Metaphysical Energy Therapy in the Treatment of Cranial Nerve Palsies with Special Reference to Bell’s Palsy

Neuropathy, or nerve injury, is a severe and common impediment of diabetes. Studies evaluate that 50% of people with diabetes will develop neuropathy. Diabetic nerve injury is impairment of a single solitary nerve (also named mononeuropathy). Com- monly 2 cranial nerves Viz., cranial nerve VII and cranial nerve VI are involved in facial nerve palsies. The former one is called Bell’s palsy and is acute Lower Motor Neuron facial nerve paralysis (>80%) causing an inability to control facial muscles on the affected side. The later one is sixth nerve palsy, (the abducens nerve), which is responsible for triggering contraction of the lateral rectus muscle to abduct (i.e., turn out) the eye resulting in double vision on the affected side. In recent times, we have found to our amazement, rapid restoration of normalcy within a few hours to a few days, of Cranial Nerve palsies in diabetic subjects at our centre. We are presenting a group of cases having Type2DM over different time periods from 6 to 20 years and those who suddenly suffered facial nerve palsy and they came to VHSDRC for treatment. They were started on the new modality called the Dynamic Acupuncture Mediated Meta-physical Energy Therapy (DAMM Therapy), to recover from the facial palsy. The DAMM therapy is a unique novel way of infusing and transferring healing energy from the therapist to the patient. Within 2 - 7 sittings of DAMM therapy patients showed 75% - 100% improvement in their clinical condition.

Infrared thermography and meridian-effect evidence and explanation in Bell's palsy patients treated by moxibustion at the Hegu (LI4) acupoint Overall regulation or a specific target?

Subjects with Bell＇s palsy and healthy individuals were treated with moxibustion thermal stimulation on the Hegu （LI4） acupoint; an infrared thermal imaging system was used to observe facial-temperature changes. Bell＇s palsy patients developed low or high temperatures at the affected side, with poor symmetry. Healthy people showed high temperatures on the forehead, medial angle of the eye, nasal ala and around the lips, but low temperatures on bilateral cheeks, thus forming a ＂T-type hot area＂ in the face, with good temperature symmetry. Moxibustion treatment for 11 minutes significantly improved high asymmetry in temperature in the faces of Bell＇s palsy patients. This evidence indicates that moxibustion treatment on Hegu enables increases in facial temperatures in healthy people and Bell＇s palsy patients, especially around the lips. Moxibustion stimulation at the Hegu not only improves the global circulation but also has specific effects on the lips in Bell＇s palsy patients, but the underlying mechanism needs further investigation.

Recovery from Bell’s palsy after treatment using uncultured umbilical cord-derived mesenchymal stem cells:A case report

BACKGROUND Bell’s palsy is an idiopathic facial palsy with an unknown cause,and 75%of patients heal spontaneously.However,the other 25%of patients continue experiencing mild or severe disabilities,resulting in a reduced quality of life.Currently,various treatment methods have been developed to treat this disease.However,there is controversy regarding their effectiveness,and new alternative treatments are needed.CASE SUMMARY The patient suffered from left-sided facial paralysis due to Bell’s palsy for 7 years.The patient received an uncultured umbilical cord-derived mesenchymal stem cell transplant eight times for treatment.After follow-up for 32 mo,the paralysis was cured,and there was no recurrence.CONCLUSION Uncultured umbilical cord-derived mesenchymal stem cell transplantation may be a potential treatment for patients with Bell’s palsy who do not spontaneously recover.

Misdiagnosis of Facial Nerve Palsy: A Case Report of Sporadic Vestibular Schwannomas (Non-NFM2) Causing Facial Nerve Palsy Be Misled by Bell’s Palsy in a Child

We report a case of a rare sporadic Vestibular Schwannoma of a 9-month-old girl who had a right-sided lower motor type facial nerve palsy. The patient was initially diagnosed with Bell’s palsy and received steroid treatment accordingly, two months later the patient’s condition deteriorated, and further evaluation of CT and MRI brain was conducted that showed a mass lesion in the posterior fossa causing compression on the facial nerve. Misdiagnosis of facial nerve paralysis is common among children due to multiple related etiologies and varying rates of incidence in comparison to adults. The authors hope to address this issue in this report. Background: Facial nerve paralysis has been a matter of concern for many researchers to understand its nature, causes and presentation according to different age groups. In adults, Bell’s palsy (BP), the idiopathic form of facial nerve paralysis, is more common compared to children where most cases are due to secondary etiologies. Therefore, pediatricians are in an important position to identify these patients early in order to launch the most effective diagnostic and treatment approaches.

