• Title/Summary/Keyword: Facial nerve grading

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Bell마비의 임상적 분석 (Clinical Analysis of Bell's Palsy)

  • 김경집;이동국;석정임
    • Annals of Clinical Neurophysiology
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    • 제9권1호
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    • pp.5-10
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    • 2007
  • Background: Bell's palsy (BP) is a self-limited rapid onset facial palsy that is non-life-threatening and has a generally favorable prognosis. Facial paralysis can be caused by numerous conditions, all of which should be excluded before the diagnosis of BP is reached. The etiopathogenesis and clinical course of BP are uncertain. So we analyzed the epidemiology and clinical course of BP patients. Methods: The subjects include 100 cases of BP examined during the period of 18 months. Careful clinical history, neurologic examinations, laboratory tests, electrophysiologic studies, and brain imaging were performed. Follow-up examinations were done once a week during the first month and subsequently once a month until normal function was restored or for up to 3 months. Facial nerve function was assessed by House-Brackman (HB) facial nerve grading scale and electrophysiologic studies. Results: Except 13 recurrent BP patients, we analyzed 87 BP patients. Forty-four (50.6%) were men and 43(49.4%) were women and the mean age was 51.0(${\pm}16.6$) years. Three (3.4%) patients showed a familial tendency. The initial examination within 1 week after attack revealed 35.2% was below HB grade 4 and 64.8% was above grade 3. The associated symptoms are as follows; postauricular pain, increase tear flow, taste change, hyperacusis and drooling. The initial facial nerve conduction study and blink reflex within 1 week after attack showed abnormal findings in 12.6% and 100%, respectively. Brain MRI was performed in 59(67.8%) patients and showed abnormal enhancement of affected nerve in 57(96.6%). Follow-up examination showed that 78.2% of the patients partially improved within 4 weeks and completely improved within 3 months. Finally 80.5% of the total patients obtained normal function in 3 months. Conclusions: We report epidemiologic, clinical, electrophysiologic and radiologic characteristics of BP patients.

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Bell's Palsy 환자의 건측-환측 안면부 피부온도차이에 관한 연구 (Differences Between Facial Skin Temperature of the Paralyzed Side and Those of the Normal Side in Bell's Palsy Patients)

  • 남동현;고형균;박영배
    • 대한한의학회지
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    • 제28권1호통권69호
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    • pp.126-136
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    • 2007
  • Objectives : Bell's palsy in an acute peripheral facial nerve paralysis that usually affects only one side of the face. The seventh cranial nerve carries predominantly motor fibers, but also supplies some autonomic innervation, sensation to park of the ear, and taste to the anterior two thirds of the tongue. The aim of this study is to provide evidence of differences between facial skin temperature of the paralyzed side and normal side in Bell's palsy patients. Methods : the author studied 68 patients with Bell's palsy whose facial nerve function had been documented by the House-Brackmann grading system. We measured skin temperature of the forehead, zygoma, lower lip, temple and lower jaw area of the paralyzed side and those of the normal side. Results : there were significant facial skin temperature differences between the forehead area of paralyzed side and that of normal side of GrII(P<0.05) and III(P<0.05). The result also showed that the facial skin temperature difference according to the aflection period vanished when air temperature was calibrated (F=1.700, P=0.178). Conclusions : Thermography is a useful diagnostic tool in Bell's palsy if the air temperature is low enough to cool the facial skin temperature and the forehead area is evaluated as the sampling zone.

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위내시경 검사 후 발생한 양측성 안면신경마비 치험 1례 (A Case Report of a Patient with Facial Nerve Palsy that Occurred Consecutively on Both Sides After Gastroscopy)

  • 진효원;정솔;박정림;황지현;윤종민;문병순
    • 대한한방내과학회지
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    • 제43권5호
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    • pp.989-996
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    • 2022
  • The purpose of this study is to report a rare case of bilateral facial palsy after endoscopy and the effects of a series of traditional Korean medicine treatments applied to the patient. The patient was treated with Western oral medications for seven days and then with traditional Korean medicine consisting of acupuncture, moxa, and herbal medicine (Dodamgeopung-san-gami and Yukgungeopung-san-gami) for two months. Treatment progress was measured using the House-Brackmann grading system and Yanagihara's unweighted grading scale. We were able to notice some improvements in the patient's symptoms: the House-Brackmann scale went from 5/4 to 2/1, and the Yanagihara scale from 13/16 to 38/40. This study thus reports that traditional Korean medicine treatments can be applied to bilateral facial palsy found in rare cases and still be effective.

