scholarly journals Association of Patients’ Characteristics with Acupuncture Treatment Outcomes in Treating Bell’s Palsy: Results from a Randomised Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Xianjun Xiao ◽  
Qianhua Zheng ◽  
Yunzhou Shi ◽  
Leixiao Zhang ◽  
Ling Zhao ◽  
...  
Keyword(s):  
Acupuncture Treatment ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Complete Recovery ◽  
Bell’S Palsy ◽  
Acute Stage ◽  
Chorda Tympani ◽  
Bell's Palsy ◽  
Significant Difference ◽  
Multicenter Randomized Controlled Trial

Background. Acupuncture has been found to be effective for treating Bell’s palsy (BP). However, which class of BP patients will have a better response to acupuncture remains uncertain and requires investigation. Methods. We performed a secondary analysis of a multicenter, randomized, controlled trial. BP patients were randomly divided into five acupuncture treatment groups. The degree of facial nerve recovery was assessed according to the House–Brackmann grading system (HB grade). Grade I was defined as complete recovery (CR), and grades II–VI were defined as incomplete recovery (IR). The relevant patient characteristics were collected and compared between CR and IR groups by univariate and logistic regression analyses. Results. Eight-hundred twenty-six subjects were analyzed. Among these, 698 (85%) subjects had a good prognosis. No significant difference in the effectiveness of the five treatments was observed (all P>0.05). The likelihood of IR increased by 2.2% with each one-year increase in age (odds ratio (OR) 1.022, 95% confidence interval (CI) 1.005–1.038; P=0.009). The likelihood of IR increased by 9% with each kg/m2 increase in BMI (OR 1.090, 95% CI 1.019–1.165; P=0.012). The likelihood of IR at the recovery stage was higher than that at the acute stage (OR 7.996, 95% CI 4.570–13.991; P<0.001), and the likelihood of IR of patients with lesions at or above the chorda tympani was higher than that of patients with lesions below the chorda tympani (OR 1.989, 95% CI 1.256–3.150; P=0.003). The likelihood of IR increased by 281.7% with each unit increase in the HB grade (OR 2.817, 95% CI 2.113–3.756; P<0.001). Conclusions. Younger patients at the acute stage of the disease with low BMIs, low initial HB grades, and lesions below the chorda tympani were more likely to respond to acupuncture.

Pathogenesis of Bell's Palsy

1977 ◽  
Vol 86 (4) ◽  
pp. 549-558 ◽  
Author(s):  
Ruth Gussen
Keyword(s):  
Facial Nerve ◽  
Complete Recovery ◽  
Bell’S Palsy ◽  
Facial Canal ◽  
Chorda Tympani ◽  
Bell's Palsy ◽  
Nerve Branch ◽  
Collagen Formation ◽  
Myelin Sheaths ◽  
Metabolic Exchange

The pathogenesis of Bell's palsy is presented as retrograde epineurial compression edema with ischemia of the facial nerve. Although the etiology is unknown, an attractive theory is vasospasm, from any cause, along any facial nerve branch, with the chorda tympani, perhaps, the usual primary involvement. Retrograde vascular distension and edema, within the epineurium of the bony facial canal, compresses the nerve from outside its perineurial sheath. The compression force may be mild or severe, resulting in varying degrees of reversible or irreversible ischemic degeneration of myelin sheaths and axons, with varying degrees of cellular reaction to myelin breakdown. The edema may be resorbed, leaving reversible or irreversible nerve damage, or may stimulate collagen formation within the epineurium, with persisting fibrous compression (entrapment) neuropathy of the facial nerve. This concept is consistent with the varying results of Bell's palsy, and depends on the severity and duration of edema, and whether fibrosis occurs within the epineurium of the facial canal. Epineurial fibrosis also results in disturbance of metabolic exchange through the epineurial-permeurial-endoneurial tissues, and may ultimately result in obliteration of vascular drainage. Two temporal bone cases of Bell's palsy, one occurring ten years before death, with residual paralysis. and one two years before death, with clinical recovery, are added to the previously described four cases in the literature, three of early Bell's palsy, and one of remote palsy with almost complete recovery.