Bell’s Palsy Post COVID-19 Vaccination: A Retrospective Cross-Sectional Study in a Single Tertiary Center

Introduction: Bell’s palsy is an uncommon adverse effect of the COVID-19 vaccine that has been reported in clinical trials. Even though a few studies have linked the vaccination to Bell’s palsy, the actual mechanism is uncertain. Objectives: To describe the demographic data and COVID-19 vaccines-related data with Bell’s palsy in a tertiary centre of Malaysia, Hospital Kuala Lumpur. Methods: A retrospective cross-sectional study was observed among vaccinated recipients who developed Bell’s palsy within 60 days and sought treatment in the Otorhinolaryngology Department Hospital Kuala Lumpur, Malaysia between 1st May 2021 and 30th November 2021. The demographic data, clinical history, and vaccination history were collected from clinical records. The facial paralysis was graded according to the House-Brackmann grading system. Results: A total of 26 patients with a mean age was 38.5 years;higher incidence in younger age, below 60 years old (n = 24), specifically 18 - 30 years old (n = 11). We observed an equal number in relation to gender and onset (after the first or second dose) of facial palsy. Predominantly were Malay (n = 21) and only 6 patients had comorbidities. We found there was no difference in regard to the type of vaccine among Bell’s palsy patients;Pfizer (n = 9), followed by Sinovac (n = 9) and AstraZeneca (n = 8). Conclusion: Bell’s palsy was found to be a possible adverse event of the COVID-19 vaccine. Younger groups were noted as susceptible to this rare adverse effect. However, the benefits of vaccination outweigh the risk of Bell’s palsy, which has a good prognosis. More research with larger samples is needed to determine the true relationship between vaccination and Bell’s palsy.

Bell’s palsy and choreiform movements during peginterferon α and ribavirin therapy

Neuropsychiatric side effects of long-term recombinant interferon-α therapy consist of a large spectrum of symptoms. In the literature, cranial neuropathy, especially Bell's palsy, and movement disorders, have been reported much less often than other neurotoxic effects. We report a case of Bell's palsy in a patient with chronic hepatitis C during peginterferon-α and ribavirin therapy. The patient subsequently developed clinically inapparent facial nerve involvement on the contralateral side and showed an increase in choreic movements related to Huntington's disease during treatment.

Acupuncture and vitamin B_(12) injection for Bell's palsy:no high-quality evidence exists

OBJECTIVE： To assess the efficacy of acupuncture combined with vitamin B12 acupoint injection versus acupuncture alone to reduce incomplete recovery in patients with Bell＇s palsy. DATA RETRIEVAL： A computer-based online retrieval of Medline, Web of Science, CNKI, CBM databases until April 2014 was performed for relevant trials, using the key words ＂Bell＇s palsy or idiopathic facial palsy or facial palsy＂ and＂acupuncture or vitamin B12 or methylcobalamin＂. STUDY SELECTION： All randomized controlled trials that compared acupuncture with acupuncture combined with vitamin B12 in patients with Bell＇s palsy were included in the me- ta-analysis. The initial treatment lasted for at least 4 weeks. The outcomes of incomplete facial recovery were monitored. The scoring index varied and the definition of healing was consistent. The combined effect size was calculated by using relative risk （RR） with 95% confidence interval （C/） using the fixed effect model of Review Manager. MAIN OUTCOME MEASURES： Incomplete recovery rates were chosen as the primary outcome. RESULTS： Five studies involving 344 patients were included in the final analysis. Results showed that the incomplete recovery rate of Bell＇s palsy patients was 44.50% in the acupuncture combined with vitamin B12 group but 62.57% in the acupuncture alone group. The major acupoints were Taiyang （EX-HN5）, Jiache （ST6）, Dicang （ST4） and Sibai （ST2）. The combined effect size showed that acupuncture combined with vitamin B12 was better than acupuncture alone for the treatment of Belrs palsy （RR = 0.71, 95%CI： 0.58-0.87; P = 0.001）, this result held true when 8 patients lost to follow up in one study were included into the analyses （RR = 0.70, 95%CI： 0.58-0.86; P = 0.0005）. In the subgroup analyses, the therapeutic effect in patients of the electroacupuncture subgroup was better than in the non-electroacupuncture subgroup （P = 0.024）. There was no significant dif- ference in the incomplete recovery rate by subgroup analysis on drug types and treatment period. Most of the included studies were moderate or low quality, and bias existed. CONCLUSION： In patients with Bell＇s palsy, acupuncture combined with vitamin 812 can reduce the risk of incomplete recovery compared with acupuncture alone in our meta-analysis. Because of study bias and methodological limitations, this conclusion is uncertain and the clinical appli- cation of acupuncture combined with vitamin B12 requires further exploration.

