Diagnosis of Peripheral Facial Palsy Associated with Parvovirus B19 Infection by Polymerase Chain Reaction

Human parvovirus B19 (PVB19) infection causes neurological manifestations, including encephalitis, meningitis, and neuropathy, but facial nerve palsy is rare. Moreover, no case of facial nerve palsy related to PVB19 infection that was diagnosed by PCR and serology has been reported. A 19-month-old boy without the medical history developed facial nerve palsy and was treated with prednisolone and valacyclovir. On the 19th day, erythema appeared on his body, and the PVB19-specific IgM and PVB19 DNA were detected in the serum, leading to the diagnosis of infectious erythema associated with PVB19 infection. This case indicates that PVB19 may be one of the causative agents of facial nerve palsy.

Role of Biomarkers as Prognostic Factors in Acute Peripheral Facial Palsy

Acute peripheral facial palsy (APFP), including Bell’s palsy and Ramsay Hunt syndrome, is a disease that affects daily life through facial motor dysfunction, causing psychological problems. Various tests to evaluate prognosis have been studied; however, there are no validated predictive biomarkers to guide clinical decision making. Therefore, specific biomarkers that respond to treatment are required to understand prognostic outcomes. In this review, we discuss existing literature regarding the role of APFP biomarkers in prognosis and recovery. We searched the PubMed, EMBASE, and Cochrane Library databases for relevant papers. Our screening identified relevant studies and biomarkers correlating with the identification of predictive biomarkers. Only studies published between January 2000 and October 2021 were included. Our search identified 5835 abstracts, of which 35 were selected. All biomarker samples were obtained from blood and were used in the evaluation of disease severity and prognosis associated with recovery. These biomarkers have been effective prognostic or predictive factors under various conditions. Finally, we classified them into five categories. There is no consensus in the literature on the correlation between outcomes and prognostic factors for APFP. Furthermore, the correlation between hematologic laboratory values and APFP prognosis remains unclear. However, it is important to identify new methods for improving the accuracy of facial paralysis prognosis prediction. Therefore, we systematically evaluated prognostic and potentially predictive APFP biomarkers. Unfortunately, a predictive biomarker validating APFP prognosis remains unknown. More prospective studies are required to reveal and identify promising biomarkers providing accurate prognosis.

Bilateral facial colliculus syndrome caused by pontine tegmentum infarction: a case report

Background Bilateral facial colliculus syndrome is a rare clinical presentation in patient with pontine infarction. We herein described a case of bilateral facial paralysis and complete horizontal gaze palsy possibly caused by paradoxical embolization from patent foramen ovale related stroke. Case presentation A 55-year-old male presented with sudden onset of complete peripheral facial palsy and horizontal gaze palsy after Valsava maneuver. MRI revealed symmetric involvement of bilateral pontine tegmentum in accordance with the location of facial colliculus. CSF analysis and follow-up MRI showed no evidence of central demyelinating disease. Subsequent echocardiography revealed patent foramen ovale and closure surgery was performed. Conclusions Facial colliculus syndrome with symmetric dorsal pontine tegmentum involvement may a rare manifestation in posterior circulation stroke.

Analysis of Clinical Research Trends for Acupotomy Treatment of Peripheral Facial Palsy

The purpose of this review was to investigate acupotomy treatment for peripheral facial palsy. By reviewing recent clinical trends, this may contribute to standardizing acupotomy treatment methods. There were 7 randomized controlled trials and 6 case series using acupotomy treatment for peripheral facial palsy published between January 01, 2014 and April 05, 2021, which were retrieved from 9 online databases. The number and characteristics of participants, main treatment sites, combination treatments, size of acupotomy needle, frequency and total period of treatment, evaluation indices, efficacy, and adverse events were analyzed. “Tender point or induration,” “infraorbical foramen,” and “buccal mucosa” were the most used treatment sites. The sizes of acupotomy needles varied from 20 mm to 80 mm in length, and 0.35 mm to 1.0 mm in diameter. One treatment cycle was performed every 3 to 5-7 days, and the number of treatments per treatment session ranged from 3 to 5-9 cycles. The results were evaluated using 1 to 4 evaluation indices and 9 different evaluation indices were used overall. The efficacy rate was the most used index, followed by the House-Brackmann grade, and electrocardiography. The “Risk of Bias 2,” categorized most studies as having “some concerns.” There were few adverse events reported.