Ipsilateral Acoustic-Reflex Adaptation Testing for Detection of Facial-Nerve Pathology

1988 ◽  
Vol 53 (4) ◽  
pp. 378-382 ◽  
Author(s):  
Shlomo Silman ◽  
Carol A. Silverman ◽  
Stanley A. Gelfand ◽  
John Lutolf ◽  
Deborah J. Lynn

Abnormal acoustic-reflex adaptation monitored in the same ear for both contralaterally and ipsilaterally presented tonal activators is reported in three cases. One case had Bell's palsy, whereas the other two cases had no clinically observable evidence of seventh-nerve involvement. These cases show that the existence of abnormal acoustic-reflex adaptation in the absence of Bell's palsy does not necessarily implicate the presence of eighth-nerve pathology.

1988 ◽  
Vol 97 (6_suppl3) ◽  
pp. 14-17 ◽  
Author(s):  
Naoaki Yanagihara ◽  
Shinji Kitani ◽  
Kiyofumi Gyo

Combined measurements of reflexive lacrimation, stapedial reflex, and electrically induced taste give an indication of the site and extent of infratemporal lesions of the facial nerve. Using refined test batteries, we established the presence of intratemporal lesions in Bell's palsy in 80 patients with facial paralysis. In the acute stage of Bell's palsy, suprastapedial lesions predominated and the occurrence of a suprageniculate lesion was not rare. In the subacute stage, the lesions proximal to the stapedial nerve tended to subside and infrastapedial lesions increased. In 60% of 53 patients with denervation verified by electrodiagnostic examinations, the suprastapedial lesion was responsible for degeneration of the nerve. In the other 40%, degeneration involved the infrastapedial segment.


1984 ◽  
Vol 42 (4) ◽  
pp. 341-345 ◽  
Author(s):  
J. A. Bueri ◽  
L. G. Cohen ◽  
Marcela E. Panizza ◽  
Olga P. Sanz ◽  
R. E. P. Sica

A group of patients with Bell's palsy were studied in order to disclose the presence of subclinical peripheral nerve involvement. 20 patients, 8 male and 12 female, with recent Bell's palsy as their unique disease were examined, in all cases other causes of polyneuropathy were ruled out. Patients were investigated with CSF examination, facial nerve latencies in the affected and in the sound sides, and maximal motor nerve conduction velocities, as well as motor terminal latencies from the right median and peroneal nerves. CSF laboratory examination was normal in all cases. Facial nerve latencies were abnormal in all patients in the affected side, and they differed significantly from those of control group in the clinically sound side. Half of the patients showed abnormal values in the maximal motor nerve conduction velocities and motor terminal latencies of the right median and peroneal nerves. These results agree with previous reports which have pointed out that other cranial nerves may be affected in Bell's palsy. However, we have found a higher frequency of peripheral nerve involvement in this entity. These findings, support the hypothesis that in some patients Bell's palsy is the component of a more widespread disease, affecting other cranial and peripheral nerves.


2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
L. M. Marques ◽  
J. Pimentel ◽  
P. Escada ◽  
G. Neto D'Almeida

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Akira Inagaki ◽  
Sachiyo Katsumi ◽  
Shinji Sekiya ◽  
Shingo Murakami

AbstractIn Bell’s palsy, electrodiagnosis by electroneurography (ENoG) is widely used to predict a patient’s prognosis. The therapeutic options for patients with poor prognostic results remain controversial. Here, we investigated whether early intervention with intratympanic steroid therapy (ITST) is an effective treatment for Bell’s palsy patients with poor electrodiagnostic test results (≤ 10% electroneurography value). Patients in the concurrent ITST group (n = 8) received the standard systemic dose of prednisolone (410 mg total) and intratympanic dexamethasone (16.5 mg total) and those in the control group (n = 21) received systemic prednisolone at the standard dose or higher (average dose, 605 ± 27 mg). A year after onset, the recovery rate was higher in the ITST group than in the control group (88% vs 43%, P = 0.044). The average House-Brackmann grade was better in the concurrent ITST group (1.13 ± 0.13 vs 1.71 ± 0.16, P = 0.035). Concurrent ITST improves the facial nerve outcome in patients with poor electroneurography test results, regardless of whether equivalent or lower glucocorticoid doses were administered. This may be ascribed to a neuroprotective effect of ITST due to a higher dose of steroid reaching the lesion due to dexamethasone transfer in the facial nerve.


