History Of Bell Research Articles

Bell's Palsy, an Adverse Event Following COVID Vaccines.

Bell's palsy is one of the most concerning complications of the COVID vaccine that has impacted vaccine acceptance among the general population. These vaccines were introduced to provide immunity against the SARS-CoV-2 coronavirus and have been found to be quite effective. Little did we know that Bell's palsy could be one of its serious complications. We used various search engines to gather data in the form of a case series and case reports related to patients who were affected by the vaccine and had developed Bell's palsy. A total of eleven case reports and 4 case series were included in the analysis. The vaccines mentioned in the case reports were Pfizer, Moderna, Sinovac, AstraZeneca, and Janssen, while the case series included Pfizer and Sinovac. The majority of patients were female and aged between 31-40 years. Right-sided laterality was observed in 45.45% of patients, left-sided laterality in 45.45% of patients, and bilateral laterality in 9.1% of patients. Three patients had a history of Bell's palsy or stroke. After treatment, three patients showed partial improvement, six patients fully recovered, and the status of two patients was unknown. Bell's palsy is a rare complication that can occur after receiving the COVID-19 vaccine. This review aims to increase awareness about this rare adverse event of the vaccine so that it can be properly addressed and managed. Additionally, it will serve as a foundation for future research on the administration of the COVID-19 vaccine.

The Inter-Relation of Objective Assessment of The Bell’s Palsy with House-Brackmann Score: A Prospective Study

Introduction: Bell’s palsy is the most common acute peripheral mononeuropathy, which leads to the partial or complete inability to voluntary movement of the facial muscles on the affected side of the face. The study aimed to evaluate the objective assessment of the Bell’s palsy with House-Brackmann score. Methods: This Observational, Prospective study was to be conducted at tertiary care hospital among from June 2022 to September 2022 on 11 patients diagnosed with Bell’s Palsy. A patient’s history includes age, sex, and clinical features. Assessments include facial nerve grading system such as House-Brackmann score, which was used to grade the facial nerve severity. Results: Out of 11 patients, 7 patients of Bell’s Palsy (63%) were reported with Grade IV of House- Brackmann score. The remaining patients were scored under Grade III and Grade V. Patients of age group from 9 to 75 were taken. Among them, age group of 9-40 years were 45% and 40- 80 years were 55%. The result shows that Grade IV is predominant over others, male and elder patients are leading over female and middle- aged patients. 63.7% patient’s clinical features were come under Grade IV of House- Brackmann score. 27.2% of patients had an increased risk of hypertension, 18.1% had Diabetes Mellitus, 18.1% had past history of CVA, 9% had past history of Seizure, and known history of Bell ’s palsy. Conclusion: Using the House-Brackmann grading system, the severity of the patient presenting with Bell’s palsy could be reliably predicted.

Association Between Thyroid-Stimulating Hormone Level and Bell's Palsy.

To investigate whether dysregulated thyroid hormone function is associated with Bell's palsy. Cross-sectional. Electronic medical record database of Clalit Health Services (CHS). CHS is an Israeli payer-provider, integrated health care system, serving >4.5 million members (54% of the Israeli population). Older than 18 years with Bell's palsy, during 2002 to 2019. None. A total of 1,374 patients with Bell's palsy who had thyroid-stimulating hormone (TSH) blood levels measured up to 60 days before the palsy were matched (1:2) for age and sex with 2,748 controls who had TSH blood levels and no history of Bell's palsy. Retrospective review of the CHS database, from 2002 to 2019 yielded 11,268 patients with Bell's palsy, of which, 1,374 met the inclusion criteria. Mean age was 57.9 years, and 61.4% were female. A higher percentage of patients in the Bell's palsy group had low TSH (≤0.55 mIU/L) compared with controls (5.7% vs. 3.6%, p < 0.001). Low TSH compared with TSH > 0.55 mIU/L, was independently associated with 1.45-fold increased odds for having Bell's palsy (95% CI 1.11-2.02, p < 0.001), when controlled for age, sex, body mass index, diabetes, hypertension, prior cerebrovascular accident, hemoglobin level, and purchasing thyroid hormone drugs. Among the patients with TSH ≤ 0.55 mIU/L, 95.5% had normal free thyroxin and 97.7% had normal free triiodothyronine levels (subclinical hyperthyroidism). For 47.1% of patients, TSH remained ≤0.55 mIU/L, 3 to 12 months after the Bell's palsy occurred and most patients had normal free thyroxin (95.4%) and normal free triiodothyronine (91.8%). Subclinical hyperthyroidism is independently associated with Bell's palsy after controlling for multiple confounding factors.