Bell’s palsy workup:Does audiometry add value?

Objective:To investigate if routine audiometry in Bell’s palsy patients has prognostic value.Methods:Retrospective case review was conducted on all Bell’s palsy patients(n紏191)seen at the tertiary otolaryngology specialist outpatient clinic from 2015 to 2017.Correlation of ipsilesional audiometric thresholds with patients’time-to-recovery and initial clinical severity(measured by House-Brackmann(HB)scoring)were used for the prognostic outcome measure.Audiometry results were analyzed using three contiguous frequency pure-tone average(1kHz,2kHz,4kHz).Statistical analysis was done via Stata(v13.1),significance tests were 2-sided at 5%significance level.Results:There was no significant difference between audiometric thresholds between the ipsilesional ear and the contralateral ear(p=0.87).Time-to-recovery was significantly longer for patients with severe initial presentation as compared to mild and moderate severity(p<0.01).There was no correlation found between the audiometry results and HB score at presentation(p=0.39).There was no correlation found between ipsilesional audiometric thresholds and time-to-recovery(p=0.58).Conclusion:Our study suggests that routine audiometry has limited prognostic value in Bell’s palsy patients.

Isolated Bell's palsy-An unusual presentation of dengue infection

Dengue fever is a very common arthropod-borne infection in tropical countries.Neurological complications in dengue fever are relatively uncommon and among these,isolated cranial neuropathies have been reported only very rarely.We present an unusual neurological complication of Bell’s palsy(lower motor neuron 7 th nerve palsy) associated with dengue infection.To the best of our knowledge,there have been very few documented cases of Flavivirus causing isolated Bell’s palsy.

Psychological Factors Are Closely Associated with the Bell's Palsy: A Case-control Study

To observe the differences in psychological status between Bell’s palsy (BP) patients and healthy subjects, and to examine the relationship between psychological factors and the severity of BP, we conducted a case-control, multi-center clinical investigation. A total of 695 subjects were assigned to the case group (n=355) and the control group (n=340). House–Brackmann grading system and Facial Disability Index (FDI) were adopted to assess the BP patients; Kessler Psychological Distress Scale (K10) and 16 Personality Factor (16PF) scale were employed to evaluate the psychological distress and personality profiles of all subjects. Two independent samples t test was used to compare the differences between cases and controls, and to compare the differences among different BP patients. Pearson correlation analysis was used to examine the relationship between psychological factors and severity of facial paralysis. The results showed that psychological distress (K10) in case group (27.09±5.80) was significantly higher than that in control group (13.43±3.02) (t=–37.219, P=0.000). The scores of personality factor Warmth (A), Openness to Change (Q1), Self-Reliance (Q2) were lower in cases than in the controls (P<0.01, P<0.05, P<0.05, respectively), whereas the scores of Sensitivity (I), Vigilance (L), Apprehension (O), and Tension (Q4) were significantly higher in cases than in the controls (P<0.05, P<0.01, P<0.01, P<0.01, respectively). In addition, the psychological distress was significantly higher in female patients, severe (HB score Ⅳ–Ⅵ) patients, and subacute (onset time 72–168 h) patients compared with that in male patients, mild (HB score Ⅰ–Ⅲ)patients, and acute (onset time≤72 h) patients (P<0.05). The scores of personality factor in female patients, severe patients, and subacute patients were also significantly different from male patients, mild patients, and acute patients (P<0.05). The result of Pearson correlation analysis showed that psychological factors (K10, personality A, F, L, N, O, Q4) were closely related to HB scores. We are led to conclude that the psychological status between BP patients and healthy people are different; psychological distress and personality factors are closely associated with severity of facial paralysis.

