Facial nerve paralysis in children

Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital(due to delivery traumas and genetic or malformative diseases) or acquired(due to infective,inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.

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.

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.

Einstein-Local Counter-Arguments and Counter-Examples to Bell-Type Proofs

J. S. Bell’s well-known proofs of inequalities (and related work) are shown to be invalidated by two counter-arguments (-examples) that are based on Einstein-local propositions: Bell-type inequalities of Einstein-Podolsky-Rosen experiments must include, as virtually all physical theories do, elements of physical reality and their mathematical representations that relate to continua as opposed to exclusively finite numbers. Furthermore, Bell-type inequalities must be valid for all possible experimental geometries that lead to the quantum result. Based on these propositions, violations of Bell-type inequalities are demonstrated without violating Einstein locality, without conspiracy type theories and even for the case that all known “loopholes” are closed.

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.

Logical Conflict between Bell’s Locality and Probability Theory

Based on “locality” considerations, John Stuart Bell and his followers have derived inequalities and theorems that, when taken together with actual experiments that have been performed by Aspect and others, appear to contradict physical reality as defined by Einstein. However, their specifically applied concept of locality is in conflict with the Fundamental Model of probability theory and the set theoretic definition of conditional probabilities. Bell-type inequalities are, therefore, not adequate to decide ponderous questions regarding physical reality.

Nasogastric tube syndrome:A Meta-summary of case reports

BACKGROUND Since its description in 1790 by Hunter,the nasogastric tube(NGT)is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral feeding.However,the risks associated with its placement are often underes-timated.Upper airway obstruction with a NGT is an uncommon but potentially life-threatening complication.NGT syndrome is characterized by the presence of an NGT,throat pain and vocal cord(VC)paralysis,usually bilateral.It is poten-tially life–threatening,and early diagnosis is the key to the prevention of fatal upper airway obstruction.However,fewer cases may have been reported than might have occurred,primarily due to the clinicians'unawareness.The lack of specific signs and symptoms and the inability to prove temporal relation with NGT insertion has made diagnosing the syndrome quite challenging.AIM To review and collate the data from the published case reports and case series to understand the possible risk factors,early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway obstruction.METHODS We conducted a systematic search for this meta-summary from the database of PubMed,EMBASE,Reference Citation Analysis(https://www.referencecitation-analysis.com/)and Google scholar,from all the past studies till August 2023.The search terms included major MESH terms"Nasogastric tube","Intubation,Gastrointestinal","Vocal Cord Paralysis",and“Syndrome”.All the case reports and case series were evaluated,and the data were extracted for patient demographics,clinical symptomatology,diagnostic and therapeutic interventions,clinical course and outcomes.A datasheet for evaluation was further prepared.RESULTS Twenty-seven cases,from five case series and 13 case reports,of NGT syndrome were retrieved from our search.There was male predominance(17,62.96%),and age at presentation ranged from 28 to 86 years.Ten patients had diabetes mellitus(37.04%),and nine were hypertensive(33.33%).Only three(11.11%)patients were reported to be immunocompromised.The median time for developing symptoms after NGT insertion was 14.5 d(interquartile range 6.25-33.75 d).The most commonly reported reason for NGT insertion was acute stroke(10,37.01%)and the most commonly reported symptoms were stridor or wheezing 17(62.96%).In 77.78%of cases,bilateral VC were affected.The only treatment instituted in most patients(77.78%)was removing the NG tube.Most patients(62.96%)required tracheostomy for airway protection.But 8 of the 23 survivors recovered within five weeks and could be decannulated.Three patients were reported to have died.CONCLUSION NGT syndrome is an uncommon clinical complication of a very common clinical procedure.However,an under-reporting is possible because of misdiagnosis or lack of awareness among clinicians.Patients in early stages and with mild symptoms may be missed.Further,high variability in the presentation timing after NGT insertion makes diagnosis challenging.Early diagnosis and prompt removal of NGT may suffice in most patients,but a significant proportion of patients presenting with respiratory compromise may require tracheostomy for airway protection.

Why Bell’s EPRBA Experiment Is Meaningless

We demonstrate that a Bell type of experiment asks the impossible of a Kolmogorovian correlation. An Einstein locality explanation in Bell’s format is therefore excluded beforehand by way of the experimental and statistical method followed.

Bell’s Theorem and Einstein’s Worry about Quantum Mechanics

With the use of a local dependency on instrument setting parameters of the probability density of local hidden variables, it is demonstrated that a Kolmogorov formulation reproduces the quantum correlation. This is the novelty of the work. In a Bell experiment, one cannot distinguish between Bell’s formula and the here presented local Kolmogorov formula. With the presented formula, no CHSH can be obtained. Therefore, the famous CHSH inequality has no excluding power concerning local extra Einstein parameter models. This result concurs with other previous research concerning difficulties with Bell’s formula.

SURGICAL TREATMENT OF PERIPHERAL FACIAL PARALYSIS

The facial nerve passes through the temporal bone and is the longest nerve that travels in a bony canal with a complex course and high susceptibility to injury.When facial nerve becomes swollen from insults such as trauma, inflammation, tumor or iatrogenic injury, its distal

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。

表面肌电生物反馈疗法对小儿Bell's麻痹面肌功能恢复的观察

目的观察表面肌电生物反馈疗法对小儿Bell's麻痹的疗效。方法选取Bell's麻痹的患者60例,随机分为对照组和治疗组。其中对照组30例,治疗组30例。对照组患者给予常规神经内科药物治疗:包括泼尼松,维生素B_1、甲钴胺等药物。治疗组患者在对照组治疗基础上加用表面肌电生物反馈治疗,应用肌电图(EMG)检测两组患者患侧面神经从茎乳孔到眼轮匝肌及口轮匝肌部位的潜伏期及波幅的变化,并于治疗前后进行H-B分级评定。结果两组患者于治疗前后患侧面神经潜伏期及波幅有显著性变化。H-B分级比较有显著提高。并且治疗组优于对照组。结论采用表面肌电生物反馈治疗能有效改善面瘫症状,改善面肌肌力,促进面神经麻痹侧面神经功能的恢复。

