 weeks. ENoG amplitudes of four facial muscles (frontalis, nasalis, orbicularis oculi, and orbicularis oris) at the initial visit and after 2 weeks, as well as age, sex, affected side, and diagnosis, were compared between the two groups.ResultsNo differences were observed in degeneration ratios across all subsites in the initial ENoG, which can be explained by the fact that Wallerian degeneration is not yet complete at this early stage. However, the second ENoG, performed after degeneration had progressed, showed significant differences across all subsites. Binary logistic regression analysis revealed that the degeneration ratio of the orbicularis oris muscle was the best predictor of early recovery (odds ratio, 0.961; p = 0.014). Receiver operating characteristic curve analysis also revealed that the degeneration ratios of all subsites measured in the second ENoG were useful in predicting early recovery, with the highest possibility at the orbicularis oris muscle (area under the curve = 0.789). When the degeneration ratio exceeded 60% in all subsites in the second ENoG, a favorable prognosis was not expected.ConclusionThis study provides the preferred testing time and measurement sites for ENoG to predict early recovery from facial paralysis. Given the personal and social impact of facial paralysis, predicting early recovery is crucial for reassuring patients, providing better treatment, and encouraging early reintegration into society.

A clinical nomogram for predicting recurrence after percutaneous radiofrequency ablation in the management of primary hemifacial spasm.

Prenatal superficial musculoaponeurotic system anlage.

Successful functional and aesthetic results have been achieved with face transplants, especially for large or complex defects. However, patients must undergo long-term immunosuppressive therapy, which poses morbidity and mortality risks. Acute and chronic rejection episodes can result in skin discoloration and hardness. The aesthetic loss in our case occurred as mustache and beard losses owing to these rejection attacks. Facial mimic muscles have not been shown to be functional in all published facial transplant cases. Despite the lack of sensory or motor nerve repair, our patient regained normal skin sensation and most facial mimic muscle functions within the first postoperative year. Sensation is gained through nerve healing that develops from the grafts and flap base, in addition to sensory nerve repair. We believe that providing good contact of healthy mimic muscles in the recipient bed with the facial flap leads to successful aesthetic results, depending on intensive physical therapy.

Myofascial pain dysfunction syndrome (MPDS) is a common musculoskeletal non-inflammatory disorder affecting the temporomandibular joint (TMJ) characterized by localized pain and restricted mouth opening. Patients with MPDS typically consult a dentist and are prescribed pharmacotherapy, which has associated side effects. Soft tissue manipulation is a safer and effective alternative to pharmacotherapy for MPDS. However, comparative studies are lacking between pharmacotherapy and manual therapy approaches. To determine and compare the effectiveness of soft tissue manipulation versus pharmacotherapy in the management of MPDS affecting TMJ. Dental and physiotherapy outpatient department settings of a tertiary care hospital. Individuals between 18 and 55 years of age presenting with pain on palpation of TMJ, restricted mouth opening, and intermittent clicking of joints. Single blinded randomized controlled trial. Thirty-four individuals were included and randomized into two groups. Seventeen individuals in the experimental group received soft tissue manipulation techniques such as massage and myofascial release (MFR) for facial muscles. The intervention was given by a qualified and trained physiotherapist who executed five hands-on sessions every other day over 10 days. Seventeen individuals in the control group were prescribed muscle relaxants with analgesics. The referring/consulting dentist prescribed medication for 7 days. In both groups, the patients were analyzed pre-and post-intervention using the following outcome measures: Numeric Pain Rating Scale (NPRS), Chronic Graded Pain Version (CGPV) 2.0, maximum mouth opening (MMO), and TMJ Disability Index (TMI). A statistically significant difference was observed in both groups for pain, CGPV2.0, MMO, and TMI with p = 0.001. An intergroup comparison showed no significant difference between the two groups in terms of pain (p = 0.066); however, a significant difference was noted in CGPV2.0, MMO, and TMI with p = 0.001, with the soft tissue manipulation group being superior to the pharmacotherapy group. Soft tissue manipulation was more effective in alleviating pain, improving mouth opening, and reducing disability in patients with MPDS of TMJ. Further, pharmacotherapy only showed an effect on pain reduction with no increase in mouth opening.