Bell's palsy at high altitude——an unsuspected finding

Background:Bell's palsy is a common condition seen in clinical practice.The aetiology of this condition is not clearly defined and neuroimaging is essential to exclude intracranial causes of infra-nuclear facial palsy.Case presentation:We report a young soldier,who presented with Bell's palsy and neuroimaging revealed an unsuspected finding of multiple intracranial calcifications.Detailed evaluation revealed the additional diagnosis of vitamin D deficiency and secondary hyperparathyroidism due to lack of sun exposure at high altitude area.Conclusion:The health care practitioners,looking after the soldiers at high altitude areas should be aware of the measures to prevent vitamin D deficiency.Intracranial calcifications are uncommon in hyperparathyroidism and Bell's palsy.

The prevalence of metabolic syndrome in non diabetic patients with a previous history of Bell’s palsy

Objectives: To compare the prevalence and each parameter of metabolic syndrome between non diabetic patients with previous Bell’s palsy and non diabetic healthy subjects. Material and method: A number of 454 Bell’s palsy patients (aged 15 years old and over) were initially recruited as the study group. 874 non diabetic healthy participants of a metabolic syndrome surveillance study were randomized by R program as the control group to make up a 1:3 ratio of case to control. Metabolic syndrome was defined by International Diabetes Foundation criteria. The descriptive statistics analysis, t-test and Chi-Square test were applied for statistical analysis. Results: Seventy two non diabetic, previous Bell’s palsy cases (30 males and 42 females) were eligible as the study group. Their mean age was 51 (39.8 - 63.2) years old. The prevalence of metabolic syndrome in the study and the control groups were 22.2% and 21.8% respectively (p = 0.93). Nevertheless, the prevalence of hypertension was significantly higher in the study group (62.5% vs. 47.7%) (p = 0.04). Conclusions: No difference in the prevalence of metabolic syndrome was found. However, hypertension was significantly prevalent in the study group.

Bell’s palsy after inactivated COVID-19 vaccination in a patient with history of recurrent Bell’s palsy: A case report

BACKGROUND With rapid and extensive administration of inactivated coronavirus disease 2019(COVID-19)vaccine to the general population in China,it is crucial for clinicians to recognize neurological complications or other side effects associated with COVID-19 vaccination.CASE SUMMARY Here we report the first case of Bell’s palsy after the first dose of inactivated COVID-19 vaccine in China.The patient was a 36-year-old woman with a past history of Bell’s palsy.Two days after receiving the first dose of the Sinovac Life Sciences inactivated COVID-19 vaccine,the patient developed right-side Bell’s palsy and binoculus keratoconjunctivitis.Prednisone,artificial tears and fluorometholone eye drops were applied.The patient’s symptoms began to improve by day 7 and resolved by day 54.CONCLUSION As mRNA COVID-19 vaccine trials reported cases of Bell’s palsy as adverse events,we should pay attention to the occurrence of Bell’s palsy after inactivated COVID-19 vaccination.A history of Bell’s palsy,rapid increase of immunoglobulin M and immunoglobin G-specific antibodies to severe acute respiratory syndrome coronavirus 2 may be risk factors for Bell‘s palsy after COVID-19 vaccination.

