• Annals of Clinical Neurophysiology
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• v.3 no.1
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• pp.9-14
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• 2001

Background : Bell's palsy(BP) is defined as an idiopathic peripheral facial paralysis of acute onset, accounting for more than 50% of all cases of facial paralysis. Different theories on the etiology of BP have been proposed. Herpes simplex virus-1(HSV) has been the most suspicious causative agent, but varicella zoster virus(VZV) also is suspected. Objectives : We evaluated the serological changes of IgG and IgM titer of HSV and VZV to know the causative agent of BP. Materials and Methods : Subjects consisted of 35 patients who developed acute idiopathic unilateral facial palsy(16 men and 19 women from 9 to 78 years old) within a week of onset. We took the serum of the acute and convalescent stages, respectively. Serum IgG and IgM titer of HSV and VZV were measured in acute and convalescent stages by EIA method. Results : Only the HSV IgG titer showed statistically significant elevation in the convalescent stage(p=0.0291). Others did not show any significant change between the acute and convalescent stage. Conclusion : We concluded that HSV may be related to the causative agent of BP.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.326-331
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• 1998

Facial nerve paralysis is a common pain clinical diagnosis. But ipsilateral or contralateral recurrent facial paralysis is found in about 2.6~19.5% of facial paralysis and especially bilateral facial paralysis is rare. While idiopathic facial paralysis is the most common diagnosis, a comprehensive evaluation must be completed prior to this diagnosis in patients with bilateral facial paralysis. A representative case of bilateral alternating facial paralysis treated with stellate ganglion block (SGB) is presented. A 57 years old male patient who had the onset of a right facial paralysis 7 months ago visited pain clinic. Five months after the onset of right facial paralysis, as it was improving, he developed a left facial paralysis. He had history of hypertension, diabetus mellitus and pain episode on mastoid process before facial paralysis developed. Electrical test showed incomplete neuropathy on both side and computed tomography (CT) scan was normal. He was treated with SGB, physical theraphy and aspirin medication. After 25 times SGB, he was recovered almost completely.

• Journal of Medicine and Life Science
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• v.16 no.1
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• pp.1-5
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• 2019

Our purpose was to evaluate usefulness of the contrast-enhanced 3 dimensional fluid attenuated inversion recovery (3D-FLAIR) technique of half brain volume to diagnose the patients with facial neuritis based on segment-based analysis. We assessed retrospectively 17 consecutive patients who underwent brain MR imaging at 3 tesla for facial neuritis: 11 patients with idiopathic facial neuritis and 6 with herpes zoster oticus. Contrast enhanced 3D-FLAIR sequences of the half brain volume were analyzed and 3D T1-weighted sequence of the full brain volume were used as the base-line exam. Enhancement of the facial nerve was determined in each segment of 5 facial nerve segments by two radiologists. Sensitivity, specificity and accuracy of enhancement of each segment were assessed. The authors experienced a prompt fuzzy CSF enhancement in the fundus of the internal auditory canal in patients with enhancement of the canalicular segment. Interobserver agreement of CE 3D-FLAIR was excellent(${\kappa}$-value 0.885). Sensitivity, specificity, and accuracy of each segment are 1.0, 0.823, 0.912 in the canalicular segment; 0.118, 1.0, 0.559 in the labyrinthine segment; 0.823, 0.294, 0.559 in the anterior genu; 0.823, 0.529, 0.676 in the tympanic segment; 0.823, 0.235, 0.529 in the mastoid segment, respectively. In addition, those of prompt fuzzy enhancement were 0.647, 1.0, and 0.824, respectively. Incidence of prompt fuzzy enhancement with enhancement of the canalicular segment was 11 sites(55%): 6 (54.5%) in idiopathic facial neuritis and 5 (83.3%) in herpes zoster. Enhancement of the canalicular segment and prompt fuzzy enhancement on CE 3D-FLAIR was significantly correlated with occurrence of facial neuritis (p<0.001). CE 3D-FLAIR technique of the half brain volume is useful to evaluate the patients with facial neuritis as an adjunct sequence in addition to contrast-enhanced 3D T1-weighted sequence. On segment-based analysis, contrast enhancement of the canalicular segment is the most reliable. Prompt fuzzy enhancement is seen in not only herpes zoster, but in idiopathic facial neuritis.

• Journal of Acupuncture Research
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• v.33 no.1
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• pp.57-68
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• 2016

Objectives : The purpose of this study was to investigate the correlation between patients' characteristics and the beginning period of improvement, as well as contribute to the efficient management of Bell's palsy patients. Methods : The subjects were 94 patients with Bell's palsy. This study was carried out through the use of an administrative database that included patients' characteristics and clinical information. The analysis of the beginning period of improvement by gender, hypertension, diabetes, drinking history, smoking history and facial palsy history was conducted by independent sample t-test. The analysis of the beginning period of improvement by age, House-Brackmann grade, Yanagihara scale and period receiving Korean medical treatment was conducted by Pearson's correlation analysis. Further analysis of the beginning period of improvement by associated symptoms and seasons was conducted by one-way analysis of variance. Results : 1. Significant correlations were not found between the beginning period of improvement and gender, age, season, smoking history, drinking history, facial palsy history, House-Brackmann grade, Yanagihara scale, hypertension, diabetes or associated symptoms. 2. There was significant correlation between the period of receiving Korean medical treatment and the beginning period of improvement. Conclusion : In this study, the earlier that patients received korean medicine treatment after onset, the earlier that the beginning period of improvement could be seen. Therefore, for the efficient management of facial paralysis patients, it is expected to help secure a baseline.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.2
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• pp.86-92
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• 2005

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus/superior orbital fissure has been termed Tolosa-Hunt syndrome(THS). The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. There was the 56 years old man who suffered from painful ophthalmoplegia and facial palsy. The oriental medical treatment without steroids and analgesics reduced the symptoms of the patient remarkably during 5 weeks. There is few report that treat THS with oriental medical method. If more clinical trials like this are proved to be effective, we can expect that oriental medical treatment will be a good method in THS.

