- Bell's palsy treated with photobiomodulation in an adolescent: Rare case report and review of the published literature. [Journal Article]
- IJInt J Paediatr Dent 2018 Sep 14
- CONCLUSIONS: Photobiomodulation was effective to treat Bell's palsy in a pediatric patient, being a true noninvasive approach and with no side effects, although there is still no established definitive protocol.
- Bell's Palsy-Tertiary Ischemia: An Etiological Factor in Residual Facial Palsy. [Journal Article]
- IJIndian J Otolaryngol Head Neck Surg 2018; 70(3):374-379
- The facial nerve is unique among the motor nerves. It has long and tortuous course through the temporal bone and within the Fallopian canal. Because of this it is more prone to paralysis than any oth...
The facial nerve is unique among the motor nerves. It has long and tortuous course through the temporal bone and within the Fallopian canal. Because of this it is more prone to paralysis than any other nerve in the body. The most frequent type of facial palsy is Bell's palsy. This is an acute idiopathic lower motor neuron palsy of the facial nerve which does not normally progress and which is most usually unilateral and self limiting,: the majority of cases remit within 4-6 months and nearly always remission is complete by 1 year. In those cases that do not recover it is my contention that this is caused by Either the progression, or after effects, of secondary ischemia: tertiary ischemia. In turn this causes thickening of the facial nerve sheath with a fibrous band or bands forming with resultant strangulation and compression of the nerve, which hampers its recovery. In such cases facial nerve decompression with slitting of the sheath and cutting of any fibrous bands would be the preferred management when allied with aggressive medical therapy.
- Weather, Weather Changes and the Risk of Bell's Palsy: A Multicenter Case-Crossover Study. [Journal Article]
- NNeuroepidemiology 2018 Sep 11; 51(3-4):207-215
- CONCLUSIONS: Our findings support the hypothesis of an association between certain weather conditions and the risk for BP with acute changes in atmospheric pressure and ambient temperature as the main risk factors. Additionally, contrasting results for risk of BP after temperature changes in the diabetic and non-diabetic subgroups support the paradigm of a diabetic facial palsy as a distinct disease entity.
- Unusual discovery of a vestibular schwannoma following eradication therapy for Mycobacterium abscessus. [Journal Article]
- BCBMJ Case Rep 2018 Aug 29; 2018
- A young man with cystic fibrosis in his early 30s presented to accident and emergency with acute onset unilateral lower motor neuron facial palsy, hearing loss and impaired balance following Mycobact...
A young man with cystic fibrosis in his early 30s presented to accident and emergency with acute onset unilateral lower motor neuron facial palsy, hearing loss and impaired balance following Mycobacterium abscessus eradication induction therapy. The hearing loss and impaired balance developed over a 3-day period prior to the onset of facial palsy. Further investigation with a CT scan and MRI scan led to a diagnosis of vestibular schwannoma. The facial palsy resolved with steroid treatment; however, the hearing loss is irreversible, which has had a profound impact on his life and career. This case is intriguing as the cause and association of events are unclear. A working diagnosis of incidental Bell's palsy and unilateral hearing loss caused by the vestibular schwannoma was applied. However, the onset of these symptoms in relation to M. abscessus eradication induction therapy promotes discussion.
- The Case for Local Needling in Successful Randomized Controlled Trials of Peripheral Neuropathy: A Follow-Up Systematic Review. [Journal Article]
- MAMed Acupunct 2018 Aug 01; 30(4):179-191
- Objectives: This work follows-up on a systematic review, published in 2017, of acupuncture for the treatment of mono- and polyneuropathy and associated symptoms. Previously reviewed trials of acupun...
Objectives: This work follows-up on a systematic review, published in 2017, of acupuncture for the treatment of mono- and polyneuropathy and associated symptoms. Previously reviewed trials of acupuncture for neuropathy primarily used acupuncture points in close proximity to underlying nerves. Further exploration of point selection for the treatment of each neuropathic condition is needed to assess the anatomical relationships between acupuncture points and peripheral nerves with respect to the treatment of neuropathy. Methods: The 13 randomized controlled trials included in the original review studied acupuncture for neuropathy caused by diabetes, Bell's palsy, carpal tunnel syndrome (CTS), human immunodeficiency virus (HIV), and idiopathic causes. The present review reexamines all acupuncture points used, focusing on specific neuropathic condition treated. Anatomical diagrams are presented to highlight acupuncture points underlying the nerves' anatomical relationships. Each selected acupuncture point is reviewed in detail, including its Traditional Chinese Medicine theory-based function, the point's indications for use, and the peripheral nerve most closely associated with it. Results: In Bell's palsy, the majority of selected acupuncture points were associated with the ipsilateral facial nerve. In CTS, the majority of the selected acupuncture points were closely associated with the median nerve and its branches. In polyneuropathy caused by diabetes, HIV, or idiopathic causes, most selected acupuncture points were in close proximity to peripheral nerves. Conclusions: All reviewed trials of acupuncture for neuropathy and neuropathic pain use acupuncture points that are closely associated with the peripheral nerves treated. Local needling is crucial for successful treatment of peripheral neuropathy.
- Facial nerve palsy in children: A retrospective study of 124 cases. [Journal Article]
- JPJ Paediatr Child Health 2018 Aug 24
- CONCLUSIONS: Facial palsy in children is a manifestation of a heterogeneous group of causes. The most common aetiology of FNP in children in our study was idiopathic (Bell's palsy), followed by infective causes, such as acute otitis media and neurotropic herpes viruses. Therefore, treatment should be adapted to each patient depending on the underlying disease and severity of FNP.
- Facial nerve decompression. [Journal Article]
- COCurr Opin Otolaryngol Head Neck Surg 2018; 26(5):280-285
- CONCLUSIONS: Appropriately selected patients with facial paralysis secondary to Bell's palsy or temporal bone trauma may benefit from facial nerve decompression. Patients should be counseled regarding the risks of decompression and that the return of maximal facial nerve function may be delayed up to 12 months.
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- Use of the masseteric nerve to treat segmental midface paresis. [Journal Article]
- BJBr J Oral Maxillofac Surg 2018 Aug 16
- Segmental midface paresis with or without synkinesis reflects incomplete recovery from Bell's palsy, operations on the cranial base or parotid, or trauma, in 25%-30% of cases. To correct the deficit,...
Segmental midface paresis with or without synkinesis reflects incomplete recovery from Bell's palsy, operations on the cranial base or parotid, or trauma, in 25%-30% of cases. To correct the deficit, the masseteric nerve was used to deliver a powerful stimulus to the zygomatic muscle complex, with the addition of a cross-face sural nerve graft to ensure more spontaneous smiling. By doing this, the orbicularis oculi muscle continues to have an appropriate stimulus from the facial nerve, and the zygomatic muscle complex is separately innervated, which considerably reduces synkinesis between the two muscle compartments. For those patients with muscular contractures of the midface, the new healthy neural stimulus relaxes muscles at rest. From January 2011 to March 2017, 20 patients presented with segmental facial paresis of the midface and were operated on using this new technique. All patients were evaluated before and after operation using Clinician-Graded Electronic Facial Paralysis Assessment (eFACE), and they showed considerable postoperative improvements in static, dynamic, and synkinetic variables. Our proposed use of the masseteric nerve to treat segmental facial paresis produces favourable results, but our initial data require confirmation by further studies.