Bell's Palsy and COVID-19 Vaccination: A Systematic Review.

Background: Bell's palsy is a rare adverse event reported in COVID-19 vaccines. Given the importance of neurological manifestations, the necessity to highlight and scrutinize the incidence of them following COVID-19 vaccination is needed. This study aimed to systematically review the reported cases of Bell's palsy following vaccination against COVID-19. Methods: This systematic review is conducted based on the Cochrane Collaboration Handbook and PRISMA Statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) and using the Joanna Briggs Institute (JBI) methodology for systematic reviews. The inclusion criteria for the included published studies were patient age ≥18 years, history of Bell's palsy after COVID-19 vaccination and established diagnosis in the patients with COVID-19 vaccination. The exclusion criteria were repeated cases and missing clinical information. The search strategy aimed to find both published and unpublished studies in August 2021 and updated by hand searching in May 2022 using the identified keywords and index terms in Cochrane Library, MEDLINE (PubMed), Web of Science, Scopus, ProQuest, and Google scholar. Finally, the reference lists of all identified reports and articles were searched for additional studies. The JBI critical appraisal tools for case reports or case series were used to assess the risk of bias in the included studies. Results: During the electronic search, hand search, and reference check, we identified 1281 citations, and in hand searching, we detected additional 15 studies. After omitting duplicated citations and assessing the title, abstract, and full text 15 case-report and two case-series studies were included for the critical appraisal process and were included in this study. Pfizer and Moderna vaccines were the most common vaccines among articles that reported the cases of Bell’s palsy. Left-sided paralysis was more common than right-sided paralysis. The interval between receiving the vaccine and the onset of facial weakness was between 1 and 48 days. Conclusion: Further studies with larger sample sizes are necessary to assess the association between Bell's palsy and the dose-response of the COVID-19 vaccine.

Bell's palsy and SARS-CoV-2 vaccines

Bell's palsy and SARS-CoV-2 vaccines

КОЛОКОЛА И ЗВОНАРСКАЯ ТРАДИЦИЯ НА КУЗНЕЦКОЙ ЗЕМЛЕ: ИСТОРИЯ И СОВРЕМЕННОСТЬ

The article is devoted to the history of bells and bell-ringing art on the territory of present Kemerovo Region. The topicality of the article is in considering this phenomenon as a part of the historical and cultural heritage. The unique technology and ringing art, the Orthodox faith and a special way of life of the Russian people and bells joined in the history of bells. Bell ringing has developed into a large-scale, national phenomenon; the state and the Russian society recognize its aesthetic value. Based on archival documents, materials of the periodical press of pre-revolutionary, Soviet, and modern periods, research works of historians and ethnographers, the authors demonstrate the formation of the bell-instrumental image of the region and highlight different historical periods: from the construction of the first bell towers, the complete prohibition of bell ringing to their revival, and the formation of new traditions. It is concluded that the situation with bells and ringing traditions is significantly dependent on the Church policy of the state in a certain historical period. It is specific that, throughout the study period, most of the bell ringers received and receive a small monetary reward for their obedience, and therefore, many of them tend to leave this job as soon as possible, replacing it with a more paid one. The current situation is certain not to contribute to the development and improvement of bell-ringing art. Nowadays, a small number of bells and the lack of its own bell production in Kuzbass region cannot contribute to solving the problem of restoring the Russian bell tradition. For the full revival of the bell-ringing tradition in the region, it is also necessary to have a competent complete set of bell funds, which today can hardly be described as organized and systematic. Bell rebounds are packed mainly at random. However, the situation has changed in recent years as instruments with planned ringing have got used. The authors make a conclusion about the necessity of the analysis of bell funds, their classification, and the identification of accounting and certification issues. Today, the revival of the art of bell ringing is based on both the preservation of old traditions and the formation of new ones. An important role in the development and popularization of the bell tradition is played by the activities of Orthodox bell ringers’ courses, festivals, exhibitions, master classes. All this forms the bell-instrumental image of Kuzbass region.