한 대학병원에서 분석한 재발 벨마비 환자의 임상양상 (Clinical Analysis of Recurrent Bell's Palsy in One University Hospital)

  • 김창형;이동국
    • Annals of Clinical Neurophysiology
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    • 제15권1호
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    • pp.1-6
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    • 2013
  • Background: Bell's palsy (BP) is the most common cause of unilateral lower motor facial palsy. Recurrent paralysis of the facial nerve is unusual and reported in only 7-8%. Methods: A total of 394 consecutive patients with acute BP patients were enrolled at Daegu Catholic University Hospital from July 2005 to September 2012. We classified the patients into two groups-single BP and recurrent BP-and compared them by patient characteristics, clinical features, MRI findings, electrophysiologic findings and prognosis. The degree of BP was graded according to the House and Brackmann facial nerve grading system. Results: Recurrent BP was observed in 31 (7.9%) patients. The number of recurrence was varied from 2 to 5. The recurrent BP (9.7%) had more incidence of family history and MRI enhancement than those of single BP (2.2%, p=0.047). The single BP (63.4%) had better recovery than recurrent BP (45.2%, p=0.045). Conclusions: The recurrent BP had more incidence of family history, MRI enhancement and poor prognosis than the single BP.

침치료(鍼治療)에 의한 말초성(末梢性) 안면신경마비(顔面神經麻痺)의 임상적(臨床的) 관찰(觀察) (Clinical Observation of Bell's Palsy)

  • 강성길;김용석
    • 대한한의학회지
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    • 제16권2호
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    • pp.9-16
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    • 1995
  • 1994년 3월부터 1995년 2월까지 1년동안 말초성 안면신경마비로 경희의료원 한방병원 침구1과에 침치료를 받기 위하여 내원한 환자중 발병한지 1주일 이내로 이부(耳部) 대장포진(帶狀疱疹)이나 종양 또는 외상을 당하지 않은 초발환자 44명을 대상으로 일주일에 3회씩 합곡(合谷)(L14), 족삼리(足三里)(ST36), 영향(迎香)(LI20), 찬죽(BL2), 예풍(TE17), 지창(地倉)(ST4), 협차(頰車)(ST6), 수구(水溝)(GV26), 승장(承漿)(CV24), 양백(陽白)(GB14)과 어요(魚腰)(Ex-HN4)를 선혈(選穴)하여 자침하고 치료경과를 관찰하였다. 지창(地倉)에서 협차(頰車), 수구(水溝)와 승장(承漿)에서 지창(地倉), 양백(陽白)에서 어요(魚腰)로는 투자법을 실시하였다. 환자의 평균연령은 39.3세이었고, 여성이 63.6%를 차지하였고 그중 한 명은 임신중이었다. 안면신경마비의 회복판정 척도는 House-Brackmann facial nerve grading scales를 사용하여 초진부터 초진후 7주까지 또는 7주이내 완전히 회복될 때까지 매주 평가하였다. 86.4%의 환자가 초진후 7주이내에 완전히 회복 되었으며, 회복되는데 걸리는 기간은 평균 3.7주로 관찰되었다.

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Narrative Review of the Association between Cervical Region Treatment and Facial Paralysis

  • Young-Jun Kim;Hye-Ri Jo;So-Rim Kim;Dong-Guk Shin;Da-Won Lee;Yeon-Sun Lee
    • Journal of Acupuncture Research
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    • 제40권4호
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    • pp.319-328
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    • 2023
  • Facial nerve palsy refers to sudden, unilateral lower motor neuron facial paralysis. This study aimed to determine the importance of neck treatment in the treatment of facial paralysis. A literature search was performed on six online databases and other sources until January 15, 2023. A total of 426 papers were retrieved. After excluding duplicated and inconsistent papers, papers not including cervical treatment, and experimental papers on animals, two papers were finally selected. The type of treatment method, therapeutic effects, assessment of the risk of bias in randomized controlled trials, and non-randomized controlled trials and side effects were evaluated. Chiropractic, manual therapy, facial meridian massage, and acupotomy were applied to the face and cervical spine region. The results showed that each treatment had a significant therapeutic effect through evaluation index measurement methods, such as the visual analog scale and Yanagihara's unweighted regional grading system. This study demonstrated the importance of the cervical spine area in the treatment of facial paralysis. However, this study has many limitations. Thus, high-quality randomized controlled comparative studies on the treatment of the cervical spine area only or studies that include cervical spine area treatment as an interventional treatment while performing oriental or comprehensive treatment are needed.