scholarly journals Protocol for randomized controlled trial of electric stimulation with high-volt twin peak versus placebo for facial functional recovery from acute Bell’s palsy in patients with poor prognostic factors

2020 ◽  
Vol 7 ◽  
pp. 205566832096414
Author(s):  
Myriam Loyo ◽  
Margaret McReynold ◽  
Jess C Mace ◽  
Michelle Cameron
Keyword(s):  
Poor Prognosis ◽  
Electric Stimulation ◽  
Controlled Trial ◽  
Complete Recovery ◽  
Bell’S Palsy ◽  
Controlled Study ◽  
Bell's Palsy ◽  
High Quality ◽  
Patient Reported ◽  
Peak Versus

Background Electric stimulation (ES) can prevent muscle atrophy and promote tissue healing and therefore may help prevent sequelae of Bell’s palsy but due to lack of high-quality studies, the effectiveness of ES in Bell’s palsy remains controversial. Here we describe a protocol to evaluate the effects of monophasic high volt ES in patients with Bell’s palsy and poor prognosis for recovery. Results This is a protocol for a prospective, double-blinded, randomized, placebo-controlled study. Participants include adults with acute Bell’s palsy with poor prognosis for full recovery due to complete paralysis or being over age 60. ES will be a monophasic, high-volt pulsed waveform, 100μsec pulse duration, 35 hertz, motor-level intensity. Follow up will be at months 1, 2, 3 and 6. The primary outcome will be the proportion of patients with complete recovery using the eFACES tool. Secondary outcomes include patient reported quality of life measured by FaCE and the synkinesis assessment questionnaires, objective photographs, time to complete recovery, adverse effects, and tolerability. Conclusion This protocol has the potential to provide high quality evidence regarding the effects, up to 6 months after onset, of pulsed monophasic high-volt ES for patients with acute Bell’s palsy and poor prognosis for complete recovery.

scholarly journals COMPLETE MANAGEMENT OF ARDITA (BELL’S PALSY) AS PER AYURVEDA CHIKITSA SUTRA – A CASE REPORT

2021 ◽  
Vol 09 (3) ◽  
pp. 650-656
Author(s):  
Ram Lakhan Meena ◽  
Santoshkumar Bhatted ◽  
Nilam Meena
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Facial Nerve ◽  
Present Report ◽  
Complete Recovery ◽  
Bell’S Palsy ◽  
Bell's Palsy ◽  
Contemporary Science ◽  
The Face ◽  
Grading Scale

Bell’s palsy, also known as acute idiopathic lower motor neuron facial paralysis, is characterized by sud-den onset paralysis or weakness of the muscles to one side of the face controlled by the facial nerve. In contemporary science, administration of steroids is the treatment of choice for complete facial palsy. Cer-tain Panchakarma procedures and internal Ayurvedic medicines have been proved to be beneficial in the management of Ardita vata. The present report deals with a case of 62-year-old male patient diagnosed as Ardita vata was treated with various Panchakarma procedures like Nasya, Shirobasti, Kukkutanda Swedana, Dashmoola Ksheer Dhoom, Gandoosh and oral Ayurveda medicines. Criteria of assessment was based on the scoring of House-Brackmann Facial Nerve Grading scale. After completion of Ayurveda treatment, the patient Shown almost complete recovery without any adverse effects. This case is an evi-dence to demonstrate the effectiveness of Ayurveda treatment in case of Ardita vata (Bell’s palsy).

scholarly journals Comparative Review of the Correlation Between Electroneurography, Electromyography, Hematology Tests, or the Heart Rate Variability Test, with an Improvement in the Severity of Bell’s Palsy Symptoms

2021 ◽  
Vol 38 (3) ◽  
pp. 192-199
Author(s):  
Ji-Min Hwang ◽  
Jun-Yeon Kim ◽  
Ha-Na Kim ◽  
Kyeong-Ju Park ◽  
Min-Gi Jo ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Negative Correlation ◽  
Bell’S Palsy ◽  
Nerve Degeneration ◽  
Total Power ◽  
Mean Corpuscular Hemoglobin ◽  
Bell's Palsy ◽  
Comparative Review ◽  
Significant Difference