Bell's面瘫对患者的心理影响及其心理健康状况

目的探讨Bell's面瘫对首次发病患者形象、情绪、日常生活及社会活动的影响及发病早期患者的心理健康状况。方法采用自编面瘫对患者形象、情绪及社会活动影响的调查问卷及症状自评量表(SCL-90),对63例首次发病的Bell's面瘫患者进行调查。统计分析采用t检验及相关分析。结果Bell's面瘫对首次发病患者形象、情绪、日常生活及社会活动均有明显影响。Bell's面瘫患者SCL-90的躯体化、强迫、人际关系敏感、焦虑、抑郁、敌对、恐怖、精神病性因子分均高于全国成人常模,其SCL-90总分与自编面瘫影响问卷各条目得分均存在统计学相关关系。结论Bell's面瘫给首次发病患者带来不良心理影响,他们存在广泛的心身症状,这些不良影响与其心身症状有关。

复方丹参滴丸治疗Bell's面瘫的随机对照研究

目的评价复方丹参滴丸治疗Bell's面瘫的疗效与安全性。方法将60例Bell's面瘫患者随机分为两组,治疗组30例,对照组30例。治疗组采用复方丹参滴丸为主,辅以药物治疗和物理治疗;对照组只应用药物治疗和物理治疗。两组均治疗30 d后观察疗效。结果治疗组总有效率为90.00%,对照组总有效率为80.00%,两组间差异有统计学意义。临床观察中未发现治疗组有不良反应发生。结论复方丹参滴丸治疗Bell's面瘫安全有效,值得在临床上应用。

穴位注射配合电针治疗顽固性Bell’s面瘫的临床疗效观察

目的 :研究穴位注射配合电针与传统针灸两种不同治疗方法在治疗顽固性面瘫中的作用 ,以探讨更适宜在临床中推广应用的治疗方案。方法 :采用临床半随机对照的研究设计方案 ,观察两种不同治疗方案的临床痊愈率、平均痊愈时间。结果 :穴注配合电针治疗方案无论在临床痊愈率还是平均痊愈时间方面均优于传统针灸治疗方案 (P <0 0 5 )。结论 :建议在顽固性Bell’s面瘫患者针灸治疗中推广应用穴注配合电针治疗方案 ,以缩短治疗时间 。

瞬目反射和面神经电图在Bell′s麻痹中的应用

目的探讨Bell’s麻痹患者行瞬目反射(blinkreflex,BR)、面神经电图(electroneurogram,ENG)检测的意义。方法36例Bell′s麻痹患者在发病1周内行BR和ENG测定。结果患侧R1、R2及R2′缺如者23例,其余13例患侧较健侧R1、R2及R2′波潜伏期延长,异常率100%;患侧面神经运动传导潜伏期延长、波幅降低,与健侧比较差异有显著性(P<0.05),早期异常率为63.9%。结论BR测定是诊断Bell’s麻痹的敏感指标,同时结合ENG可全面、客观地评价面神经损害的程度和预后。

Bell’s面瘫患者心理健康状况研究

目的 探讨 Bell’s面瘫患者的心理健康状况及其相应对策。方法 采用症状自评量表 ( Symptom Checklist90 ,SCL-90 )对 3 9例 Bell’s面瘫患者进行测试 ,与《精神科评定量表手册》中提供的常模进行比较 ,并且将 3 9例患者分不同性别、不同年龄组进行比较。结果 SCL-90测试显示 Bell’s面瘫患者在焦虑、人际关系、躯体化因子均分 (分别为 1 .5 4±0 .2 8、1 .81± 0 .3 2、1 .48± 0 .3 2 )皆高于国内常模 ( P<0 .0 5～ 0 .0 1 ) ;女性组、≤ 45岁组的焦虑、人际关系及躯体化因子均分分别显著性高于男性组和 >45岁组 ( P<0 .0 5 )。结论 Bell’s面瘫患者存在心理健康问题 ,不同性别、年龄患者的心理健康状况严重程度不同 ,应采用心理干预。

316例Bell’s面瘫患者注意力与暗示性影响因素研究

目的：评价Bell’s面瘫患者注意力及暗示性程度并探讨其影响因素。方法：Bell’s面瘫患者316例,采用House Brackmann（HB）分级量表评估患者面瘫程度,划消实验、暗示性测验评估面瘫患者注意力和暗示性程度。根据病程将患者分为急性期（≤72 h）和亚急性期（72~168 h）;根据病情程度将患者分为轻度（HB评分Ⅰ~Ⅲ级）和重度（HB评分Ⅳ~Ⅵ级）。独立样本t检验比较不同病程和病情患者HB评分、注意力评分、暗示性评分;Spearman等级相关分析和多元逐步回归分析探讨影响面瘫患者注意力、暗示性的因素。结果：急性期、轻度面瘫患者注意力评分高于亚急性期、重度面瘫患者;急性期、轻度面瘫患者暗示性评分低于亚急性期、重度面瘫患者;面瘫患者HB评分与注意力呈负相关,与暗示性程度呈正相关;影响注意力的主要因素有HB评分、病程、文化程度、年龄等;影响暗示性的主要因素有病情程度、病程、性别、年龄、文化程度等。结论：面瘫患者注意力下降,暗示性程度增强,主要与面瘫程度、病程、文化程度、年龄。