Knowledge and Awareness Regarding Bell’s Palsy Among the General Population in the Western Region of Saudi Arabia

Background: Bell's palsy is a paralysis of the seventh cranial nerve that controls the muscles of the face, leading to sudden weakness on one side of the face. Of the total, 60–75% of Bell’s palsy cases are considered idiopathic. Thirty percent of the patients have poor recovery as they may experience facial muscle weakness, facial disfigurement, psychological trauma, and facial pain. Method: This study aimed to examine the awareness level regarding Bell’s palsy among the general population of the Makkah, Jeddah and Taif regions of Saudi Arabia. A cross-sectional study design was undertaken from June to September 2021, included 418 participants, and data were collected using an Arabic self-administered online survey. Institutional review board approval and informed consent were obtained. Results: There was a significant association between sex and the knowledge of Bell’s palsy (P=.022). In addition, a previous history of Bell’s palsy was significantly associated with a good knowledge level: 38.1% of participants with a previous history of facial palsy had a good awareness level compared with 17.6% of those who did not (P=.019). Conclusion: The overall awareness regarding Bell’s palsy was unsatisfactory. More efforts, including health education programs, should be made to improve public awareness regarding this disorder and to achieve favorable outcomes and avoid future complications of the condition.

Bell Names in the History of the Russian Language (Linguistic and Cultural Aspect)

The paper considers principles of naming the bells and the main features, according to which the bell could get either name. Scientists believe that to a greater extent the structure of such onym units characterizes the specifics of how the bells were treated in Kievan Rus and the overall attitude of the Russians to them. The study was based on the analysis of the unique catalogue containing linguistic units and reflecting the history of bells, bell ringing and bell casting. The main sources of the study included compiled chronicles, archive materials, register of monastic and temple property, inscriptions on bells, and church charters. The study was conducted through comparative-historical, linguistic and cultural analysis, as well as field analysis within the cognitive stylistics. As a result, 51 bell names and their historical background were analyzed. The authors conclude that the study of linguistic units related to the history of bells and bell ringing in Russia alongside with their casting features will make it possible to bridge the historical knowledge gap and to draw some conclusions on the way the Russians perceive the linguistic worldview of this unique element of the Russian culture.

Differences in the Diameter of Facial Nerve and Facial Canal in Bell’s Palsy—A 3-Dimensional Temporal Bone Study

Bell's palsy is hypothesized to result from virally mediated neural edema. Ischemia occurs as the nerve swells in its bony canal, blocking neural blood supply. Because viral infection is relatively common and Bell's palsy relatively uncommon, it is reasonable to hypothesize that there are anatomic differences in facial canal (FC) that predispose the development of paralysis. Measurements of facial nerve (FN) and FC as it follows its tortuous course through the temporal bone are difficult without a 3D view. In this study, 3D reconstruction was used to compare temporal bones of patients with and without history of Bell's palsy. Twenty-two temporal bones (HTBs) were included in the study, 12 HTBs from patients with history of Bell's palsy and 10 healthy controls. Three-dimensional models were generated from HTB histopathologic slides with reconstruction software (Amira), diameters of the FC and FN were measured at the midpoint of each segment. The mean diameter of the FC and FN was significantly smaller in the tympanic and mastoid segments (p = 0.01) in the BP group than in the controls. The FN to FC diameter ratio (FN/FC) was significantly bigger in the mastoid segment of BP group, when compared with the controls. When comparing the BP and control groups, the narrowest part of FC was the labyrinthine segment in control group and the tympanic segment in the BP. This study suggests an anatomic difference in the diameter of FC in the tympanic and mastoid segments but not in the labyrinthine segment in patients with Bell's palsy.