Background: In this retrospective study, we aimed to determine which diagnostic tests were associated with an improvement in Bell’s palsy symptoms. Methods: There were 30 patients who visited Kyung Hee University Korean Medicine Hospital from April 1, 2017 to February 29, 2020, and who received East-West collaboration treatment for Bell’s palsy. The tests included electroneurography (ENoG), electromyography (EMG), hematology, and heart rate variability (HRV) results which were used to determine if any test correlated with improvement of Bell’s palsy symptoms. Results: The initial severity of symptoms did not correlate with the tests performed, with the exception of mean corpuscular hemoglobin concentration (p = 0.013). For both ENoG for oculi degeneration and mean EMG tests, the rate of nerve degeneration showed a significant negative correlation with the improvement of Bell’s palsy symptoms. Amongst the HRV test indicators, the square root of the mean of the sum of the squares of differences between the adjacent normal R-R wave interval, the standard deviation of intervals, total power, very low frequency, and high frequency of the wave was negatively correlated with improvement of Bell’s palsy symptoms. Similarly, glycosylated hemoglobin Type A1c (HbA1c) and erythrocyte sedimentation rate (ESR) showed a negative correlation with improvement of symptoms of Bell’s palsy. With the exception of HbA1c and ESR, the remaining hematology test results showed no significant difference when comparing before and after treatment. Conclusion: ENoG, EMG, HRV test, HbA1c, and ESR negatively correlated with improvements in Bell’s palsy symptoms and may determine the prognosis of Bell’s palsy.

scholarly journals Efficacy of Manipulative Acupuncture Therapy Monitored by LSCI Technology in Patients with Severe Bell’s Palsy: A Randomized Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Weizheng Zhong ◽  
Haibo Yu ◽  
Xiaodan Rao ◽  
Jianhuang Wu ◽  
Yanhua Gou ◽  
...  
Keyword(s):  
Acupuncture Therapy ◽  
Facial Palsy ◽  
Recovery Rate ◽  
Therapy Group ◽  
Controlled Trial ◽  
Blood Perfusion ◽  
Bell’S Palsy ◽  
Laser Speckle ◽  
Bell's Palsy ◽  
Contrast Imaging

To determine if the effect of manipulative acupuncture monitored by laser speckle contrast imaging (LSCI) can improve facial blood perfusion in patients with severe Bell’s palsy. This randomized, single-blind, controlled trial included 120 newly diagnosed patients (within 14 days) with severe Bell’s palsy (House–Brackmann grading system (HBGS) ≥ grade IV). The patients were randomized (1 : 1) to receive either acupoints acupuncture combined with manipulations of twirling, lifting, and thrusting treatments (manipulative acupuncture) or acupoints acupuncture therapy alone (simple acupuncture). These treatments consisted of a total of 24 sessions, three times per week, and each treatment lasted for 30 min. Following 8 weeks of treatment and 6 months after the initial onset of facial palsy, facial nerve functioning was scored (HBGS) and clinical efficacy was measured. The patients’ facial blood perfusion significantly improved following manipulative acupuncture assisted by LSCI compared with that at baseline ( P < 0.01 ). At the conclusion of the 8-week treatment, both groups showed improvement; however, the recovery rate was significantly different (manipulative acupuncture 53.3% vs. simple acupuncture 33.9%, P < 0.05 ). Follow-up analysis at 6 months after the onset of facial palsy revealed a significantly higher recovery rate (91.7% vs. 78.0%; P < 0.05 ). In addition, the number of treatments in the observation group was less than that in the simple acupuncture therapy group ( P < 0.05 ). Compared with simple acupuncture therapy, manipulative acupuncture therapy led to a more significant recovery rate in the treatment of severe Bell’s palsy and required a shorter course of treatment. This trial was registered with ChiCTR1800019463.

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