• Title/Summary/Keyword: House-Brackmann Grade

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Case Study of a Patient with Sequelae of Facial Palsy (안면신경마비 후유증 정안침 증례보고)

  • Lee, Eun Ji;Kim, Sung Tae;Kwon, Min Gu;Shin, Hyun Kwon;Koh, Yong Jun;Kang, Su Woo;Na, Jae Il;Sul, Jae Uk;Jo, Hyun Jung;Jung, Pil Sun;Hyun, Min Kyung;Jung, Min Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.4
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    • pp.347-351
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    • 2015
  • This study examines a clinical progress of treatment for the sequelae of facial palsy through Jung-ahn acupuncture. The patient in this case was diagnosed with facial paralysis a few years ago. The patient was treated with Korean medicine and Western medicine, but was given up without improvement. The paretic symptom was found out in left side of the face. Also facial spasm and epiphora caused by blepharoptosis were existed. The patient got 8 times Jung-ahn acupuncture treatment from September 18th, 2014 to September 26th, 2014. House-Brackmann facial nerve grading system(H-B scale) was implemented. On the first time of the treatment, H-B scale was Grade Ⅴ and facial nerve grading was 2/8. Facial spasm and epiphora caused by blepharoptosis in lower eyelid were appeared on facial expressions and conversation. After total 8 treatments(therapies), H-B scale was Grade Ⅲ and facial nerve grading was 5/8. The symptoms of facial paralysis and blepharoptosis were improved. Jung-ahn acupuncture is estimated to be effective in facial palsy sequela. More cases are required to develop treatment of facial palsy sequela.

Study on the possibility of Digital Infrared Thermographic Imaging as a prognosis evaluation tool for patients with facial palsy (안면신경마비 환자의 예후 평가 도구로서의 적외선 체열 촬영(DITI - Digital Infrared Thermographic Imaging) 가능성에 대한 연구)

  • Bae, Hyo-Bin;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.62-75
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    • 2017
  • Objectives : The aim of this study is to evaluate possibility of DITI as prognosis evaluation tool of facial palsy. Methods : We investigate prognosis of facial palsy through EMR(Electronic Medical Record) of inpatient from December 2016 to June 2017. We evaluated the sex, age distribution, length of hospital stay, paralysis site, number of treatment after discharge, change of H-B Grade at entrance and exit, temperature difference of both sides of DITI, and Nerve Conduction Study(NCS) with reference to EMR recorded symptom change. Results : 1. Significant correlations were not found between DITI and House-Brackmann Grade change, NCS(%), the date of admission. 2. There was a negative correlation between NCS(%) and hospitalization period in patients with facial palsy. The higher the NCS, the faster the recovery rate of facial palsy. 3. In patients with facial palsy, the temperature difference between the two sides after the DITI image shows that the affected side tends to be lower than the normal side. Conclusions : In this study, only DITI temperature difference between both sides of face is not significant in determining the prognosis of facial palsy. Further research is needed to conduct DITI at the same time and to improve accuracy through a sufficient assessment of the degree of facial palsy.

Clinical Study on Gadolinium-DPTA enhanced MRI of Bell's palsy (구안와사(口眼喎斜) 환자(患者)의 Gadolinium-DPTA enhanced MRI 소견(所見)에 대한 임상적(臨床的) 고찰(考察))

  • Kim, Jae-Soo;Choi, Woo-Suk;Kim, Yong-Suk;Koh, Hyung-Kyun;Kang, Sung-Keel;Kim, Chang-Hwan
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.87-98
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    • 2000
  • This study is designed to evaluate the clinical implications of Gd-DPTA (Gadolinium-diethyl enetriamine pentacetic acid) enhanced MRI(Magnetic resonance imaging) in Bell's palsy and find it's usefulness in Oriental Medicine In this study, 25 outparients with Bell's palsy were studied that MRI was performed. To evaluate degree of facial palsy, H-B(House-Brackmann) Grade was used. In Oriental Medical therapy, Acupuncture and Herbal medicine were treated. Subjective cause was divided into exposure to chill, fatigue, stress, mixed cases. Enhanced site was compared with symptoms which were disorder of eye, hearing, taste, and facial muscle palsy. Also, Relation between time which was performed MRI and enhancement was analyzed. The enhanced lesion in MRI was divided into five segments; Internal audiitory canal, Labyrinthine segment, Geniculate ganglion, Tympanic segment, Mastoid segment. In Bell's palsy, 20 of 25 patients(80%) had abnormal contrast enhancement of the facial nerve. The H-B grade and interval performed MRI from onset were directly proportionate to enhancement. That is to say, Severe facial palsy short interval show high possibility of enhancement. There was no relation between subjective causes and enhanced site of facial nerve in MRI. Also Clinical symptoms didn't coincide with MRI findings.

