• Title/Summary/Keyword: paralysis of facial nerve

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Comparison between Subjective Scoring and Computer-Based Asymmetry Assessment in Facial Nerve Palsy

  • Lee, Doh Young;Kim, Hyun Seok;Kim, So Young;Park, Kwang Suk;Kim, Young Ho
    • Korean Journal of Audiology
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    • v.23 no.1
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    • pp.53-58
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    • 2019
  • Background and Objectives: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). Subjects and Methods: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. Results: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p<0.001). The PC-FAAP was significantly more consistent in group I and group III (p<0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). Conclusions: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

A Case of Varicella-Zoster virus infection with multiple cranial nerve involvement (다발성 하부뇌신경을 침범한 대상포진 감염 치험 1례)

  • Shin, Jung-Eun;Yoo, Seung-Joo;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.222-230
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    • 1999
  • Varicella-zoster virus(VZV) becomes latent in the sensory ganglia after primary infection and emerges from latency to cause zoster in adults. After primary infection, VZV remains latent in the dorsal spinal ganglia. The mechanisms responsible for its reactivation and the clinical entity of herpes zoster are poorly understood. Reactivation of VZV is commonly known to manifest as Ramsay Hunt syndrome which is one of the VZV-associated neurologic diseases with facial paralysis, ear pain, and a characteristic herpetic auricular rash. It is now known that lesions of this syndrome can affect all cranial nerves. Central, cervical and peripheral effects of this syndrome is polyneuropathic in nature. VZV usually involves the 5th and 7th cranial nerves and less commonly the lower cranial nerves such as 9th and 10th. We report a treated case of healthy 40 years old male with VZV infection of the 5th, 9th and 10th cranial nerves. The patient typically showed herpetic vesicles in the auricle and temporal bone area without facial paralysis.

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A Clinical Study of Facial Paralysis (안명신경 손상 환자의 임상적 고찰)

  • Huh, Choon-Bok;Suh, Tae-Soo
    • Journal of Korean Physical Therapy Science
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    • v.5 no.3
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    • pp.643-650
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    • 1998
  • Facial nerve is subject to injury at any point in the course from the cerebral cortex to the motor end plate in the face, so many etiologic varieties of facial paralysis may be encountered, including trauma, viral infection and the idiopathic. Authors have studied 39 cases of facial paralysis which had experienced of treatment in our department from March, 1996 to March, 1997 at Dong San Medical Center. The results obtained are as follows : 1) The highest age incidence showed 10 cases(24.6%) in 3rd decade 2) Among the total of 39 cases, male were 21 cases(53.8%) and female were 18cases(46.2%). 3) At the involved side, left side were 19 cases(48.7%) and right side were 18 cases(46.2%). 4) The causes of facial paralysis were; idiopathic (Bell's palsy) in 19 cases(48.7%) infectious in 6 cases(15.4%) neoplastic in 6 cases(15.4%) traumatic in 5 cases(12.9%) metabolic in 2 cases(5.1%) congenital in 1 cases(2.6%) 5) In time interval between onset of symptom and treated initial date, 26 cases(66.7%) in below 10 days and 8 cases(20.5%) in 11-20 days 6) Correlation of recovery rate according to the treated duration did not differ significantly 7)Result after treatment were satisfactory

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Correlation between Surface Electromyography and Conventional Electromyography in Facial Nerve Palsy (안면마비 환자에서 표면 근전도 검사와 통상적 근전도 검사간 상관관계)

  • Jang, Haneul;Yoo, Seung Don;Lee, Jong Ha;Soh, Yunsoo;Kim, Dong Hwan;Chon, Jinmann;Lee, Seung Ah;Kim, Hee-Sang;Yun, Dong Hwan;Kwon, Jung Ho
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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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.

Melkersson-Rosenthal Syndrome -Report of a Case- (Melkersson-Rosenthal Syndrome -증례보고-)

  • Kim, Tae-Jung;Park, Wook;Lee, Sung-Keun;Kim, Il-Ho;Song, Hu-Bin;Hwang, Kyung-Ho;Kim, Sun-Chong;Kim, Sung-Yul
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.57-60
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    • 1989
  • The Melkersson-Rosenthal (M-R) syndrome consists of a triad of (1) recurrent peripheral facial nerve paralysis which develops alternately on both sides of face, (2) non-inflammatory facial edema, and (3) fissuring of tongue. A 59 years old female patient developed the left facial palsy on September, 1988. Right facial palsy developed continuously 2 months later after the spontaneous remission of left facial palsy. On February, 1989, we have found out M-R syndrome which accompanied with migraine type of intermittent headache, and hypertension in one attack of cerebral stroke several years ago, there were no diabetes mellitus, pulmonary tuberculosis and brain tumor in clinical studies. Although the causes of this syndrome were not noted, we performed the stellate ganglion block and transcutaneous electrical nerve stimulation for treatment of the palsy, but the clinical effectiveness of these were not satisfactory.