Electrophsiological study in the prognosis of Bell palsy

AIM:To estimate the prognosis of Bell palsy.METHODS:Blink reflex(BR),electromyography(EMG),motor latency(ML )and amplitude(AMP )of facial nerve were performed in 42p atients with Bell’ s pal-sy.The patients were followed about half a year.RESULTS:(1)When 1of the 3R waves related with the ill side existed or appeared in 3weeks after onset,97%patients could reco ver completely.The recovery time wa s related to the time of the occurrence of R wave.(2)When 1of the 3R waves appeared in the 4th week,60%patients could recover complete-ly.When none of the 3waves appeared a fter the 4th week,100%patients could not recover completely.EMG sh owed spontaneous activities in 3of the 6patients in the 4th week.(3)Motor latency and amplitude of facia l nerve were examined when the illness stopped developing.All patients had normal latencies.5patients’ amplitudes reduced more than 90%.3o f the5patients did not appear the related R waves after the 4th week.CONCLUSION:BR might provide the early sign of good prognosis of Bell’ s palsy.BR together with EMG and ML an d AMP of facial nerve might provide the later sign of poor p rognosis.

多部位肌肉面神经电图检测对贝尔麻痹患儿面神经功能及预后的评估价值

目的探讨面神经电图(ENoG)检测多块面肌方法在贝尔麻痹(BP)患儿面神经功能评估及早期预测预后中的价值。方法选取2020年6月至2022年9月在昆明医科大学附属儿童医院诊治的90例BP患儿,首诊时应用ENoG检测额肌、鼻肌、口轮匝肌、上眼轮匝肌及下眼轮匝肌等5块面肌的ENoG值及复合肌肉动作电位(CMAP)波幅,并采用House Brackmann分级系统(HBGS)对患儿的面神经功能进行评估,随访至完全恢复或至首诊后6个月,通过HBGS再次评估患儿的面神经功能。分析比较不同面肌的ENoG值在各年龄组(婴幼儿组、学龄前儿童组、学龄儿童组)及各预后组(完全恢复组、不完全恢复组)间的差异,以及与首诊HBGS评级的相关性。绘制受试者工作特征曲线并计算曲线下面积(AUC),以评估早期不同面肌的ENoG值对BP患儿预后的价值。结果首诊时患儿各部位ENoG值越低,则对应的首诊HBGS评级越高(P<0.05);鼻肌、上眼轮匝肌及下眼轮匝肌表现更显著(P<0.01)。首诊时的鼻肌、上眼轮匝肌及下眼轮匝肌的ENoG值显示,完全恢复组的秩平均值高于不完全恢复组(P<0.05);首诊时鼻肌、上眼轮匝肌及下眼轮匝肌的ENoG值可用于评估BP患儿的预后,AUC值分别为0.732、0.695及0.796(P<0.05);将上眼轮匝肌与鼻肌ENoG值联合、上眼轮匝肌与下眼轮匝肌ENoG值联合、下眼轮匝肌与鼻肌ENoG值联合,准确性进一步提升,AUC分别为0.740、0.799及0.806(P<0.01);首诊HBGSⅡ~Ⅲ级患儿的预后明显好于Ⅳ~Ⅴ级患儿(P<0.01)。结论BP发病初期鼻肌、上眼轮匝肌及下眼轮匝肌的ENoG值与HBGS评级一样可反映患儿病情的严重程度,较低的ENoG值提示BP可能恢复不完全,增加ENoG面肌检测部位可提高BP患儿预后评估的准确性。

