Role of Neuromuscular Electrical Stimulation in Bell’s Palsy: A Case Study of Three Patients

Bell's palsy is an idiopathic, unilateral facial paralysis, caused by a malfunction anywhere along the facial nerve's peripheral portion, from the pons distally. Bell's palsy is treated by removing the cause of nerve injury, strengthening the face muscles, and restoring facial function. Physical therapy in the form of neuromuscular electrical stimulation (NMES), massage and facial exercises is used as adjuvant to hasten recovery. The aim of this study is to access of role of neuromuscular electrical stimulation (NMES) treatment in Bell’s palsy patients. A detailed neurological assessment of three patients was done with emphasis on facial muscles and severity of paralysis was graded according to House Brackmann scale (HBS). Conventional physiotherapy was given in the form of electrical stimulation, facial massage, exercises and functional re-education on a daily basis. Patients were assessed at weekly and 1months after the treatment. They experienced complete recovery within 1month follow-up, no recurrence was observed and all patients have normal facial movement. Physiotherapy in the form of NMES and facial exercises has a effective role in the early management of Bell’s palsy. Keywords: Bell’s palsy; neuromuscular electrical stimulation; House Brackmann scale; physiotherapy.

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

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj2209032021 ◽

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).

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ROLE OF AYURVEDA IN THE MANAGEMENT OF ARDITA (BELL’S PALSY) – A CASE REPORT

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj4709082021 ◽

2021 ◽

Vol 9 (8) ◽

pp. 1898-1903

Author(s):

Seema Bahatkar ◽

Rajiv Tarpe ◽

Kinjal H. Daiyya

Keyword(s):

Signs And Symptoms ◽

Bell’S Palsy ◽

Point Of View ◽

Bell's Palsy ◽

Oral Medications ◽

Angle Deviation ◽

The Face ◽

Ayurvedic Treatment ◽

Modern Perspective

Ardita is considered as one amongst the vata nanatmaj vyadhis described in Ayurvedic classics. Ardita is a condition caused due to the unusual functioning of vata dosha which results in loss of functioning of one half of the face. It can be correlated with Bell's Palsy from modern perspective. This disease proves to be disturbing from a functional and cosmetic point of view. A 27year old male patient came to OPD with a chief complaint of difficulty in closing right eye, angle deviation of the mouth towards left, difficulty while eating, unable to whistle as well as puffing of cheeks, drooling of saliva, etc. from 20 days. History and examination lead to the diagnosis of Bell's Palsy. Consid- ering the signs and symptoms, the patient was treated as per the ayurvedic line of treatment for Ardita. The patient was admitted and ayurvedic treatment (Panchakarma + Oral medications) i.e. Nasya, Pindasweda, Kukkutanda sweda, Akshitarpan was given for 21days. The patient had great relief with marked improvement in the above said symptoms. Thus, Ayurveda is fruitful in treating patients with Ardita. Keywords: Ardita, Nasya, Pindasweda, Kukkutanda sweda, Akshitarpan

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Role of Vitamin D Deficiency on The Onset and Prognosis of Bell’s Palsy

ENT Updates ◽

10.32448/entupdates.814569 ◽

2020 ◽

Author(s):

Emre OCAK ◽

Muhammed Sefa UYAR ◽

Deniz KOCAOZ ◽

Emre MİRİCİ ◽

Aydın ACAR

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Bell’S Palsy ◽

Bell's Palsy

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Migraine Abort Therapy Using Neuromuscular Electrical Stimulation, A Study on the Role of NO and Cerebellum in the Migraine Pathophysiology

10.24947/baojn/2/2/120 ◽

2016 ◽

Vol 2 (2) ◽

Author(s):

Yurisaldi SA

Keyword(s):

Electrical Stimulation ◽

Neuromuscular Electrical Stimulation ◽

Migraine Pathophysiology

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Clinical Study of Bell's Palsy at Tertiary Care: Our Experience

Annals of Otology and Neurotology ◽

10.1055/s-0039-1693096 ◽

2019 ◽

Vol 02 (01) ◽

pp. 16-20

Author(s):

M. B. Bharathi ◽

Thanzeem Unisa ◽

Swathi Chandresh ◽

Venkatesh C. R. ◽

Harsha S.