• Annals of Clinical Neurophysiology
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• v.24 no.1
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• pp.17-20
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• 2022

Facial diplegia (FD) rarely occurs as a regional Guillain-Barré syndrome (GBS) variant. A 70-year-old male presented with bifacial weakness that had started on the left side and extended to the right after several days. He was then treated using steroids and gradually improved. Serum antiganglioside antibody testing revealed positivity for anti-GM1 IgG antibodies. FD can be idiopathic, but it is an uncommon GBS variant. The ganglioside antibody test may increase the possibility of diagnosing isolated FD.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.643-650
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• 1998

Facial nerve is subject to injury at any point in the course from the cerebral cortex to the motor end plate in the face, so many etiologic varieties of facial paralysis may be encountered, including trauma, viral infection and the idiopathic. Authors have studied 39 cases of facial paralysis which had experienced of treatment in our department from March, 1996 to March, 1997 at Dong San Medical Center. The results obtained are as follows : 1) The highest age incidence showed 10 cases(24.6%) in 3rd decade 2) Among the total of 39 cases, male were 21 cases(53.8%) and female were 18cases(46.2%). 3) At the involved side, left side were 19 cases(48.7%) and right side were 18 cases(46.2%). 4) The causes of facial paralysis were; idiopathic (Bell's palsy) in 19 cases(48.7%) infectious in 6 cases(15.4%) neoplastic in 6 cases(15.4%) traumatic in 5 cases(12.9%) metabolic in 2 cases(5.1%) congenital in 1 cases(2.6%) 5) In time interval between onset of symptom and treated initial date, 26 cases(66.7%) in below 10 days and 8 cases(20.5%) in 11-20 days 6) Correlation of recovery rate according to the treated duration did not differ significantly 7)Result after treatment were satisfactory

• Clinical and Experimental Pediatrics
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• v.50 no.3
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• pp.272-276
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• 2007

Purpose : Bell's palsy is defined as an idiopathic facial nerve paralysis of sudden onset. In spite of intensive clinical and experimental investigation, there is still uncertainty in the incidence, etiology, and preferred mode of treatment in children. The objective of this study was to analyze clinical outcome and prognosis of children with Bell' palsy. Methods : We analyzed 61 cases of Bell's palsy diagnosed at the Department of Wonkwang University Hospital from January 1998 to July 2006. The inclusion criteria were any children with acute isolated unilateral lower motor neuron type of facial nerve palsy. The clinical findings and investigations were reviewed including age, sex, affected site, seasonal incidence and result of steroid treatment. Chi-square and Fisher's exact test was used to compare clinical outcome between duration of complete recovery and age. Results : There was no difference in incidence according to sex or age. Incidence was higher in summer and winter. There was no difference in complete recovery rate and duration between steroid treated group and control group. In the group of children younger than 6 years, duration of complete recovery was shorter than older children. Conclusion : We found increasing the incidence of Bell's palsy in summer and winter. Children younger than 6 years had shorter duration in complete recovery.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.288-291
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• 2018

Hemiplegic migraine (HM) is a rare subtype of migraine with aura and is accompanied by a fully reversible motor aura. HM can occur in two forms: familial or sporadic. Currently, three genes are related to familial HM. Typically, HM occurs in the first or second decade of life and involves gradually progressing aura symptoms in succession, accompanied by headaches. The aura includes visual, sensory, motor, aphasic and often basilar-type symptoms. Motor aura (weakness) is related to the regions where the sensory aura is involved, and it usually starts at the hand before spreading to the arm and face. Aphasia is a common form of speech aura, but does not typically present as a difficulty in understanding. In this case report, the sensory-motor aura started at the right face and then gradually progressed to the right leg without any symptoms in the ipsilateral upper extremity. To the best of my knowledge, there has been no previous case report for the presentation of a hemiplegic migraine, as in this case report. As there is a possibility of misdiagnosis of Bell's palsy at the early stage of this case, this case report suggests that a physician should consider the rare possibility of stroke or HM when a patient presents with unilateral facial palsy.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.3
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• pp.1-10
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• 2017

Objectives : The purpose of this study is to investigate the practice patterns of traditional Korean medicine (TKM) doctors and the acceptance of payment model in order to develop a new TKM health insurance payment model linked with TKM clinical practice guidelines (CPGs). Methods : Lumbar herniated intervertebral disc (HIVD) and idiopathic facial palsy (IFP) were selected as a test diseases to develop a new TKM payment model. The level of benefit coverage in the National Health Insurance (NHI) was designed. The survey asked 228 TKM doctors about their practice patterns in HIVD and IFP patients and acceptance of new payment model. Results : Mean of medical cost for treatment of HIVD was 441,000 KW, mean of treatment period ranged from 4.9 to 17.5 weeks, and mean of number of treatment ranged from 14.6 to 50.4 HIVD patients. In the case of IFP, mean of medical cost for treatment of IFP was 468,000 KW, mean of treatment period was at least 4.2 and up to 15.9 weeks and mean of number of treatment ranged from 14.2 to 52 IFP patients. Conclusions : Current study suggests that mixed payment model of per-visit and episode-based model seem to be proper. The model 1 bundles both items which were covered and not covered by NHI in a rational way. The model 2 is based on the development and application of critical pathway. Lastly, model 3 suggests bundling of items covered by current NHI. Acceptance of TKM doctors is expected to be highest in the model 3.