七叶皂苷钠、强的松治疗Bell麻痹的随机对照研究

目的 探讨七叶皂苷钠治疗Bell麻痹的有效性。方法 采用随机对照研究 ,收集首次诊断Bell麻痹的急性期患者 85例 ,随机分为七叶皂苷钠组 (七叶皂苷钠加基础治疗 ) 30例、强的松组 (强的松加基础治疗 ) 2 8例、基础治疗组 2 7例 ,基础治疗包括多种维生素、针灸、理疗等 ,均在发病 3天内给予相应的治疗。采用House Brach mann(H B)面神经麻痹评定标准 ,分别于治疗前与治疗后 1个月时评定面神经麻痹等级。结果 治疗前 3组患者性别、年龄、面瘫部位、发病至开始治疗时间、首次治疗时H B面瘫等级分布均无统计学差异 ,具有可比性。治疗后 1个月时三组患者H B面瘫等级经Kruskal Wallis秩和检验 ,有统计学差异 (P =0 0 4 8)。 3组间两两比较显示七叶皂苷钠组、强的松组面瘫恢复均优于基础治疗组 ,有统计学意义 (P值分别为 0 0 4 5、0 0 14 ) ;而七叶皂苷钠组与强的松组面瘫恢复比较无统计学差异 (P =0 6 16 )。结论 七叶皂苷钠可替代皮质类固醇治疗Bell麻痹 ,同时避免皮质类固醇的副作用。

针灸治疗Bell's面瘫疗效的系统评价

目的 系统评价针灸促进Bell s面瘫康复和减少其远期发病率的效果。方法 计算机检索MED LINE、EMBASE、LILAS、中国生物医学文献数据库和Cochrane肌肉疾病组注册组资料库 ,检索时间截止至 2 0 0 2年 12月 ;同时检索其它相关灰色文献 ,获取所有涉及针灸治疗Bell s面瘫的随机和半随机对照试验。而后选择符合纳入标准的临床试验 ,评价其方法学质量 ,并从中提取患者基本情况、干预措施、终点指标和结果等相关资料进行系统评价。结果 共有 3个小规模的临床随机对照试验 ,合计 2 88例患者符合纳入标准 ,但因其在试验设计、报道上存在明显缺陷 ,以及试验之间存在较大差异 ,不符合Meta分析条件 ,因而只进行了定性分析。结果显示 ,针灸治疗Bell s面瘫有一定疗效 (P均 <0.0 1)。结论 针灸治疗Bell s面瘫有效 ,但入选的 3个随机对照试验规模小 ,质量不高 ,降低了这一结论的可靠性。开展高质量、内在真实性好的相关随机对照试验非常必要。

Bell麻痹治疗效果的影响因素分析

目的:探讨康复治疗Bell麻痹治疗效果的影响因素。方法:Bell麻痹患者96例,综合脉冲短波、高压电位、针灸和运动治疗。康复治疗前后用面部分级系统(facialgradingsystem,FGS)进行评分,并随访远期效果。分析影响住院和门诊患者痊愈和遗留后遗症的因素。结果:96例患者中随访到72例(75.00%)。61例痊愈,占84.72%;11例有后遗症,占14.28%。痊愈患者除康复治疗前和治疗后FGS评分高于有后遗症患者(P<0.05—0.01),在病程的第1周内开始康复治疗,明显早于有后遗症患者(P<0.01)。门诊和住院患者在获得同等治疗效果的条件下,门诊患者治疗周期平均13.96±8.02天,较住院患者缩短5天,差异有非常显著性意义(P<0.01)。门诊患者在病程的第1周内开始康复治疗,明显早于住院患者(P<0.05)。结论:早期综合康复治疗能缩短Bell麻痹病程和提高治愈率,在病程第1周内及时选择合理的康复治疗是取得良好预后的关键所在。

轻中度单侧Bell面瘫红外热辐射强度异常分析

Bell面瘫是一种多发的面神经疾病,首次发病以轻中度居多。应用红外热成像原理,探寻一种客观无创的Bell面瘫评估方法。人体面部穴位大都呈左右对称分布,取患者病变一侧的相关穴位为实验组,另一侧同一穴位为对照组,分别研究其红外热辐射特性,急性期内,同一穴位在健侧与患侧的红外热辐射强度差异显著,即存在明显的温差(大于0.3℃)。在红外热像上,患侧的穴位与其周边组织形成一个不规则的辐射异常区,伪彩色化后的色彩与健侧对比鲜明。同时,病变程度越重,同一穴位两侧的温差越大。其中颧髎、地仓、颊车、鱼腰、阳白五个穴位的双侧温差与面瘫的病变程度正相关,分别为0.676,0.498,0.506,0.545,0.518,P<0.05,有统计学意义。由此可见,红外热像可以用于客观评估Bell面瘫的病变程度。