The prevalence of metabolic syndrome in non diabetic patients with a previous history of Bell’s palsy

Objectives: To compare the prevalence and each parameter of metabolic syndrome between non diabetic patients with previous Bell’s palsy and non diabetic healthy subjects. Material and method: A number of 454 Bell’s palsy patients (aged 15 years old and over) were initially recruited as the study group. 874 non diabetic healthy participants of a metabolic syndrome surveillance study were randomized by R program as the control group to make up a 1:3 ratio of case to control. Metabolic syndrome was defined by International Diabetes Foundation criteria. The descriptive statistics analysis, t-test and Chi-Square test were applied for statistical analysis. Results: Seventy two non diabetic, previous Bell’s palsy cases (30 males and 42 females) were eligible as the study group. Their mean age was 51 (39.8 - 63.2) years old. The prevalence of metabolic syndrome in the study and the control groups were 22.2% and 21.8% respectively (p = 0.93). Nevertheless, the prevalence of hypertension was significantly higher in the study group (62.5% vs. 47.7%) (p = 0.04). Conclusions: No difference in the prevalence of metabolic syndrome was found. However, hypertension was significantly prevalent in the study group.

Abobotulinum Toxin A (Dysport) and Botulinum Toxin Type A (Botox) for Purposeful Induction of Eyelid Ptosis

Chemodervation with abobotulinum toxin A (Dysport) and botulinum toxin type A (Botox) is finding an expanding role in functional and cosmetic cases. We describe the use of chemodenervation with abobotulinum toxin A for functional corneal protection in two cases and botulinum toxin type A for facial symmetry after Bell's palsy in one patient. The first case is a 75-year-old female with a nonhealing corneal erosion in her right eye secondary to epithelial basement membrane corneal dystrophy who underwent injection of 24 units of abobotulinum toxin A to the right Muller's muscle and levator palpebrae superioris to induce a protective ptosis. The second case is a 40-year-old male with corneal decompensation in the right eye after penetrating keratoplasty who underwent similar injection at both sites. The third case is a 46-year-old Asian female with history of Bell's palsty affecting her right side and causing mild left eyelid retraction who was injected 3 units of botulinum toxin type A to her Muller's muscle for lid positioning. Chemodenervation is used in these cases to purposefully induce ptosis by careful injection to Muller's muscle and the levator palpebrae superioris for functional and cosmetic purposes.

More light on ruby laser’s history

More light on ruby laser’s history

Neurosarcoidosis presenting as an isolated intrasellar mass: case report and review of the literature

Isolated neurosarcoidosis without evidence of extracranial manifestation continues to be a rare phenomenon. This case report and others in the literature demonstrate the difficulty in making the diagnosis of isolated neurosarcoidosis, as it may be indistinguishable from other pathologies on radiographic and laboratory studies. This case report and review of the literature will emphasize the need for clinical suspicion for neurosarcoidosis in patients with intrasellar lesions and the appropriate clinical history. A 37-year-old female presented with visual field changes and a headache unresponsive to nonsteroidal anti-inflammatory medications. A history of Bell's palsy, hypothyroidism, and a history of sarcoidosis in the patient's father were noted. Imaging revealed an intrasellar mass resembling a pituitary macroadenoma. Routine neuroendocrine laboratory studies were consistent with hypopituitarism, and all other standard laboratory tests were normal. An endonasal transsphenoidal resection of the intrasellar lesion was done. The tissue was inconsistent with a typical adenoma. Intraoperative pathology reported non-caseating granulomatous disease. Based on the patient's history and intraoperative pathology she was diagnosed with neurosarcoidosis, which was confirmed by final pathologic analysis. Minimal debulking was performed to decompress the optic chiasm. The patient was then placed on corticosteroids and methotrexate and responded well to medical therapy. If isolated neurosarcoidosis is diagnosed early it will save a costly and invasive work-up. Radiographic and laboratory studies may aid in diagnosis but no studies are pathognomonic. Neurosarcoidosis is diagnosed by a combination of imaging, diagnostic tests, and good clinical suspicion.