Background Tetrahydrocannabinol (THC) vaping has become increasingly prevalent, yet available empirical data on puffing behavior during THC vape use remain limited. This study aimed to characterize the puff duration of people who use THC vapes by analyzing publicly available YouTube videos. Additional observations included device type, liquid composition, and notable user behaviors. Methods YouTube was systematically searched using predefined search terms related to THC vaping. Videos published between 2018 and 2024 were screened for inclusion based on clear visibility of puffing events. A total of 100 videos were included in the analysis. Puff initiation and termination were defined by visible facial muscle contraction and relaxation, respectively. Puff duration was determined using frame-by-frame analysis. Results The mean puff duration obtained from 456 analyzed puffs was 3.68 seconds with no significant differences between cartridge and disposable devices ( p =0.1). Behavioral observations included engagement in extended puffing, coughing, and subjective description of aerosol harshness and flavor. Conclusions The observed puff durations during THC vape use closely aligned with those previously reported for electronic nicotine delivery systems (ENDS), suggesting that ENDS puffing regimens may be appropriate for preliminary emissions testing of THC vape products. However, distinct user behaviors reported in this study highlight the need for THC vape specific protocols that reflect real-word use patterns.

The human capacity for facial mimicry plays a vital role in social bonding and emotional comprehension. This study investigates the role of facial mimicry in preference formation. To do so, One-hundred and six participants, comprising of fifty-three dyads engaged in a preference-based paradigm where in each trial participants had to listen and then choose between two movie synopses, while their facial muscle activity was recorded using wearable facial electromyography (EMG) electrodes. In the first part of the experiment, one participant read aloud the two synopses, and in the second part both participants listened to a pre-recorded actress. Our findings revealed that speaker-listener facial mimicry of muscles associated with positive emotions was linked with increased likelihood of selecting that synopsis. In addition, listener's choice was better predicted by speaker-listener's facial mimicry than by individuals' facial expressions alone. Notably, these results were maintained even when only smiling mimicry was measured with the pre-recorded actress, highlighting the robustness of this effect. Our findings reveal the central role facial mimicry plays in preference formation during social interaction.

Peripheral facial paralysis results in complete loss of contractibility in facial muscles, atrophy and asymmetry. Patients performed functional electrical stimulation (FES) home training twice daily over 1 year to show its effect and define stimulation parameters. A specific response was obtained in all 10 patients. Since the mean phase duration (PD) could be reduced (155.0 ± 55.0 to 51.0 ± 12.4 msec), this allowed the mean stimulation frequency to be increased (1.3 ± 0.5 to 5.0 Hz ± 1.5 Hz). The PD reduction to generate the same charge increased the voltage (16.2 ± 2.5 to 27.2 V ± 5.9). A suitable combination of PD and amplitude elicited a selective response without activation of other facial muscles using a PD of ≥ 25 ms (> 25 000 µs). FES changes the stimulation parameters for improving the training effect on denervated facial muscles. It prevents denervation atrophy and stops facial asymmetry.

The orbicularis oculi (OOc) and risorius muscles are typically regarded as distinct anatomic and functional units with no known direct muscular connections. Although rare variants of the facial musculature have been reported, their implications for facial dynamics and clinical practice remain underexplored. To the best of our knowledge, this report presents a previously undescribed direct link between the OOc and risorius muscles, highlighting their potential functional and clinical significance. This report presents an anatomical variant in which the lateral fibers of the OOc muscle descend abnormally, running lateral to the zygomaticus major and in close proximity to the zygomatic retaining ligaments (McGregor's patch). In the mid-cheek region, several of these fibers blended with the superior fibers of the risorius muscle, forming a direct muscular connection at the lateral boundary of the facial expression muscles, and ultimately inserting into the modiolus. This bilateral anatomical variant was not accompanied by other notable anomalies in the adjacent facial structures. This report presents a previously undescribed direct connection between the OOc and risorius muscles. This configuration may allow for coordinated movement between eyelid closure and mouth corner retraction, thereby facilitating complex and integrated facial expressions. Clinically, recognition of this variation is important for procedures such as botulinum toxin injection, musculo-aponeurotic system-based facial surgery, and facial reconstruction, as it may influence both functional and aesthetic outcomes.