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A Case of Delayed Facial Palsy and Dizziness in Miller-Fisher Syndrome (Miller-Fisher 증후군에서 나타난 지연형 안면마비 및 현훈 치험 1례)

  • Song, Mi-Sa;Yoon, Hwa-Jung;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.3
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    • pp.254-261
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    • 2019
  • Objective : Miller-Fisher syndrome(MFS) is a type of acute inflammatory polyneuropathy, a disease characterized by abnormal muscle coordination, absence of tendon reflexes, and paralysis of the eye muscle. This study is to report a case of delayed facial palsy and dizziness in Miller-Fisher syndrome, treated with traditional Korean medicine. Methods : A 57-year-old male was diagnosed with Miller-Fisher syndrome accompanied by neurological symptoms such as right facial palsy and dizziness. He received traditional Korean medicine treatment such as acupuncture(including pharmacopuncture, needle embedding therapy, electroacupuncture) and herbal medicine for 17 days. Results : Each neurological symptoms were improved after traditional Korean medicine. In case of facial palsy, House Brackmann Grading System was reduced form grade 3 to grade 2, and Sunnybrook Scale was improved from 39 to 55. Also, other symptoms such as dizziness and headache was also improved. Conclusions : This case report suggests that traditional Korean medicine may have a role in treating neurological symptoms such as facial palsy and dizziness in patient diagnosed with Miller-Fisher syndrome.

Three Case Reports of Patients with Facial Nerve Palsy Treated by SJS Non-Resistance Technique-Facial Palsy (SJSNRT-F) Combined with Korean Medicine Treatment (안면마비에 대한 SJS 무저항요법-안면마비(SJSNRT-F)를 포함한 복합한방치료 증례보고 3례)

  • Lee, Yunha;Chai, Jiwon;Choi, Dongjoo;Ku, Seunghyeok;Kim, SungHyun;Moon, Hyunwoo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.87-95
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    • 2021
  • Objectives This study aimed to investigate the effect of SJS non-resistance technique-facial palsy (SJSNRT-F) using Korean medicine treatment on facial nerve palsy through three case studies. Methods SJSNRT-F, with other Korean medicine treatments, was performed on three patients who underwent treatment at OO Korean Medicine Hospital from March 2021 to August 2021. Additionally, the House-Brackmann grading system (H-B grade) and Yanagihara's unweighted grading system (Yanagihara's score) were evaluated in these patients. Results There was a significant increase in the Yanagihara scores. Except for one patient who was discharged early, two patients showed improvement in the H-B grade. Conclusions This study suggests that Korean medicine treatment including SJSNRT-F may affect the treatment of facial nerve palsy. However, better clinical studies are needed to confirm the same.

Clinical Characteristics Analysis of 185 Pediatric and Adolescent Patients Who Visited Korean Medicine Hospital with Peripheral Facial Nerve Paralysis (말초성 안면신경마비를 주소로 한방병원에 내원한 소아청소년기 환자 185례에 대한 임상적 특징 분석)

  • Hong, Ye Na;Yu, Sun Ae
    • The Journal of Pediatrics of Korean Medicine
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    • v.37 no.1
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    • pp.58-72
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    • 2023
  • Objectives The purpose of this study is to analyze the latest clinical trends in peripheral facial nerve palsy pediatric and adolescent patients who treated in Korean medicine hospital. Methods The study was conducted based on 185 cases of pediatric and adolescent patients with peripheral facial nerve paralysis who visited Korean medicine hospital from January 2017 to June 2022. Results The mean age of onset of facial nerve paralysis in children and adolescents was 11.7 years, and the incidence rate was higher in boys than in girls. The seasonal distribution was the most common in autumn, and 91.4% were diagnosed with Bell's palsy. The recurrence rate was 7.6%. The severity was evaluated on the House-Brackmann Grading System (HBGS) scale, and the most common was Grade III. It took an average of 6.5 days from the date of onset to visit the hospital, and 75.7% visited the hospital within a week from the date of onset. Hospitalized treatment was 69.2%. The higher the HBGS grade, the more hospitalized treatment was, and the total number of treatments and the duration of treatment tended to increase. The average treatment period from the first visit date was 119.6 days. 17.8% received only Korean medicine treatment, and 69.2% took Western medicine with herbal medicine. Conclusions In this study, there was a difference in the average treatment period from previous studies according to the study period setting. Long-term studies on the recovery rate and prognosis of pediatric facial paralysis are needed.