Subcutaneous Forehead Lift: Technique and Early Results

Objective: To present our indications, technique, and results for a modified subcutaneous forehead lift. Methods: Retrospective chart review of 16 patients who underwent a subcutaneous forehead lift. Results: Tumescent anesthesia was used in all 16 patients. Seven patients underwent the procedure without the use of a fibrin sealant, whereas a commercially available fibrin sealant was used in the other 9 surgeries. In 1 of 7 patients in whom a fibrin sealant was not used, a postoperative seroma was evacuated in the first 24 hours after surgery. In patients in whom a fibrin sealant was used, there were no cases of hematomas or seromas. Twelve patients had concomitant upper eyelid surgery (ptosis repair and/or blepharoplasty), and 4 patients had no upper eyelid surgery. Two patients had a small dehiscence with no long-term sequelae. There were no instances of keloid formation. Postoperative brow position was judged to be good in 9 patients, adequate in 4 patients, and undercorrected in 3 patients. Forehead rhytids were improved in all patients. There were 2 cases of asymmetry, 1 of them in a patient with a history of Bell's palsy. There were no cases of symptomatic postoperative scalp hypoesthesia or decreased forehead movement. Our analysis revealed a trend toward improved postoperative brow position with increasing experience, which was manifested in a more aggressive release of the subcutaneous attachments of the lateral brow and a larger skin excision. Conclusions: Subcutaneous forehead lift with tumescent anesthesia and a fibrin sealant is a safe and effective technique that provides the surgeon with good control of brow positioning while directly addressing forehead rhytids. It avoids significant postoperative scalp hypoesthesia. In our series, the use of a fibrin sealant was correlated with elimination of postoperative hematoma or seroma, even though these patients had no postoperative pressure dressings. This technique can be an important addition to the oculofacial surgical armamentarium.

Clinical characteristics of patients with ischemic ocular nerve palsies and lacunar brain infarcts: a retrospective comparative study

Ischemic ocular motor nerve palsies (IOMP) and lacunar brain infarcts share a similar pathological mechanism. The clinical characteristics of patients as well as the protective role of aspirin should therefore be similar in both conditions. The medical records of 107 consecutive patients with IOMP and 160 patients with lacunar cerebrovascular accidents (CVA) were reviewed and analyzed with respect to patient characteristics, vascular risk factors, and aspirin intake. The data on patients with and without aspirin were compared within each group as well as between both groups. Hyperlipidemia, smoking, high carotid stenosis (>70%) and the presence of more than one vascular risk factor in an individual patient were found to be more common in patients with lacunar brain infarcts regardless of aspirin intake. Absence of vascular risk factors was encountered more in IOMP patients. The recurrence of lacunar CVA was significantly higher than recurrence of IOMP. A history of Bell's palsy was more common in IOMP patients than in patients with lacunar CVA. Within the IOMP group, the prevalence of vascular risk factors did not differ between the aspirin and non-aspirin group. Ischemic heart disease (IHD), CVA and recurrence were found more often in the aspirin group. Within the CVA group hypertension, IHD, cardiac arrhythmia and recurrence rate were more common in the aspirin group whereas smoking was found to be more common in the non-aspirin group of patients. Arteriosclerosis is the main cause of lacunar CVA and IOMP. However, IOMP depends less on the presence of vascular risk factors than does lacunar CVA. Furthermore, aspirin - at least at low doses - does not seem to have a protective effect on either of these conditions, but more extensive prospective studies of homogeneous groups of patients are needed to clarify the preventive role of antiplatelet agents in IOMP.