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Botulinum Toxin Therapy versus Anterior Belly of Digastric Transfer in the Management of Marginal Mandibular Branch of the Facial Nerve Palsy: A Patient Satisfaction Survey

  • Butler, Daniel P;Leckenby, Jo I;Miranda, Ben H;Grobbelaar, Adriaan O
    • Archives of Plastic Surgery
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    • v.42 no.6
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    • pp.735-740
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    • 2015
  • Background Botulinum toxin (BT) chemodenervation and anterior belly of digastric muscle (ABD) transfer are both treatment options in the management of an isolated marginal mandibular branch of the facial nerve (MMB) palsy. We compare the patient satisfaction following either BT injections or ABD transfer in the management of their isolated MMB palsy. Methods Patients in the ABD-arm of the study were identified retrospectively from September 2007 to July 2014. The patients in the BT-arm of the study were identified prospectively from those attending the clinic. Both groups of patients completed a validated patient satisfaction survey. Statistical analysis was performed and a P-value <0.05 was considered statistically significant. Results Seven patients were in the ABD-arm and 11 patients in the BT-arm of the study. The patient satisfaction in both groups was high with 45% of ABD-arm patients and 40% of BT-arm patients rating their overall outcome as 'better' or 'much better', which was significantly more than the proportion rating their outcome as 'worse' or 'much worse' (P<0.001), although there was a significant trend towards those in the ABD-arm being more likely to be dissatisfied with their outcome (P=0.01). Conclusions BT therapy is a good first-line intervention in the management of isolated MMB palsy. We have, however, shown that the overall satisfaction in both groups is high. Therefore, in patients who would prefer a more permanent solution to manage their facial asymmetry, ABD transfer remains a satisfactory treatment option with a good level of patient satisfaction.

A Case of Ramsay Hunt Syndrome with Aseptic Meningitis (무균성 뇌수막염을 동반한 Ramsay Hunt 증후군 1례)

  • Yi, Yeon Yul;Choi, Sung Dong;Jeung, Seung Yeon;Suh, Byung Kyu;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.298-302
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    • 1997
  • Ramsay Hunt syndrome is a viral associated disease with severe otalgia, vertigo, fever, herpetic eruptions on either side of the external auditory meatus and cavum concha, ipsilateral facial nerve palsy and cochleovestibular dysfunction. This syndrome may be the most common cause of unilateral facial paralysis and involvement of both the vestibular and cochlear branch of 8th cranial nerve. And loss of taste sensation may be developed in same involement site. This syndrome affects adults in most cases, and a samll number of children with herpes zoster oticus have been reported. And concomittantly CNS invlovement of this snydrome is very rare. We experienced a 7 years old aged patient of Ramsay Hunt syndrome who had evidence of aseptic meningitis, and this patient showed well reponses with Acyclovir and symptomatic therapy. So, we report this case with brief review of related literatures.

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Ramsay-Hunt Syndrome involving the 2nd, 3rd cervical ganglia (경부 2, 3번 피부절을 침범한 Ramsay-Hunt 증후군 1례)

  • Lee, Chung Seok;Choi, Yong Seok;Song, Eun Hyang;Kim, Jeung Mee;Han, Jeong Ho;Kim, Doo Eung
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.85-88
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    • 2002
  • Ramsay-Hunt syndrome is a viral disease associated with peripheral facial nerve paralysis accompany by erythematous vesicular rashs on the ear(zoster oticus) or in the mouth. Based on clinical presentations that indicated involvement of more than one ganglion, the gasserian, geniculate, petrous, accessory, jugular and second and third dorsal root ganglia comprised a chain in which inflammation of a single ganglion could extend to nearby ganglia. A 71-year-old man presented with left. peripheral facial palsy with otalgia, vesicular eruption in $V_2$, $V_3$, C2, C3 dermatome, tinnitus, and hearing loss.

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Complete denture rehabilitation of a fully edentulous patient with unilateral facial nerve palsy: A case report (편측성 안면 신경마비 환자에서의 총의치 수복 증례)

  • Choi, Eunyoung;Lee, Ji-Hyoun;Choi, Sunyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.4
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    • pp.451-457
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    • 2017
  • Bell's palsy is an acute-onset unilateral peripheral facial neuropathy. For patients with sequelae of facial paresis, the successful rehabilitation of fully edentulous arches is challenging. This case report described the treatment procedures and clinical considerations to fabricate complete dentures of a patient who showed unilateral displacement of mandible, unilateral chewing pattern and parafunctional jaw movement due to sequelae of Bell's palsy. Gothic arch tracing was used to record reproducible centric relation and lingualized occlusion was performed to provide freedom to move between centric relation and the patient's habitual functional area in fabricating satisfactory dentures in terms of function and esthetics.

Eight and a Half Syndrome: A Clinical Study of 2 Cases (8과 1/2 증후군 2례)

  • Park, Ji-Min;Kim, Jong-Han;Yoo, Je-Hyuk;Yoon, Ga-Young;Nam, Dong-Woo;Lee, Sang-Hoon;Kim, Jong-In
    • Journal of Acupuncture Research
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    • v.29 no.3
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    • pp.139-148
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    • 2012
  • Objectives : The purpose of this case is to report the improvement of two patients diagnosed with eight and a half syndrome after combination therapy of oriental and western medicine. Methods : We treated the patients with combination therapy of oriental and western medicine such as acupuncture, moxibustion, herbal medication, antithrombotic agents and steroid therapy. Changes of peripheral facial paralysis were evaluated using House-Brackmann facial grading system and the degree of dizziness, tenderness and pain of upper abdomen were assessed using numerous rating scale. Changes in motor grade of upper and lower extremities were evaluated using medical research council scale. Results : We have recently experienced two cases of eight and a half syndrome - a syndrome characterized by the coexistence of one and a half syndrome, a rare ophthalmoparetic syndrome characterized by a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other, and cranial nerve VII palsy. The one and a half syndrome was caused by acute cerebral infarction. Two patients in this report were improved through combination therapy of oriental and western medicine. Conclusions : We report the clinical course and treatment methods of eight and a half syndrome.