Facial Nerve Decompression for Facial Nerve Palsy with Temporal Bone Fracture: Analysis of 25 Cases (측두골 골절후 발생한 안면마비 환자의 안면신경감압술: 25명 환자들의 증례분석)

  • Nam, Han Ga Wi;Hwang, Hyung Sik;Moon, Seung-Myung;Shin, Il Young;Sheen, Seung Hun;Jeong, Je Hoon
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.131-138
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    • 2013
  • Purpose: The aim of this study is to present a retrospective review of patients who had a sudden onset of facial palsy after trauma and who underwent facial nerve decompression. Methods: The cases of 25 patients who had traumatic facial palsy were reviewed. Facial nerve function was graded according to the House-Brackmann grading scale. According to facial nerve decompression, patients were categorized into the surgical (decompression) group, with 7 patients in the early decompression subgroup and 2 patients in the late decompression subgroup, and the conservative group(16 patients). Results: The facial nerve decompression group included 8 males and 1 female, aged 2 to 86 years old, with a mean age of 40.8. In early facial nerve decompression subgroup, facial palsy was H-B grade I to III in 6 cases (66.7%); H-B grade IV was observed in 1 case(11.1%). In late facial nerve decompression subgroup, 1 patient (11.1%) had no improvement, and the other patient(11.1%) improved to H-B grade III from H-B grade V. A comparison of patients who underwent surgery within 2 weeks to those who underwent surgery 2 weeks later did not show any significant difference in improvement of H-B grades (p>0.05). The conservative management group included 15 males and 1 female, aged 6 to 66 years old, with a mean age of 36. At the last follow up, 15 patients showed H-B grades of I to III(93.7%), and only 1 patient had an H-B grade of IV(6.3%). Conclusion: Generally, we assume that early facial nerve decompression can lead to some recovery from traumatic facial palsy, but a prospective controlled study should and will be prepared to compare of conservative treatment to late decompression.

Gamma-Knife Radiosurgery for Vestibular Schwannoma (청신경초종에 대한 감마나이프 방사선 수술)

  • Paeng, Sung Hwa;Kim, Moo Seong;Sim, Hong Bo;Jeong, Yeong Gyun;Lee, Sun Il;Jung, Yong Tae;Kim, Soo Chun;Sim, Jae Hong
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1308-1313
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    • 2001
  • Object : The goals of radiosurgery include preservation of neurological function and prevention of tumor growth. We document the results of gamma-knife radio-surgery for vestibular schwannoma. Method & Object : Eighty-two patients underwent stereotactic radiosurgery for an vestibular schwannoma from October, 1994 to December, 2000. Sixty-five of these patients were followed up for radiological and clinical evaluation. As pregamma-knife modality, surgical resection were done in 23 patients,and V-P shunt in 2 patients. Initial symptoms were headache(n=45), dizziness(n=16), tinnitus(n=17). While normal facial function(House-Brackmann grade 1) was present in 48 patients(73.8%), other patients showed grade 2 function in 8, grade 3 function in 7,and grade 4 function in 2. The Gardner/Robertson scale was used to code hearing function. Male to female ratio was 1:3. Mean tumor volume was $7.98cm^3$. Mean dose delivered to the tumor margin was 14.2Gy,and mean maximal dose was 28.3Gy. Results : Mean follow-up duration of 19.9 months. Thirty-five showed decrease(53.8%) in size, 19 patients(29.2%) stationary, 3(4.6%) initial decrease follow up increase, 5(7.6%) initial increase follow up decrease,and 59 patients (90.8%) were well controlled. Two patients experienced transient facial neuropathy, one transient trigeminal neuropathy, and one transient hearing deterioration. After gamma-knife radiosurgery, ventriculoperitoneal shunt was done in 4 patients. Conclusions : Gamma-knife radiosurgery can be used to treat postoperative residual tumors as well as in patients with concomitant medical problems in patients with preserved hearing function. Gamma-knife radiosurgery is safe and effective method to treat small, medium sized(less than 3cm in extracanalicular diameter), intracanalicular vestibular schwannoma, associated with low rate of cranial neuropathy.

