• Title/Summary/Keyword: Facial neuropathy

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Evaluation of Facial Synkinesis With Applied Blink Reflex Test (순목반사검사를 응용한 안면근육 공동반사운동 평가)

  • Kim, Jung-Mee;Han, Young-Su;Cho, Jeong-Seon;Park, Sang-Eun;Ha, Sang Won;Han, Jeong-Ho;Cho, Eun-Kyoung;Kim, Doo-Eung
    • Annals of Clinical Neurophysiology
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    • v.7 no.2
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    • pp.88-92
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    • 2005
  • Blink reflex could be a useful tool to differentiate facial synkinesis as one of complications of facial neuropathy, from volitional associated movements. We had performed applied blink reflex test for 23 patients with objective evidence of hemifacial weakness in which orbicularis oculi muscle(zygomatic branch) and mentalis muscle(mandibular branch) are electrophysiologically evaluated in response to supraorbital stimulation of trigeminal nerve. For an unaffected side of face there is no evidence of positive blink reflex from the mentalis muscle. We concluded that a positive blink reflex from mentalis muscle is almost always suggestive of chronic facial neuropathy even in clinical silence of facial synkinesis, or an aberrant reinnervation after peripheral facial neuropathy, and does not electrophysiologically correlate with the severity of facial palsy.

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Isolated facial diplegia variant of Guillain-Barré syndrome with anti-GM1 IgG antibody

  • Jung, Jin Ho;Lee, Sukyoon;Seo, Jung Hwa;Bae, Jong Seok;Shin, Kyong Jin;Kim, Jong Kuk;Yoon, Byeol-A;Oh, Seong-il
    • Annals of Clinical Neurophysiology
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    • v.24 no.1
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    • pp.17-20
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    • 2022
  • Facial diplegia (FD) rarely occurs as a regional Guillain-Barré syndrome (GBS) variant. A 70-year-old male presented with bifacial weakness that had started on the left side and extended to the right after several days. He was then treated using steroids and gradually improved. Serum antiganglioside antibody testing revealed positivity for anti-GM1 IgG antibodies. FD can be idiopathic, but it is an uncommon GBS variant. The ganglioside antibody test may increase the possibility of diagnosing isolated FD.

A Case of Painful Trigeminal Neuropathy as a Complication of Progressive Systemic Sclerosis (진행성 전신성 경화증환자에게서 보인 동통성 삼차신경병증 1예)

  • Shin, Kyong Jin;Jun, Dong Chul;Kim, Ju Han;Kim, Seung Hyun
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.146-148
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    • 2002
  • Progressive systemic sclerosis (PSS) is a multi-systemic disorder characterized by abundant fibrosis of the skin, blood vessels, and visceral organs. But it rarely affects the peripheral nervous system. We report a 36-year-old man of painful trigeminal neuropathy as a complication of PSS. He was referred from Rheumatology for the evaluation of abruptly developed bilateral facial pain. He had facial hypesthesia and paresthesia on neurologic examinations. In the blink reflex, ipsilateral and contralateral R1 and R2 responses were not detected during bilateral supraorbital stimulation. But normal latency and CMAP amplitude of facial NCV were found. Under the impression of trigeminal neuropathy caused by PSS, steroid therapy was tried, and his clinical symptoms and electrophysiologic findings were improved. PSS could be the cause of the painful trigeminal neuropathy.

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Neuromodulation for Trigeminal Neuralgia

  • Chung, Moonyoung;Huh, Ryoong
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.640-651
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    • 2022
  • Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.

Pontine Lesion Presenting as Trigeminal Sensory Neuropathy (교뇌의 병변를 보이는 삼차신경 감각신경병증 환자 1예)

  • Oh, Dong-Hoon;Heo, Jae-Hyuk;Sung, Jung-Jun
    • Annals of Clinical Neurophysiology
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    • v.7 no.1
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    • pp.43-45
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    • 2005
  • Trigeminal sensory neuropathy is a clinical diagnosis in which the main feature is facial numbness limited to territory of one or more sensory branches of the trigeminal nerve. We describe a 46-year-old woman who presented with left facial numbness in the territories of maxillary nerve and mandibular nerve. MRI disclosed a lesion in left trigeminal nerve root entry zone. In Blink test stimulating infraorbital foramen, ipsilateral R1 was delayed compared with contralateral R1. Lesion in pons or medulla can present as trigeminal sensory neuropathy.

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Effects of Dioscoreae Rhizoma (SanYak) on Peripheral Neuropathy and its Safety

  • Kim, Min-Jung;Sung, Hyunkyung;Hong, Kwon-Eui
    • Journal of Pharmacopuncture
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    • v.16 no.3
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    • pp.7-10
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    • 2013
  • Objectives: This study aimed to evaluate the evidence available in the literature for the safety and efficacy of Dioscoreae Rhizoma (DR) for the treatment of peripheral neuropathy. Methods: Literature searches were performed in MEDLINE and three Korean medical databases up to April 2013. All studies evaluating the effects on peripheral neuropathy or the safety of DR monopreparations were considered. Results: Three studies - DR extract per os (po) on diabetic neuropathy in mice, DR extract injection on the peripheral sciatic nerve after crush injury in rats and DR extract injection to patients with peripheral facial paralysis proved that DR treatments were effective for the treatment of nerve injuries. Conclusions: In conclusion, we found the DR has a strong positive potential for the treatment of peripheral neuropathy, but studies addressing direct factors related to the nerve still remain insufficient.

