• Journal of Acupuncture Research
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• 제41권1호
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• pp.53-62
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• 2024

Background: The aim of this study is to determine the correlation between clinical assessment scales, self-assessment scales, and surface electromyography (SEMG) for facial nerve palsy. Methods: This study assessed 32 cases of facial nerve palsy on the first visit, 11 cases on the second visit, and 9 cases on the third visit to the Korean medicine hospital, university. This study was conducted from October 22, 2022, to December 22, 2022. The patients were evaluated using SEMG, clinical assessment scales, and self-assessment scales 3 times. The House-Brackmann grading systems (HBGS), Yanagihara unweighted grading system (Y-score), facial disability index, numerous rating scale, and accompanying symptoms of facial nerve palsy were used for assessment. Moreover, statistical correlation was analyzed using Pearson correlation. Results: On Visit 1, Significant correlations were observed between the results of SEMG and other clinical assessment scales as well as between SEMG-F (frontalis) and different parts of the Y-score. On Visit 2, significant correlations were observed between the results of SEMG and HBGS as well as between SEMG-F and the detailed parts of the Y-score. On Visit 3, significant correlations were observed only between SEMG-F and the detailed parts of the Y-score. A significant correlation was also observed between the changes in the clinical assessment scales on Visits 1 and 3 and between the changes in SEMG-F and those in the patient self-assessment scales. Conclusion: These findings suggest that SEMG can be used to evaluate facial nerve palsy in conjunction with the use of other clinical assessment scales.

• 대한한방내과학회지
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• 제45권3호
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• pp.429-443
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• 2024

Background: The study reports the effect of Korean medicine treatment on a patient with left facial palsy caused by Wegener's granulomatosis. Case information: The patient was receiving steroid treatment for facial palsy and was hospitalized for 21 days. He received acupuncture, electroacupuncture, bee venom pharmacopuncture, and moxibustion treatment along with Ssanghwa-tang and Cheongansohabwon herbal medicine treatment. During hospitalization, the Sunnybrook facial grading scale, House-Brackmann scale and length of time for the eye to completely close were evaluated at 11/16, 11/21, 11/27, 12/1, and 12/6. Post treatment, the degree of the movement in the left eyelid was improved, it took less time for the eye to close completely, the movement of the forehead wrinkle muscles improved, but that of the facial muscles under the eyes and left orbicularis oculi muscle showed little improvement. Conclusion: Korean medicine treatment for facial palsy caused by Wegener's Granulomatosis helps restore mobility of the forehead and orbicularis oculi muscles.

• Journal of Acupuncture Research
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• 제25권2호
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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.

• Journal of Acupuncture Research
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• 제28권1호
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• pp.117-124
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• 2011

Objectives : Bell's palsy is the most common acute facial paralysis but its causes still unclear. At present, one of the most widely accepted cause is viral infections, and generally socioeconomic factors influence the viral infections. The purpose of this study is to investigate the relationship of incidence of facial palsy with socioeconomic factors. Methods : Seventeen patients with a acute facial palsy, who volunteered and completed all of the assessment measures participated. Using data on 17 participants, we examined the independent contribution of education, income, and occupation to a risk factor of severe facial palsy. Severity of global facial impairment was assessed by the facial disability index (FDI), the house-brackmann facial nerve grading system, WHO quality of life - bref (WHOQOL-BREF) and visual analogue scale (VAS) about discomfort of life. Results : There was no correlation between severity of facial palsy and gender, marriage, education, or occupation. Age greater than 60 years (p<0.05), and low monthly income(p<0.05), poor self-rated health was associated with greater severity of idiopathic facial paralysis. Conclusions : The number of subjects with facial palsy in our study (n-17) was small, and therefore generalization to larger patient populations might be unwarranted. But according to the outcome, we suggest that socioeconomic factors, especially low monthly income influence severity of bell's palsy.