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A Study of Correlation between Electromyography(EMG) and the Heart Rate Variability(HRV) Test, and Their Role as Predicting Factors for Peripheral Facial Palsy Prognosis (말초성 안면신경마비 환자에서 EMG(Electromyography)와 HRV(Heart Rate Variability)의 임상적 예후인자로서의 유용성 및 상관성 연구)

  • Kim, Chan-Young;Kim, Jong-In;Lee, Sang-Hoon;Park, Dong-Suk;Koh, Hyung-Kyun
    • Journal of Acupuncture Research
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    • v.25 no.2
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    • pp.189-197
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    • 2008
  • Objectives : This study was performed in order to investigate the effectiveness of electromyography and the Heart Rate Variability(HRV) test as prognosis factors, and to clarify correlation between Electromyography and the Heart Rate Variability test. Methods : 44 Bell's palsy patients who were graded V on the House-Brackmann scale and underwent HRV and EMG testing were retrospectively reviewed based on medical records. Results from both tests were analyzed via simple linear regression, and bivariate correlation analysis was performed to investigate the correlation between results from the two tests. The severity of the facial palsy at onset and at 2 weeks after treatment were evaluated with the H-B grade and Yanagihara grading system, and was converted into improvement scores. Results : Mean axonal loss according to electromyography showed a statistically significant correlation in predicting peripheral facial palsy improvement(p<0.01). HR, SDNN, TP, LF, HF, VLF, and LF/HF ratio on the Heart Rate Variability test showed no significant correlation in predicting peripheral facial palsy improvement. Mean axonal loss determined by electromyography, and HR, SDNN, TP, LF, HF, VLF, and LF/HF ratio recorded with the Heart Rate Variability test was analyzed with the bivariate correlation analysis method. Mean axonal loss and SDNN showed a statistically significant correlation(p<0.01) Conclusions : The Heart Rate Variability test has no statistical significance in predicting peripheral facial palsy improvement. SDNN has a statistically significant correlation with mean axonal loss as determined by electromyography.

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Clinical and Electrophysiological Characteristics of Delayed Facial Palsy in Miller-Fisher Syndrome (밀러 피셔 증후군에서 보이는 지연성 안면마비의 임상양상과 전기생리학적 소견)

  • Kwon, Doo-Hyuk;Seok, Jung-Im;Han, Woo-Ho;Lee, Dong-Kuck
    • Annals of Clinical Neurophysiology
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    • v.13 no.1
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    • pp.44-47
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    • 2011
  • Background: Miller-Fisher syndrome (MFS) is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia, and is considered a variant form of Guillain-Barre syndrome. Although some cases of delayed-onset facial palsy in MFS have been reported, the characteristics of this facial palsy are poorly described in the literature. Methods: Between 2007 and 2010, six patients with MFS were seen at our hospital. Delayed facial palsy, defined as a facial palsy that developed while the other symptoms of MFS began to improve following intravenous immunoglobulin treatment, was confirmed in four patients. The clinical and electrophysiological characteristics of delayed facial palsy in MFS, as observed in these patients, are described here. Results: Four patients with delayed-onset facial palsy were included. Delayed facial palsy developed 8-16 days after initial symptom onset (5-9 days after treatment). Unilateral facial palsy occurred in three patients and asymmetric facial diplegia in one patient. The House-Brackmann score of facial palsy was grade III in one patient, IV in two patients, and V in one patient. None of the patients complained of posterior auricular pain. Facial nerve conduction studies revealed normal amplitude in all four patients. The blink reflex showed abnormal prolongation in two patients and the absence of action potential formation in two patients. Facial palsy resolved completely in all four patients within 3 months. Conclusions: Delayed facial palsy is a frequent symptom in MFS and resolves completely without additional treatment. Thus, standard treatment and patient reassurance are sufficient in most cases.