Microvascular decompression for hemifacial spasm.

The authors report the results of 782 microvascular decompression procedures for hemifacial spasm in 703 patients (705 sides), with follow-up study from 1 to 20 years (mean 8 years). Of 648 patients who had not undergone prior intracranial procedures for hemifacial spasm, 65% were women; their mean age was 52 years, and the mean preoperative duration of symptoms was 7 years. The onset of symptoms was typical in 92% and atypical in 8%. An additional 57 patients who had undergone prior microvascular decompression elsewhere were analyzed as a separate group. Patients were followed prospectively with annual questionnaires. Kaplan-Meier methods showed that among patients without prior microvascular decompression elsewhere, 84% had excellent results and 7% had partial success 10 years postoperatively. Subgroup analyses (Cox proportional hazards model) showed that men had better results than women, and patients with typical onset of symptoms had better results than those with atypical onset. Nearly all failures occurred within 24 months of operation; 9% of patients underwent reoperation for recurrent symptoms. Second microvascular decompression procedures were less successful, whether the first procedure was performed at Presbyterian-University Hospital or elsewhere, unless the procedure was performed within 30 days after the first microvascular decompression. Patient age, side and preoperative duration of symptoms, history of Bell's palsy, preoperative presence of facial weakness or synkinesis, and implant material used had no influence on postoperative results. Complications after the first microvascular decompression for hemifacial spasm included ipsilateral deaf ear in 2.6% and ipsilateral permanent, severe facial weakness in 0.9% of patients. Complications were more frequent in reoperated patients. In all, one operative death (0.1%) and two brainstem infarctions (0.3%) occurred. Microvascular decompression is a safe and definitive treatment for hemifacial spasm with proven long-term efficacy.

Electrophysiologic pattern and T-cell subsets in Bell's palsy.

The etiology of Bell’s palsy (BP) is as yet undefined. Among the candidates are various infectious agents and in particular viruses ubiquitous in distribution and with persistence and/or latency sites in nervous cells as herpes virus [1–3]. Besides alterations in the humoral arm of the immune system, with an increase of circulating immune complexes [4], signs of activation in the cellular compartment are described [5–8]. These findings may be indirect clues directing us towards an infectious agent. Nevertheless autoimmune phenomena have also been suspected, such as in sudden hearing loss and in other inner ear disturbances [9]. The natural history of Bell’s palsy is on the other hand quite protean, suggesting a variety of pathogenetic events, all leading ultimately to nerve damage but with different outcomes. Immunologic alterations observed at onset and during BP show a relevant degree of variability that evidently emerge when large case files are considered. In our research we investigated a possible correlation between evoked SR and ENoG that gives clues to the outcome and degree of nerve impairment [10], and the determination of lymphocyte subsets. The aim of this study was to consider whether such an approach could allow us to identify subcategories of BPs, differing on the basis of prognosis and laboratory findings.

Signs of essential blepharospasm: a motion-picture analysis.

Motion pictures of 15 patients with essential blepharospasm were studied. Previously unrecognized signs indicated multiple cranial nerve involvement. These signs include impersistence of gaze, lid retraction, tongue thrust, head tilts, head jerks, vertical gaze spasms, and asymmetry. The sugns were also observed in a patient with bilateral blepharospasm who had a history of Bell's palsy suggesting facial nerve injury as a possible factor in blepharospasm. The presence of these signs can be explained by known neural pathways, but the site, or sites, of the lesion remains obscure. These signs may be important in assessing severity and in treatment evaluation.