• 한방안이비인후피부과학회지
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• 제22권1호
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• pp.148-156
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• 2009

Objectives : Facial palsy is not uncommon disease and most patients with facial palsy are peripheral type, as in Bell' s palsy. In western medicine, oral steroid is the mainstay of the treatment. Recently, oriental-western treatment became one of the alternative modality for the treatment of the facial palsy. However, the treatment result and the degree of patient' s satisfaction were not evaluated. In this study, we tried to characterize the clinical characteristics, short-term recovery rate and degree of patient' s satisfaction after oriental-western medicine treatment on facial palsy of peripheral type. Methods : Between May 2008 and December 2008, we examined 16 patients who presented with facial palsy of peripheral type in Dongguk University Medical Center. Clinical characteristics and recovery rate was analyzed by retrospective chart review. The degree of patient' s satisfaction was measured by 5 point scale. Results : The causes of facial palsy were Bell' s palsy (87.5%) and the Ramsay-Hunt syndrome (12.5%). The highest age groups of facial palsy were 6th and 7th decades. Most frequent accompanying symptom was postauricular pain. After oriental-western medicine treatment, 10 patients (62.5%) showed recovery of facial palsy better than House-Brackmann grade 2. 11 patients (68.8%) were satisfied with the oriental-western medicine treatment. Conclusions : Considering the degree of patient' s satisfaction and treatment result, we believe that oriental-western treatment could be safe and reliable protocol for the treatment of facial nerve palsy of peripheral type.

• 한방안이비인후피부과학회지
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• 제32권3호
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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.

• 대한한방소아과학회지
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• 제37권1호
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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.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.84-90
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• 2018

Objective: To assess the correlation between surface electromyography (SEMG) and conventional EMG in patients with facial nerve palsy. Additionally, compare the discomfort and the time required by the patients in two methods. Method: 36 patients with facial palsy were given nerve conduction studies (NCS) via conventional EMG. Then, the peak root mean square (RMS) values were obtained from the SEMG. We also recorded visual analogue scale (VAS), House-Brackmann scale, and the time required for the examination. Results: Pearson's correlation coefficient between the amplitude loss ratio of the RMS values obtained by SEMG compared to the unaffected side (RSEMG) and the amplitude loss ratio of CMAP amplitudes compared to the unaffected side (RCMAP) was 0.567 at the frontalis, 0.456 at the orbicularis oculi, 0.393 at the nasalis, and 0.437 at the orbicularis oris. An increase in RSEMG is positively correlated with an increase in RCMAP. The mean VAS score with conventional EMG was $3.55{\pm}1.42$, whereas that experienced when using SEMG was $0.11{\pm}0.52$ and the mean time required for conventional EMG was $610{\pm}103.84$ seconds, while that required for SEMG was $420{\pm}86.32$ seconds. Conclusion: This study demonstrated a significant positive correlation between facial muscle activities as measured by SEMG and conventional EMG in patients with facial nerve palsy. SEMG has the benefits of being more comfortable and faster when diagnosing facial palsy.

• Journal of Korean Neurosurgical Society
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• 제30권11호
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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.

• Korean Journal of Acupuncture
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• 제32권4호
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• pp.199-207
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• 2015

Objectives : The purpose of this study is to compare the effects of Hwangryunhaedok-tang pharmacopuncture therapy with Hominis Placenta pharmacopncture therapy in hospitalized patients with peripheral facial paralysis. Methods : We investigated 34 cases of patients with peripheral facial paralysis who were admitted into the Dept. of Acupuncture & Moxibustion of Dongshin University Suncheon Oriental Hospital from February 1, 2014 to June 31, 2015. Subjects were divided into two groups, Hwangryunhaedok-tang pharmacopuncture group(HR group), and Hominis Placenta Pharmacopuncture group(JH group). HR group was treated by Hwangryunhaedok-tang pharmacopuncture five times a week and JH group was treated by Hominis Placenta Pharmacopuncture five times a week. And both groups were treated by acupuncture, electroacupuncture, herbal medicine therapy, western drug therapy equally. To investigate the effectiveness of treatment, we used House-Brackmann Grading System, Yanagihara's unweighted grading system and Sunnybrook facial grading scale at before admission and after admission. Results : Each scores by 3 evaluation methods improved both in two groups. However, there were no significant differences in improvement between two groups. Conclusions : These results suggest that the Hwangryunhaedok-tang pharmacopuncture therapy is as effective as Hominis Placenta pharmacopuncture therapy to improve symptoms of peripheral facial paralysis.