Guillain–Barré syndrome (GBS) is an acute, immune-mediated inflammatory polyradiculoneuropathy. Its most common symptom is limb muscle weakness, which usually occurs symmetrically, typically involving the lower limbs. There is a weakening or abolition of deep reflexes, and radicular pain, most often in the lumbar or intercostal regions. In half of patients, facial muscle weakness can be observed. In most cases, especially at the onset of symptoms, there is paraesthesia involving the distal parts of the lower extremities and, in rarer cases, also the distal parts of the upper extremities. The uncharacteristic and varied symptoms mean that the diagnosis can present some difficulties. This review discusses the latest updates on the diagnosis and treatment of Guillain–Barré syndrome based on the 2023 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) criteria. The guidelines emphasise a systematic approach to clinical evaluation, diagnostic testing, and therapeutic strategies, using robust evidence and best-practice recommendations. Key points include the role of preceding infections, particularly Campylobacter jejuni, in the pathogenesis of the syndrome, and the identification of diagnostic subtypes, such as acute inflammatory demyelinating polyradiculoneuropathy, acute motor axonal neuropathy, and Miller Fisher syndrome. Electrodiagnostic tests have been recognised by the EAN/PNS as essential tools for diagnosing Guillain–Barré syndrome, while plasmapheresis and intravenous immunoglobulin remain the pillars of treatment. The article highlights the importance of early intervention and differentiation of Guillain–Barré syndrome from chronic neuropathies for optimal outcomes.

Flexible pressure sensors are widely used in fields such as healthcare, owing to their simple preparation method, abundant raw materials, and high sensitivity. To solve the problems of low sensitivity and high noise impact that arise with traditional capacitive pressure sensors, this paper proposes an electrical double layer microarray capacitive pressure sensor using silver nanowires and ionic liquids. AgNW/PI flexible electrodes and microarray-structured ionic liquids are utilized to obtain highly sensitive responses to changes in weak physiological signals. The microarray structure is a 20 × 20 quadrangular prism convex array. Experimental tests show that the sensor has high sensitivity (3.1202 kPa−1, 0–800 kPa) and fast response/recovery times (100/100 ms). By flexibly attaching the sensor to the skin or a computer mouse, rapid and stable monitoring of micromovements such as facial muscles, vocalization, swallowing, finger joint activity, and mouse clicks can be achieved. The results obtained here are of value for the development of intelligent flexible electronics.

Semaglutide (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist used to treat type 2 diabetes. The drug has gained popularity because of its ability to reduce body weight. However, semaglutide-induced weight loss often results in a marked reduction in fat compartments and subcutaneous adipose tissue, as well as facial muscle atrophy and signs of premature aging, including in younger patients. This phenomenon is called “ozempic face”. It is recommended to timely prescribe patients a number of cosmetic procedures aimed at prevention and correction of these changes. In preparation for semaglutide, procedures aimed at changing the quality of the skin are indicated: collagen-stimulating therapy, biorevitalization, phototherapy and radiofrequency exposure. During treatment with the drug, the procedures should improve skin turgor, affect the muscles and ligamentous apparatus and not damage the fat pouches.

Background: Bell's palsy affects approximately 20-30 per 100,000 individuals annually. While conventional facial exercises show benefits (Khan et al., 2022; Teixeira et al., 2011), systematic application of eccentric muscle training principles to facial rehabilitation remains unexplored. Objective: To propose an evidence-informed protocol integrating eccentric facial muscle exercises during early and recovery phases of Bell's palsy, emphasizing accessibility and costeffectiveness. Methods: This protocol synthesizes current facial rehabilitation evidence with established eccentric exercise principles to create a progressive home-based intervention requiring minimal equipment. Results: A 12-week protocol is presented incorporating acute protection (weeks 1-3), active eccentric training (weeks 4-8), and functional integration (weeks 9-12) phases. Total material cost: $3-23 per patient versus $1,600-3,600 for conventional therapy. Conclusion: Eccentric facial muscle exercises represent a promising, cost-effective approach addressing gaps in Bell's palsy rehabilitation. Clinical trials are warranted to establish efficacy.

Abstract Facial nerve injury arising from diseases or clinical interventions can cause significant physiological and psychological harm. Continuous monitoring of facial muscle electrophysiology can mitigate these risks by informing surgical procedures and guiding postoperative rehabilitation. However, conventional electrodes are predominantly invasive and fabricated from mechanically stiff metals that mismatch soft tissues, often leading to secondary injury and discomfort. Here, we develop an ultrasoft eutectogel and employ it as a non‐invasive electrode material for a surface electromyography (sEMG) monitoring array. The eutectogel is synthesized by random copolymerization of acrylic acid (AA) and the zwitterionic monomer 3‐[N,N‐dimethyl‐[2‐(2‐methylprop‐2‐enoyloxy)ethyl]ammonio]propane‐1‐sulfonate (SBMA) in a deep eutectic solvent (DES), yielding an electrode that integrates ultra‐low modulus, strong adhesion, ionic conductivity, and environmental tolerance. The ultra‐low modulus and adhesiveness facilitate conformal, dynamic coupling with epidermal tissues, providing an ideal material platform for non‐invasive high‐quality acquisition of physiological electrical signals, including facial nerve‐related activity. We further validate the feasibility of predicting facial nerve functional integrity using this platform. The eutectogel and the flexible multi‐electrode array provide a promising strategy for clinical protection and monitoring of facial nerve function. image

