• 한방안이비인후피부과학회지
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• 제31권4호
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• pp.42-64
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• 2018

Objectives : The purpose of this study was to investigate the non-surgical treatment of peripheral facial paralysis sequelae such as bell's palsy and Ramsay-hunt syndrome during last 10 years. Methods : We searched articles in the RISS, MEDLINE, CAJ from January, 2008 to June, 2018. Articles on the non-surgical treatment of bell's palsy and Ramsay-hunt syndrome sequelae were included. We extracted data about treatments, characteristics of intervention, outcomes from the included studies and classified in to 4 categories such as case studies, RCTs, nRCTs, literature reviews. Results : 132 potentially relevant studies were identified, of which 60 studies met our inclusion criteria. Of 60 included studies, 30 were case reports, 22 were RCTs, 4 were nRCTs, and 4 were reviews. China (81.8%) were the most common by country, bell's palsy(81.7%) by disease, and case reports(50%) by study type were the most common. Symptoms were lagophthalmos, asymmetry, contracture, spasm, dacryorrhea, synkinesis, paresthesia, crocodile tears mostly in the order of frequency, and these symptoms occurred at least one month after the onset of symptoms. The most common method of treatment was acupuncture, which was used in 49 studies. As the evaluation variables, the effective rate was the highest in 25, House-Brakmann grading system in 17, and Sunnybrook facial grading system in 7. In 95% of the studies, after-treatment was reported to be cured, but objectivity is low. Conclusions : This study suggests that Korean medicine such as acupuncture can play a valid role in the non-surgical treatment of peripheral facial paralysis sequelae. In the future, a systematic and well-designed clinical study is needed for treatment of peripheral facial paralysis sequelae.

• Annals of Clinical Neurophysiology
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• 제15권1호
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• pp.1-6
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• 2013

Background: Bell's palsy (BP) is the most common cause of unilateral lower motor facial palsy. Recurrent paralysis of the facial nerve is unusual and reported in only 7-8%. Methods: A total of 394 consecutive patients with acute BP patients were enrolled at Daegu Catholic University Hospital from July 2005 to September 2012. We classified the patients into two groups-single BP and recurrent BP-and compared them by patient characteristics, clinical features, MRI findings, electrophysiologic findings and prognosis. The degree of BP was graded according to the House and Brackmann facial nerve grading system. Results: Recurrent BP was observed in 31 (7.9%) patients. The number of recurrence was varied from 2 to 5. The recurrent BP (9.7%) had more incidence of family history and MRI enhancement than those of single BP (2.2%, p=0.047). The single BP (63.4%) had better recovery than recurrent BP (45.2%, p=0.045). Conclusions: The recurrent BP had more incidence of family history, MRI enhancement and poor prognosis than the single BP.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.122-127
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• 2001

Background : Bell's palsy(BP) is defined as an idiopathic peripheral facial paralysis of sudden onset and account more than 50% of facial paralysis. It's etiology is unclear, but herpes simplex virus type-1(HSV-1) has been the most suspicious causative agent of BP that ever been studied. We evaluated the effect of add-on acyclovir in acute stage of BP. Methods : Subject consisted of 35 patients who developed acute idiopathic unilateral facial nerve palsy(16 men and 19 women with age 9-78 years old). The treatments were started within 10 days after onset of BP. Facial nerve function was assessed by the House-Brackman facial nerve grading scale and facial nerve conduction study including blink reflex. Follow-up evaluation were made 2 month after onset. Twenty of 35 patients were treated with combined therapy of acyclovir and prednisone. As a control group, 15 patients were treated with prednisone only. We compared the improvement of neurologic defects at recovery phase. Results : Compared with two groups, difference in grading scale at recovery phase is statistically significant(p<0.01). So, acyclovir-prednisone group showed a significant improvement in grading scale at recovery phase compared with prednisone group. Conclusion : We identified the benefits of add-on acyclovir in the acute stage of BP.

• 한방안이비인후피부과학회지
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• 제24권3호
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• pp.55-64
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• 2011

Objectives : This study was performed in order to investigate the effectiveness of electroneuronography as predicting factors for peripheral facial palsy prognosis. Methods : Data were gathered with 32 Bell's palsy patients. The grade of Bell's palsy were measured 2 times; first medical exam and 4 weeks after treatment, with Lucille Daniels's Muscle test. We converted the grade system use on five rating scale. The significance of treatment verified with paired t-test used on first medical exam and 4 weeks after treatment score and predicting factors of electroneuronography verified with simple regression test. Results : The improvement score were statistically significant different before and after treatment(p<.001). Mean axonal loss according to electroneuronography showed a statistically significant correlation in predicting peripheral facial palsy (P<0.01). Conclusion : Axonal loss as determined by electroneuronography has statistical significance as predicting factors for peripheral facial palsy prognosis.