BMC Neurology ◽  
2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Ru-Lan Hsieh ◽  
Chia-Wei Wu ◽  
Ling-Yi Wang ◽  
Wen-Chung Lee

1995 ◽  
Vol 104 (7) ◽  
pp. 574-581 ◽  
Author(s):  
Toshiaki Sugita ◽  
Yasuo Fujiwara ◽  
Shingo Murakami ◽  
Yoshinari Hirata ◽  
Naoaki Yanagihara ◽  
...  

We have been the first to succeed in producing an acute and transient facial paralysis simulating Bell's palsy, by inoculating herpes simplex virus into the auricles or tongues of mice. The KOS strain of the virus was injected into the auricle of 104 mice and the anterior two thirds of the tongue in 30 mice. Facial paralysis developed between 6 and 9 days after virus inoculation, continued for 3 to 7 days, and then recovered spontaneously. The animals were painlessly sacrificed between 6 and 20 days after inoculation for histopathologic and immunocytochemical study. Histopathologically, severe nerve swelling, inflammatory cell infiltration, and vacuolar degeneration were manifested in the affected facial nerve and nuclei. Herpes simplex virus antigens were also detected in the facial nerve, geniculate ganglion, and facial nerve nucleus. The pathophysiologic mechanisms of the facial paralysis are discussed in light of the histopathologic findings, in association with the causation of Bell's palsy.


Author(s):  
Gabriel Toye Olajide ◽  
Waheed Atilade Adegbiji ◽  
Akinwale Olaleye Akinbade ◽  
Anthony Oyebanji Olajuyin ◽  
Paul Olowoyo

Background/Aim: Facial nerve palsy may cause facial asymmetry, functional and cosmetic impairment, and therefore imposes great psychological and social problems on the individual with the condition. The aim of this paper was to highlight the aetiological profile of facial nerve palsy (FNP) in two tertiary institutions in Ekiti, southwest, Nigeria. Methods: This was a retrospective review of patients with facial nerve palsy seen and treated at Ear, Nose & Throat (ENT) clinic. All folders and registers of patients diagnosed with facial nerve palsy from January 2010 to December 2019 in the central, ENT and Dental medical records departments were retrieved and reviewed. The information extracted included the socio-demographic characteristics of the patients, clinical presentation, type and aetiology of FNP, side affected, diagnosis/impression, nature of impairment, type of lesion, onset of the disease, treatment and outcome. Results: Of 76 patients analysed, 48(63.2%) were males and 28(36.8%) were females given a male to female ratio of 1:1.7. Their age ranged between 5 to 72 years with a mean of 39.83 ± 17.58 SD. The age range 21-40 years was most commonly affected, representing 31 (40.8%). The commonest cause of facial nerve paralysis was Bell’s palsy in 32(42.1%), followed by trauma 28(36.9%). Of the 28 (36.9%) that was caused by trauma, road traffic injury constituted 15(53.6%). Half (50.0 %) of the lesion affected right side of the face. Seventy (92.1%) was treated medically. Majority (37.0%) presented within one week of their symptoms. All the patients presented with deviation of mouth, followed by inability to close eye in 70 (92.1%). Higher proportion (88.2%) of our patients had lower motor neuron lesion. Conclusion: This study found that majority of our patients was young adults. Bell’s palsy was a major cause of facial nerve paralysis followed by trauma. Most of our patient presented early and did well on conservative treatment. High index of suspicion is essential especially when patients present with injuries involving head and neck region.


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