Hemifacial spasm (HFS) is a chronic neurological disorder characterized by involuntary contractions of the facial muscles and is often accompanied by psychoemotional disturbances and a decreased quality of life. The aim of this study was to assess the levels of depression, anxiety, and quality of life in patients with HFS, as well as to determine the relationship between the frequency of spasms and psychoemotional distress. Keywords: Hemifacial Spasm, Psychoemotional State, Depression, Anxiety, Quality of Life, Facial Muscle Spasms, SF-36, HDRS, HADS

The article is devoted to the study of metabolic and neurochemical factors influencing the pathogenesis of hemifacial spasm (HFS).The levels of vitamin B₁₂, cortisol, and dopamine were determined in patients with HFS and compared with those in a control group. Significant correlations were established between decreased vitamin B₁₂ levels, hyperactivity of the hypothalamic–pituitary–adrenal axis, and disturbances in neurotransmitter processes. The findings confirm the involvement of vitamin B₁₂ deficiency in the disruption of neurovascular interactions, which contributes to the development of chronic pathological spasm of the facial muscles and defines directions for comprehensive patient rehabilitation. Keywords: Hemifacial Spasm, Vitamin B₁₂, Dopamine, Cortisol, Neurotransmitter Imbalance, Metabolic Markers, Neurovascular Dysfunction, Rehabilitation

This article introduces Professor LIU Xing's clinical experience in treatment of peripheral facial paralysis at the recovery and sequelae stages with the combination of acupotomy, cupping and herbal medication. Based on the analysis of etiology and pathogenesis of peripheral facial paralysis, Professor LIU believes that "invasion of pathogenic wind to collaterals and obstruction of qi and blood" is crucial. Therefore, the treatment focuses on "dispelling wind and harmonizing blood". The compound therapeutic mode is proposed, with acupotomy, cupping and herbal decoction involved, in which, "three-step sequential method of acupotomy" is predominated. Firstly, in the prone position, five "feng" (wind) points are stimulated in patient, Fengfu (GV16), Fengchi (GB20), Yifeng (TE17), Bingfeng (SI12) and Fengmen (BL12). Secondly, in the lateral position, three-facial points are stimulated (FaceⅠneedle: Yangbai [GB14]-Yuyao [EX-HN4]; Face Ⅱ needle: Sibai [ST2]-Quanliao [SI18]; Face Ⅲ needle: Jiache [ST6]-Dicang [ST4]) to restore the deviated facial muscles. Finally, in the supine, two Dantian points are stimulated on the forehead and chest, respectively (upper Dantian: Yintang [GV24+], middle Dantian: Danzhong [CV17]), to regulate qi and blood. As the adjunctive therapies, cupping is used to remove stasis, and herbal decoction is to harmonize the body interior. In view of holistic regulation, the treatment is administered in accordance with the affected meridians, so as to expel wind, remove obstruction in collaterals and regulate qi and blood.

Depression is a major global health issue. Recent studies suggest that botulinum toxin (BoNT/A), commonly used in aesthetic procedures, might have potential as an adjunct to traditional treatments for depressive symptoms. It is hypothesized that BoNT/A could influence neurochemical pathways to help alleviate depressive symptoms. A systematic literature review was conducted focusing on Botulinum Neurotoxin Type A (BoNT/A) for depressive disorders. Primary studies published in English were included. Data were extracted on injection sites, dosage, adverse events, and outcomes. Statistical analysis included chi-squared tests and logistic regression to identify treatment predictors. Twelve studies were included, primarily targeting the glabellar region with BoNT/A injections. Approximately 71% of patients demonstrated reductions in depression symptoms. The chi-square test revealed a significant association between injection sites and depression improvement (p = 0.009). Higher doses of BoNT/A showed a marginally negative relationship with depression reduction (p = 0.098). Most adverse effects were mild, such as local site reactions and mild headaches, with no severe adverse events like suicidal ideation reported. This review describes the possible use of BoNT/A as an adjunct therapy for depressive symptoms, particularly when targeting facial muscles. Further research is needed to optimize dosage and explore the neurobiological mechanisms involved to improve therapeutic outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .