OBJECTIVE: To observe the effect of Fu's subcutaneous needling in the treatment of non-acute idiopathic facial paralysis and its effect on serum levels of nitric oxide (NO) and endothelin (ET). METHODS: A total of 76 patients with non-acute idiopathic facial paralysis were randomly divided into an observation group (38 cases, 2 cases dropped out) and a control group (38 cases, 2 cases dropped out). The patients in the control group received basic treatment (mecobalamin tablets orally, specific electromagnetic spectrum irradiation, facial muscle rehabilitation training). The patients in the observation group were treated with Fu's subcutaneous needling on the basis of the control group. The needling points included brachioradialis muscle, sternocleidomastoid muscle, trapezius muscle, etc., and the needling was inserted around the affected muscle, and the reperfusion activity was carried out at the same time, once every other day, 3 times a week. Both groups were treated for 4 weeks. The House-Brackmann (H-B) grade and H-B symptom score were observed before treatment, after 2 and 4 weeks of treatment in the two groups. The facial disability index (FDI) score [including physical function (FDIP) score and social life function (FDIS) score] and the serum levels of NO and ET were compared before and after 4 weeks of treatment in the two groups. The clinical effect and safety of the two groups were assessed. RESULTS: After 2 and 4 weeks of treatment, the H-B grade of the two groups was lower than that before treatment, and the H-B symptom scores were higher than those before treatment (P<0.001, P<0.05); the H-B grade of the observation group was lower than that of the control group, and the H-B symptom score was higher than that of the control group (P<0.01, P<0.05). After 4 weeks of treatment, the FDIP scores of the two groups were higher than those before treatment, and the FDIS scores were lower than those before treatment (P<0.05 ); the FDIP score of the observation group was higher than that of the control group, and the FDIS score was lower than that of the control group (P<0.05). After 4 weeks of treatment, the serum level of NO in the observation group was higher than that before treatment, and the serum level of ET was lower than that before treatment (P<0.05); the increase of serum level of NO and the decrease of serum level of ET in the observation group were greater than those in the control group (P<0.05). The cure rate of the observation group was 55.6% (20/36), which was higher than 22.2% (8/36) of the control group (P<0.05). There were no serious adverse reactions in both groups. CONCLUSION Fu's subcutaneous needling combined with basic treatment can effectively improve the motor function of facial muscles in patients with non-acute idiopathic facial paralysis, which may be related to the regulation of serum NO and ET levels.
Humans ; Male ; Female ; Middle Aged ; Adult ; Acupuncture Therapy ; Aged ; Facial Paralysis/physiopathology* ; Young Adult ; Nitric Oxide/blood* ; Treatment Outcome ; Acupuncture Points ; Endothelins/blood* ; Adolescent

OBJECTIVETo observe the difference in the clinical efficacy on peripheral facial palsy between electro-acupuncture (EA) assisted with surface electromyography (sEMG) and conventional EA.

METHODSSixty cases of peripheral facial palsy were randomized into an observation group and a control group, 30 cases in each one. EA was applied during the first 15 days of sickness in the two groups, at Xiaguan (ST 7), Jiache (ST 6), Dicang (ST 4), Yangbai (GB 14), Taiyang (EX-HN 5), Quanliao (SI 18) and Hegu (LI 4), once a day. In the observation, group, 15 days after sickness, according to the situation in sEMG, on the basis of the acupoints in the previous treatment, the corresponding acupoints were reselected for EA. In the control group, the conventional EA was kept on. The treatment was given once every two days till the 35th day of sickness. Separately, on the 5th, 15th and 35th days of sickness, according to the detection of sEMG in the patients of two groups, the means ratios of: root mean square (RMS) of musculi buccinators, orbicularis oris, frontalis and nasalis on the healthy and affected sides were recorded and analyzed.

RESULTSThe differences of ratio in RMS of musculi buccinators, orbicularis oris, frontalis and nasalis on the healthy and affected sides were significant statistically in comparison between the, 15th day and the 5th day, and between the 35th day and the 15th day of sickness within each group (all P<0. 01). The differences of ratio in RMS of the muscles on the healthy and affected sides were significant statistically on the 15th and 35th days between the two groups (all P<0. 05).

CONCLUSIONEA assisted with sEMG achieves the significant efficacy on peripheral facial palsy, better than the conventional EA.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Electroacupuncture ; Electromyography ; Facial Muscles ; physiopathology ; Facial Paralysis ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Electric Stimulation ; Facial Nerve ; physiopathology ; Facial Paralysis ; therapy ; Humans

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Facial Muscles ; physiopathology ; Facial Paralysis ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged

INTRODUCTIONBell's palsy is a well-recognised disease with robust research on its possible aetiologies and epidemiology, but scant information on patients' concerns and concepts regarding the condition is available. We aimed to evaluate the ideas, concerns and expectations of patients with Bell's palsy in Singapore.

METHODSA cross-sectional study was conducted at a single tertiary-care hospital in Singapore. Participants were all patients with newly diagnosed Bell's palsy referred to the otolaryngology department either from the emergency department or by general practitioners. Participants were given a self-administered questionnaire and their facial nerve palsies were graded by the consultant doctor.

RESULTSA total of 52 patients were recruited, of which 41 were available for analysis. 78.0% of patients were concerned that they were having a stroke upon presentation of the symptoms. Other beliefs about the cause of the disease included overwork or stress (36.6%), something that the patient had eaten (9.8%) and supernatural forces (2.4%). About 50% of patients had tried some form of complementary or alternative therapy other than the steroids/medicines prescribed by their general practitioner or emergency physician. While 39.0% of patients agreed that the Internet had helped them understand more about their condition in addition to the information provided by the physician, 9.8% of them specifically disagreed with this statement.

CONCLUSIONWe have found that patients with Bell's palsy in Singapore are not very knowledgeable about the disease. Although the Internet is a useful resource, a physician's explanation of the disease and its natural progression remains of utmost importance.

Access to Information ; Bell Palsy ; diagnosis ; epidemiology ; psychology ; therapy ; Complementary Therapies ; Cross-Sectional Studies ; Facial Nerve ; physiopathology ; Facial Paralysis ; complications ; therapy ; Health Knowledge, Attitudes, Practice ; Health Literacy ; Humans ; Internet ; Patient Education as Topic ; Singapore ; Surveys and Questionnaires

OBJECTIVETo explore the better therapy for peripheral facial paralysis.

METHODSOne hundred and twenty patients were randomized into three groups: a common acupuncture group: acupuncture at Yangbai (GB 14), Sibai (ST 2) and Yingxiang (LI 20) as main acupoints, a ST 9 group: acupuncture at Renying (ST 9) as main and a ST 9 plus SGB group: acupuncture at Renying (ST 9) as main cooperated with stellate ganglion block (SGB). Once daily, 7 treatments made one session. After three sessions of treatment, the latency period and amplitude of evoked potential in ENoG, R1 value and R2 value of blink reflex were compared before and after the treatment in different groups separately. The total therapeutic effect was evaluated after treatment.

RESULTSAll the treatments shortened the latency period of ENoG, and elevated the amplitude evoked potential significantly. After treatment, the latency period in ST 9 plus SGB group was reduced significantly as compared with common acupuncture group (P < 0.05). The amplitude of evoked potential in ST 9 group was increased significantly as compared with the other two groups (both P < 0.05). After treatment, in each group, R1 and R2 values were shortened significantly. The difference values of R1 and R2 in ST 9 group and ST 9 plus SGB group were all significantly higher as compared with common acupuncture group (both P < 0.05). Additionally, the difference value of R1 in ST 9 plus SGB group was higher significantly than that in ST 9 group (P < 0.05). The clinical cured and remarkably effective rate was 87.5% (35/40) in ST9 plus SGB group, which was higher than 77.5% (31/40) in ST 9 group, and 65.0% (26/40) in common acupuncture group (P < 0.05).

CONCLUSIONAs compared with common acupuncture group, ST 9 group and ST 9 plus SGB group achieve the much superior efficacy on peripheral facial paralysis. The treatment with ST 9 acupuncture and SGB can better repair the early reflex induced by the injury of facial nerve.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Autonomic Nerve Block ; Combined Modality Therapy ; Facial Nerve ; physiopathology ; Facial Paralysis ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stellate Ganglion ; physiopathology ; Young Adult

OBJECTIVETo observe the correlation relationship between acupuncture at Dicang (ST 4), Hegu (LI 4) and Houxi (SI 3) on the affected side of peripheral facial paralysis patients and activated areas in brain functional areas and central regulation mechanism of acupuncture at Hegu (LI 4) treatment.

METHODSEighteen cases with left peripheral facial paralysis were randomly divided into a Hegu group, a Dicang group and a Houxi group, 6 cases in each group. They were treated with electroacupuncture at left Dicang (ST 4), Hegu (LI 4) and Houxi (SI 3), respectively, and were examined with fMRI covering the whole brain at the same time. The fMRI data was analyzed by SPM software.

RESULTSIt was found that the left precentral gyrus area and the left postcentral gyrus area were activated when electroacupuncture at left Hegu (LI 4), and the right precentral gyrus area and the bilateral postcentral gyrus area were activated when electroacupuncture at left Dicang (ST 4), and there was no activated area at precentral gyrus area and post central gyrus area when electroacupuncture at left Houxi (SI 3).

CONCLUSIONThe sensory importation information from Hegu (LI 4) and Dicang (ST 4) can converge and coincide in the brain and may influence each other.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Brain ; diagnostic imaging ; physiopathology ; Facial Paralysis ; diagnostic imaging ; physiopathology ; therapy ; Female ; Human Body ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Young Adult

PURPOSE: The purpose of this study is to investigate peculiar patterns of facial asymmetry following incomplete recovery from facial paralysis that require optimal physical therapy for effective facial rehabilitation, and to decrease the incidence of avoidable facial sequelae. MATERIALS AND METHODS: This study involved 41 patients who had facial sequelae following the treatment of various facial nerve diseases from March 2000 to March 2007. All patients with a follow-up of at least 1 year after the onset of facial paralysis or hyperactive function of the facial nerve were evaluated with the global and regional House-Brackmann (HB) grading systems. The mean global HB scores and regional HB scores with standard deviations were calculated. Other factors were also analyzed. RESULTS: Four patterns of facial asymmetry can be observed in patients with incomplete facial recovery. The most frequently deteriorated facial movement is frontal wrinkling, followed by an open mouth, smile, or lip pucker in patients with sequelae following facial nerve injury. The most common type of synkinesis was unintended eye closure with an effort to smile. CONCLUSION: We described common configurations of facial asymmetry seen in incomplete recovery following facial nerve injury in an attempt to develop an optimal strategy for physical therapy for complete and effective facial recovery, and to decrease the incidence of avoidable sequelae.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Face/physiopathology ; Facial Asymmetry/*physiopathology ; Facial Nerve/pathology ; Facial Nerve Injuries/physiopathology/therapy ; Facial Paralysis/physiopathology/*therapy ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Treatment Outcome

OBJECTIVETo observe the change trend of the temperature asymmetry coefficient at acupoints between healthy side and affected side in patients with facial paralysis, to study the correlation between the temperature asymmetry and Facial Disability Index (FDI), to provide scientific guidance for the application of infrared thermography in the examination of severity of facial paralysis.

METHODSUsing the infrared thermography to observe the temperature asymmetry at acupoints, the temperature asymmetry coefficient at acupoints between healthy side and affected side was calculated; the correlation between the temperature asymmetry and FDI was analyzed.

RESULTSThe correlation between the temperature asymmetry coefficient and FDI was statistically significant at acupoints of Yang-bai (GB 14), Cuanzhu (BL 2), Dicang (ST 4), Yuyao (EX-HN 4), Quanliao (SI 18), Jiache (ST 6) (P < 0.05, P < 0.01).

CONCLUSIONThe temperature asymmetry coefficient at acupoints between healthy side and affected side could be a scientific measure to evaluate the severity of facial paralysis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Body Temperature ; Facial Paralysis ; diagnosis ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Thermography ; Young Adult

With the development of electronics and information technology, the application of functional electrical stimulation in the medical field has been expanding. However, the use of functional electrical stimulation to treat patients with peripheral facial paralysis is still in its infancy. The main problems include: (1) Finding in the signals which could fire the stimulator; (2) Exploring the parameters for the stimulator; (3) The effects on the muscle attributed to the electrical stimulation. A review on these problems is presented.
Electric Stimulation Therapy ; methods ; Facial Paralysis ; physiopathology ; rehabilitation ; therapy ; Humans ; Muscle Contraction