Keyword(s):

Facial Nerve ◽

Tertiary Care ◽

Bell’S Palsy ◽

Cross Sectional Study ◽

Bell's Palsy ◽

Cross Sectional ◽

Tertiary Referral Center ◽

Number Of Patients ◽

The Face ◽

History Of

Abstract Introduction Bell's palsy (BP) is the common cause of facial palsy. This study aims to report and analyze the age, sex distribution, symptomatology, site of lesion, and prognosis in 101 patients with (BP). Materials and Methods This is a cross-sectional study conducted at tertiary referral center, JSS Hospital, Mysuru. All patients consenting to participate in this study, of all ages, of either sex, both outpatients and inpatients with a diagnosis of BP during this study period were included. Results Of the 101 patients analyzed, maximum cases (25.7%) were in third decade of age; 55.4% were males, and both right and left sides of the face were equally involved. Maximum number of patients (50.5%) had a history of postaural pain at presentation Topodiagnostic tests showed majority of BP cases involving geniculate or suprageniculate regions (67.3%) in our study. 20.8% had lesion above the nerve to stapedius, and 11.9% had lesion below the nerve to stapedius. Electrodiagnostic test—electroneuromyography (ENMG)—was abnormal in 57 (67.1%) individuals at day 4. 50.4% of patients had a House-Brackmann (HB) facial nerve grade IV at presentation. 90% of the BP group in our study recovered normal to near-normal facial nerve function by the end of 28 days’ time. Conclusion Each case of BP should be evaluated with thorough clinical examination, topodiagnostic tests, and electrodiagnostic tests. Appropriate management will help in almost full recovery of disease.

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

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/6073484 ◽

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.

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EFFICACY OF FUNCTIONAL NEUROMUSCULAR ELECTRICAL STIMULATION (FNMES) IN THE IMPROVEMENT OF HAND FUNCTIONS IN ACUTE STROKE SURVIVALS

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703606 ◽

2012 ◽

Vol 02 (04) ◽

pp. 16-21

Author(s):

Mohamed Faisal C. K. ◽

Priyabandani Neha Om Prakash ◽

Ajith S.

Keyword(s):

Electrical Stimulation ◽

Acute Stroke ◽

Hand Function ◽

Neuromuscular Electrical Stimulation ◽

Control Group ◽

Stroke Patients ◽

Hand Functions ◽

Conventional Physiotherapy ◽

Block Test ◽

Experimental Group

AbstractStroke is a worldwide health problem. Hand function is one of the important factors which are affected in stroke. Stroke patients are usually given a conventional physiotherapy but if an additional FNMES is given it might show better improvement. By keeping these facts in view, the present study aims at evaluating and comparing the efficacy of conventional physiotherapy and adding FNMES will make any better outcome in the acute stroke survivals. The subjects were randomly assigned to any of the two groups; control group consisted of 15 subjects who received only conventional therapy for 4 weeks and experimental group consisting of 15 subjects who received an additional FNMES along with conventional physiotherapy for 4 weeks. The hand function was assessed on day 1 and to know the recovery, at the end of four weeks of intervention with the help of action research arm test (ARAT) and box and block test (BBT). At the end of 4 weeks of intervention both the groups showed significant improvements. On ARAT, control group showed a mean of 10.2000 whereas, experimental group showed mean of 20.8000 with p = 0.001 (p ≤ 0.05) and on BBT, the control group showed a mean of 21.666 and experimental group showed 30.933 with p = 0.41 (p ≤ S 0.05). Therefore the study concludes that, though there was improvement in both the groups, the experimental group who received an additional FNMES along with conventional physiotherapy showed better improvement in hand functions in the acute stroke survivals.

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