An Analysis of the Correlation between He-Ne Laser Therapy in Literature and Clinical Application (He-Ne 레이저에 대한 문헌과 이를 근거로 한 임상 활용 예의 비교 고찰)

  • Youn, In-Hwan;Kim, Nam-Kwen
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.2
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    • pp.192-201
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    • 2006
  • Objectives : Recently, He-Ne laser has been used for clinical purpose. We study the medical basis of He-Ne laser therapy and We make a proposal concerning the clinical application of using He-Ne laser in Medicine. Methods : We have selected data related to He-Ne laser therapy and study how to use He-Ne laser in clinic. Results : In biology, He-Ne laser therapy has been effects of an improve in skin regeneration an improve in peripheral and central nerve regeneration an improve in muscle regeneration, an anti-inflammation an alleviation of pain and a bone repair. In oriental medicine, He-Ne laser has been used to laser acupuncture and laser oriental physical treatment. In clinic, He-Ne laser have been used to care several parts like as facial palsy, facial spasm, trigeminal neuropathy, rhinitis and tinnitus. Recently, there is argument that He-Ne laser therapy is suitable to medical insurance. Conclusions : Laser therapy in oriental medicine is widespread and We can apply He-Ne laser to facial palsy, facial spasm, trigeminal neuropathy, rhinitis, tinnitus by using laser acupuncture or laser oriental physical treatment. Till now the whole mechanisms are not fully understood, so we hope to study these mechanisms actively and make suitable to medical insurance device in the near future.

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Clinical validation of the 3-dimensional double-echo steady-state with water excitation sequence of MR neurography for preoperative facial and lingual nerve identification

  • Kwon, Dohyun;Lee, Chena;Chae, YeonSu;Kwon, Ik Jae;Kim, Soung Min;Lee, Jong-Ho
    • Imaging Science in Dentistry
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    • v.52 no.3
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    • pp.259-266
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    • 2022
  • Purpose: This study aimed to evaluate the clinical usefulness of magnetic resonance (MR) neurography using the 3-dimensional double-echo steady-state with water excitation (3D-DESS-WE) sequence for the preoperative delineation of the facial and lingual nerves. Materials and Methods: Patients underwent MR neurography for a tumor in the parotid gland area or lingual neuropathy from January 2020 to December 2021 were reviewed. Preoperative MR neurography using the 3D-DESS-WE sequence was evaluated. The visibility of the facial nerve and lingual nerve was scored on a 5-point scale, with poor visibility as 1 point and excellent as 5 points. The facial nerve course relative to the tumor was identified as superficial, deep, or encased. This was compared to the actual nerve course identified during surgery. The operative findings in lingual nerve surgery were also described. Results: Ten patients with parotid tumors and 3 patients with lingual neuropathy were included. Among 10 parotid tumor patients, 8 were diagnosed with benign tumors and 2 with malignant tumors. The median facial nerve visibility score was 4.5 points. The distribution of scores was as follows: 5 points in 5 cases, 4 points in 1 case, 3 points in 2 cases, and 2 points in 2 cases. The lingual nerve continuity score in the affected area was lower than in the unaffected area in all 3 patients. The average visibility score of the lingual nerve was 2.67 on the affected side and 4 on the unaffected side. Conclusion: This study confirmed that the preoperative localization of the facial and lingual nerves using MR neurography with the 3D-DESS-WE sequence was feasible and contributed to surgical planning for the parotid area and lingual nerve.

Bilateral Alternating Bell's Palsy Treated with Stellate Ganglion Block -A case report- (양측 교대형 안면신경 마비의 치험 -증례 보고-)

  • Woo, Young-Cheol;Koo, Gill-Hoi
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.326-331
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    • 1998
  • Facial nerve paralysis is a common pain clinical diagnosis. But ipsilateral or contralateral recurrent facial paralysis is found in about 2.6~19.5% of facial paralysis and especially bilateral facial paralysis is rare. While idiopathic facial paralysis is the most common diagnosis, a comprehensive evaluation must be completed prior to this diagnosis in patients with bilateral facial paralysis. A representative case of bilateral alternating facial paralysis treated with stellate ganglion block (SGB) is presented. A 57 years old male patient who had the onset of a right facial paralysis 7 months ago visited pain clinic. Five months after the onset of right facial paralysis, as it was improving, he developed a left facial paralysis. He had history of hypertension, diabetus mellitus and pain episode on mastoid process before facial paralysis developed. Electrical test showed incomplete neuropathy on both side and computed tomography (CT) scan was normal. He was treated with SGB, physical theraphy and aspirin medication. After 25 times SGB, he was recovered almost completely.

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New Treatment in Facial Nerve Palsy Caused by Sagittal Split Ramus Osteotomy of Mandible

  • Lee, Jin Hoon;Lee, Kyung Ah
    • Archives of Craniofacial Surgery
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    • v.18 no.1
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    • pp.65-70
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    • 2017
  • A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.