• Investigative Magnetic Resonance Imaging
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• 제19권3호
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• pp.162-167
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• 2015

Purpose: To evaluate the usefulness of quantitative analysis of the facial nerve using contrast-enhanced three-dimensional (CE 3D) fluid-attenuated inversion recovery-volume isotopic turbo spin echo acquisition (FLAIR-VISTA) for the diagnosis of Bell's palsy in pediatric patients. Materials and Methods: Twelve patients (24 nerves) with unilateral acute facial nerve palsy underwent MRI from March 2014 through March 2015. The unaffected sides were included as a control group. First, for quantitative analysis, the signal intensity (SI) and relative SI (RSI) for canalicular, labyrinthine, geniculate ganglion, tympanic, and mastoid segments of the facial nerve on CE 3D FLAIR images were measured using regions of interest (ROI). Second, CE 3D FLAIR and CE T1-SE images were analyzed to compare their diagnostic performance by visual assessment (VA). The sensitivity, specificity, and accuracy of RSI measurement and VA were compared. Results: The absolute SI of canalicular and mastoid segments and the sum of the five mean SI (total SI) were higher in the palsy group than in the control group, but with no significant differences. The RSI of the canalicular segment and the total SI were significantly correlated with the symptomatic side (P = 0.028 and 0.015). In 11/12 (91.6%) patients, the RSI of total SI resulted in accurate detection of the affected side. The sensitivity, specificity, and accuracy for detecting Bell's palsy were higher with RSI measurement than with VA of CE 3D FLAIR images, while those with VA of CE T1-SE images were higher than those with VA of CE 3D FLAIR images. Conclusion: Quantitative analysis of the facial nerve using CE 3D FLAIR imaging can be useful for increasing the diagnostic performance in children with Bell's palsy when difficult to diagnose using VA alone. With regard to VA, the diagnostic performance of CE T1-SE imaging is superior to that of CE 3D FLAIR imaging in children. Further studies including larger populations are necessary.

• Journal of Acupuncture Research
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• 제19권2호
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• pp.238-249
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• 2002

Facial palsy is commonly encountered disease in the clinic but bilateral facial palsy is known as rare disease. Type of facial nerve paralysis include unilateral, recurrent ipsilateral, recurrent alternating and bilateral simultaneous palsies. Among the types, the reported incidence of bilateral simultaneous palsy is 0.3~2% of facial paralysis patients. We experienced I case of patient with bilateral simultaneous facial palsy that was concluded as bilateral bell's palsy. Objective : The purpose of this paper is to report the patient with bilateral facial palsy, who improved by oriental medical treatment. Another purpose is to review the current literature and to differential diagnosis of bilateral facial paralysis. Methods and Results : The patient was treated by acupuncture, herb medication and self-massage on facial muscle for 14 weeks. House-brackmann grading score was improved into I/I (Rt/Lt) from IV/IV. Conclusion : Through reviewing some literatures and reports, It is concluded that bilateral facial palsy was related to many other disorders and more ominous than unilateral facial palsy. therefore, its work-up should include a complete neurologic assesment and thorough evaluation. also, we consider that bilateral Bell's palsy can improve by oriental medical treatments.

• 대한한의학회지
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• 제43권2호
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• pp.8-26
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• 2022

Objectives: This study is designed to statistically analyze characteristics, treatment effect and prognosis of patients who were treated for the recurrent Bell's palsy Methods: This study retrospectively analyzed the medical records and telephone questionnaire of 82 patients treated with the recurrent Bell's palsy at the OO Korean Medicine hospital from August 01, 2018 to July 31, 2021. Results: The lower the EQ-VAS^® and HB scale before and after treatment, the higher the satisfaction with the treatment. The average of the number of days and duration of outpatient treatment for male was longer than that for female. The average number of days and duration of outpatient treatment in the group that received combined treatment was longer than that of patients who received Korean Medicine only. The higher the satisfaction of treatment, the higher the willingness to receive treatment in the event of recurrent facial palsy. HB scale after treatment was the lowest in their 40s, and the average value of HB scale after treatment tended to increase as age increased except for those in their 40s. Conclusion: This study showed that the lower the HB scale after treatment, the lower the EQ-VAS®, the higher the treatment satisfaction, and the higher the probability receiving treatment if the facial paralysis recurs. Those in their 10s to 40s showed excellent results after treatment. Comparatively, those in their 50s and above showed a little effect after treatment. Gender, affected side, history of facial palsy, season of onset, age, hypertension and diabetes had no statistically significance with recurrent Bell's palsy prognosis.