특발성 안면신경 마비 환자 20례에 대한 체침과 체침및 Rainbow therapy병행치료의 비교연구 (Comparison studies on 20 cases of Bell's palsy patients by acupunture and Rainbow therapy & acupunture)

  • 황영진;이현;허윤경;송형근;안택원;황재옥
    • 혜화의학회지
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    • 제15권1호
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    • pp.87-95
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    • 2006
  • Objective : We suggested the clinical effect of Rainbow therapy on Bell's palsy. Methods : 20 Bell's palsy patients were divided into two groups. One group(A group) was treated by acupunture and the other group(B group) was treated by acupunture and Rainbow therapy. The effect of these treatments was evaluated by Yanagihara's unweighted grading system and House-Brackmann grading system. Results and Conclusions : In Yanagihara's unweighted grading system After 1 week and 2weeks treatment, group B marked more higher than group A in treatment outcome. We discovered that it is significant differences between two groups. After 3 weeks treatment, group B marked more higher than group A in treatment outcome but it is not significant differences between two groups. In House-Brackmann's facial nerve grading system, After 1 week treatment, group B marked more higher than group A in treatment outcome. We discovered that it is significant differences between two groups. After 2 weeks and 3 weeks treatment, group A marked more higher than group A in treatment outcome but it is not significant differences between two groups.

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해면상 혈관 기형에 병발한 뇌교 출혈로 인한 좌측 내사시 환자 치험 1례 (A Case Report of Korean Medical Treatment on a Left Pontine Hemorrhage with a Cavernous Malformation)

  • 임태빈;전규리;이혜진;이경화;조승연;박정미;고창남;박성욱
    • 대한한방내과학회지
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    • 제43권5호
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    • pp.929-939
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    • 2022
  • This case report determines the effects of Korean medicine treatment on a pontine hemorrhage with a cavernous malformation. In this study, Korean medicine treatments, such as herbal medicine, acupuncture, electro-acupuncture, and moxibustion, were administered for 30 days. During the hospitalization period, evaluations were performed using the Scott and Kraft Scale, eye movement, 9-gaze photography, the House-Brackmann grading system, and Yanagihara's unweighted grading system on days 1, 12, and 30. The Scott and Kraft Scale increased from -4 to -2, while eye movement increased from 43.1% to 72.3%. The House-Brackmann grading system improved from 4 to 2, and Yanagihara's unweighted grading system increased from 13 to 31. We also discovered that the movement of the left eye was improved by 9-gaze photography. Our findings suggest that Korean medicine treatment has potential effects on esotropia and facial palsy caused by a pontine hemorrhage with a cavernous malformation.

4번째 동측으로 발생한 벨마비의 치험 1례 (A Case Report of 4th Ipsilateral Recurrent Bell's Palsy)

  • 김남옥;채상진;손성세
    • 한방안이비인후피부과학회지
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    • 제14권2호
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    • pp.198-206
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    • 2001
  • Recurrent Bell's palsy is a very rare case and have been reported that shows the incidence to be approximately 10 per cent in the Bell's palsy patents. It is generally accepted that facial paralysis caused by compression of the facial nerve by tumor develops slowly and has an unremitting course, however, reported cases have described the rare association of recurrent facial paralysis and intracranial tumor, and the same recovery rate. Usual symptoms of Bell's palsy include subacute facial palsy, hyperacusis on the affected side, postauricular pain on the affected side, altered sensation of taste, and partial trigeminal distribution hypesthesias. Complete resolution of symptoms is usually seen in 2-3months in $75-85\%$ of cases, with $25-35\%$ showing varying degrees of residual effects. We report a case of 4th ipsilateral recurrent Bell's palsy in a 14-year-old women, which was occurred in every winters. We treated her with acupuncture, moxibustion, herbal medication, carbon and silver spike point, and used House-Brackmnn grading system(HBGS) and the Fisch Detailed Evaluation of Facial Symmetry(DEFS) to assess the degree of paralysis in each part of face.

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양측성 안면신경마비 치험 1례에 관한 고찰 (Clinical Observation on 1 Case of Patient with Bilateral Facial Palsy)

  • 김민정;박상동;이아람;김경호;장준혁;김갑성
    • Journal of Acupuncture Research
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    • 제19권2호
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    • pp.238-249
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    • 2002
  • Facial palsy is commonly encountered disease in the clinic but bilateral facial palsy is known as rare disease. Type of facial nerve paralysis include unilateral, recurrent ipsilateral, recurrent alternating and bilateral simultaneous palsies. Among the types, the reported incidence of bilateral simultaneous palsy is 0.3~2% of facial paralysis patients. We experienced I case of patient with bilateral simultaneous facial palsy that was concluded as bilateral bell's palsy. Objective : The purpose of this paper is to report the patient with bilateral facial palsy, who improved by oriental medical treatment. Another purpose is to review the current literature and to differential diagnosis of bilateral facial paralysis. Methods and Results : The patient was treated by acupuncture, herb medication and self-massage on facial muscle for 14 weeks. House-brackmann grading score was improved into I/I (Rt/Lt) from IV/IV. Conclusion : Through reviewing some literatures and reports, It is concluded that bilateral facial palsy was related to many other disorders and more ominous than unilateral facial palsy. therefore, its work-up should include a complete neurologic assesment and thorough evaluation. also, we consider that bilateral Bell's palsy can improve by oriental medical treatments.

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