Wrist Ankle Acupuncture (WAA) and Body Acupuncture Accelerates Neurorehabilitation in Bell's Palsy: A Case Report

Bell’s Palsy (BP) is an acute unilateral facial paralysis due to idiopathic inflammation of the peripheral facial nerve. Corticosteroids, antiviral drugs, and physical therapy could be useful to treat BP, however these treatments could not bring complete recovery. Acupuncture could be an alternative option for BP and to show its effectiveness, we present a case report, a patient with BP treated with acupuncture. A 48-year-old female patient, a kindergarden teacher, already treated with corticosteroid and antiviral agents as soon as BP was diagnosed. Six weeks later, patient didn’t recover, with House-Brackmann score stage 3. Acupuncture was perfomed at local and distance acupoints at ears, body and face. Wrist Ankle Acupuncture (WAA) L1,2; ear acupuncture at zero point; and body points were stimulated by electroacu-puncture. After acupuncture therapy, the House-Brackmann score was grade 2. Medical options for the sequelae of BP are limited. Acupuncture’s effectivity in Bell palsy patients’ should be shown with more clinical studies. Keywords: Acupuncture; Wrist Ankle Acupuncture; Bell’s Palsy; Recovery

A case report of congenital cholesteatoma in adult patient mimicking as Bell palsy and proposed follow-up schedule for Bell palsy

Background Making the diagnosis of congenital cholesteatoma in adult patients still pose a challenge even among experienced otologists. Case presentation We are discussing a case of a young adult who was initially treated as Bell palsy in a different center. Two years later, she presented with marked unilateral hearing loss in addition to her ipsilateral non-resolving facial asymmetry. Conclusions Considering the delayed pattern of otological presentation in congenital cholesteatoma, as seen in our case, we proposed monthly follow up in patients diagnosed with Bell palsy for at least 6 months, and those who do not show noticeable recovery after 3 months warrant referral to neurologist or otorhinolaryngologist for further investigations. Contrast-enhanced, high-resolution computed tomography (HRCT) of the temporal bone complemented by magnetic resonance imaging (MRI) supported our diagnosis. Mastoid exploration and complete removal of the disease was imperative.

Effects of Mime Therapy With Sensory Exercises on Facial Symmetry, Strength, Functional Abilities, and the Recovery Rate in Bell's Palsy Patients

Background and Objectives: Bell palsy is the sudden lower motor neuron paralysis of the facial nerve, characterized by acute unilateral peripheral facial muscle weakness. Physiotherapy has been proven to be beneficial in the rehabilitation of patients with Bell palsy and is important to prevent permanent contractures of the paralyzed facial muscles. A physiotherapy technique includes electrical stimulation and mime therapy to help in restoring lost muscle functions. Also, sensory exercises include varied normality solutions administered. This study aimed to find the effects of mime therapy with sensory exercises on facial symmetry and functional abilities among Bell palsy patients. Methods: A total number of 30 participants were recruited for an interventional study and conveniently assigned into three groups (n=10), where group A received electrical stimulation with facial exercises, group B received electrical stimulation with mime therapy, and group C received a combination of electrical stimulation, mime therapy, and sensory exercises. Each group received 18 sessions; each session was for 60 minutes per day, six days per week, for three weeks. Then, all the participants were assessed using the Sunnybrook facial grading system and the facial disability index. Results: Intragroup analysis showed a significant difference within all three groups (P<0.05). Besides, the intergroup comparison showed maximum recovery in group C followed by groups B and A. Conclusion: A combination of mime therapy and electrical stimulation along with sensory exercises provides the most beneficial intervention to improve facial function and reduce facial synkinesis in Bell palsy individuals. Hence, sensory exercises are recommended as an adjunct to electrical stimulation and mime therapy for the line of treatment for individuals with Bell palsy.