• Journal of Acupuncture Research
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• 제32권4호
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• pp.167-175
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• 2015

Objectives : This study was performed to confirm the effectiveness of East-West collaborative hospital treatment on the prognosis of Bell's palsy. Methods : We screened patients who visited the Facial Palsy Center in Kyung Hee University Korean Medicine Hospital at Gangdong between June 2006 and June 2014 by inclusion/exclusion criteria. We reviewed the medical records of 270 patients, including demographics and results of electromyography. We tried to compare the recovery rate of Bell's palsy in the medical records with that of the previous study by calculating the odds ratio after 2, 3 and 6 months from the onset. Results : The odds ratio between our data and that from the previous study after 6 months from the onset was 4.899. Additionally, the odds ratios after 2 and 3 months from the onset were 1.471 and 2.054, respectively. All the odds ratios showed statistical significance. Conclusions : East-West collaborative hospital treatment showed significant effectiveness on the prognosis of Bell's palsy.

• Journal of Acupuncture Research
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• 제27권2호
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• pp.1-10
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• 2010

Objectives : The 7-zone-diagnostic system is a diagnostic device to predetermine bodily locations by measuring the energy of body. This study was to investigate the relation between the different patterns of Zone 2 of Factor AA in CP-6000A (VEGA, Germany), 7-zone-diagnostic system and the factors of Bell's Palsy. Methods : This study was carried out with the data from factors of Bell's Palsy(age, sex, period after onset, postauricular pain, season which the disease happen, contributing factor). We made three groups according to the different patterns of Zone 2 of Factor AA in CP-6000A. The Factor AA pattern of Group A is that the red bar graph of zone 2 were lower than the normal range. The Factor AA pattern of Group B was that the red bar graph of zone 2 was the normal range. The Factor AA pattern of Group C was that the red bar graph of zone 2 was higher than the normal range. After collecting the data about factors of Bel's Palsy to correspond with conditions of each group were selected, the data was analyzed statistically. Results : The values of number of patient and period after onset of group A was higher than group B and C. The values of ratio of postauricular pain of group B and C was higher than group A. The season of disease happened of group A is spring and winter, group B is winter and group C is summer and autumn. The contributing factor of disease happened of group A is none, and group B and C is stress and clod. Conclusions : In Bell's Palsy, it is thought that the red bar graph of zone 2 is lower, the group have lower energy(虛) and the energy has a character of cold(寒), and zone 2 is higher, the group has the higher energy(實) and the energy has a character of fire(熱).

• Korean Journal of Acupuncture
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• 제33권4호
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• pp.183-193
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• 2016

Objectives : The purpose of this study is to find out the effect of Postural Yinyang Correction of TMJ(Functional Cerebrospinal Therapy; FCST) on Bell's palsy. Methods : We reviewed the medical records of 41 patients who were treated for Bell's palsy at the Dept. of Acupuncture and Moxibustion, Dong-Eui University from January $1^{st}$, 2016 to August $31^{st}$, 2016. The patients were divided into 2 groups: Group A(n=21), and Group B(n=20). Patients in Group A were treated by Korean Medical Treatments with FCST using ABA(Accurate Balancing Appliance), a standard intra-oral appliance. Patients in Group B were treated by Korean Medical Treatments without FCST. To estimate the efficacy in recovering palsy, we analyzed the House-Brackmann Grading Scale and Yanagihara's Unweighted Grading System. Results : In both groups, H-B grades were improved significantly during each period except the period from the first visit to one week later(P01). The improvement of H-B grade during each period in Group A is higher than Group B except the period from one week later to two weeks later, but statistically insignificant. In Group A, Y-score was significantly improved during each period except during P01. In group B, Y-score was significantly improved during each period except during P01 and the period from the first visit to two weeks later. The improvement of Y-score during each period in Group A is higher than Group B, but statistically insignificant. Conclusions : FCST using Standard Intraoral Appliance may be helpful in treating Bell's Palsy, but the further researches are needed.