Peripheral Facial Paralysis in People Living with Human Immunodeficiency Virus (HIV)

Introduction: Peripheral facial palsy (PFP) is a frequent reason for ENT consultations. It is a common complication of human immunodeficiency virus (HIV) infection. The aim of this study was to describe the diagnostic and therapeutic aspects and to establish the correlation between PFP and HIV in our context. Patients and Method: This was a retrospective descriptive study conducted in the ENT and CFS department of the HIAOBO, covering the medical records of patients hospitalized for taking a PFP on HIV terrain from January 1, 2016 to December 31, 2020. Results: The study involved 17 patients, 10 men (59%) and 7 women (41%), a sex ratio of 1.4. The average age was 39 years with the extremes of 11 and 69 years. Shopkeepers reported 9 cases (53%). The reason for consultation was facial asymmetry in 11 cases (100%). The delay in consultation during the first week was 82.4%. Clinical signs were unilateral facial asymmetry, the opening of the palpebral fissure and lacrimation. All patients received medical treatment for PFP and HIV. Evolution was favorable, with complete recovery and no sequelae in 82.4% of cases. Surgery was performed in one case. Conclusion: PFPs are common in HIV infection. Diagnosis is clinical and management is multidisciplinary. Progression depends on the length of time taken to treat the disease.

The research progress of acupuncture and moxibustion in the treatment of peripheral facial paralysis

As a common and frequently-occurring disease in clinic,peripheral facial paralysis is worth paying attention to.In fact,as one of the methods for the treatment of peripheral facial paralysis,acupuncture has been widely promoted and applied in clinic,and has been recognized by doctors at home and abroad.However,there are many other factors that affect the curative effect in clinic due to their different operating methods.Therefore,there are still many disputes in the treatment of peripheral facial paralysis.The relevant literatures in recent years were searched and consulted in order to understand the current situation and provide routine treatment methods for clinical acupuncturists to treat this disease.And we intended to analyze and introduce from acupuncture manipulation,warm acupuncture,electroacupuncture,giant acupuncture,fire acupuncture,acupuncture combined with massage,acupuncture timing and other treatments,and different classification of acupuncture points and methods.

CLINICAL ANALYSIS ON INTEGRATED TREATMENT OF 2240 CASES OF PERIPHERAL FACIAL PARALYSIS BY STAGES IN PLATEAU REGION

Objective. To observe the therapeutic effect of integrated treatment of peripheral facial paralysis by stages in Qinghai plateau area. Methods： A total of 2 240 cases of peripheral facial paralysis treated with integrated approaches by stages were assigned to treatment group, and other 75 cases treated with acupuncture therapy assigned to control group. In treatment group, patients were treated with 1 ） medication （ Prednisone, Dipazol, etc） and TDP （“special electromagnetic spectrum”） plus ultrashort irradiation in the early stage;2） TDP plus ultrasonic wave irradiation and acupuncture of Yangbai （阳白 GB 14） to Yuyac （鱼腰EX-HN 4, penetration needling）, etc in the medium stage; 3） medium-frequency irradiation and electroacupuncture （EA） of muscle motor joints and acupoints （GB-14, etc）. Patients of control group were treated with conventional acupuncture therapy （GB-14, etc）. Results： After treatment, of the 2 240 patients in treatment group, 2 072 （92.5%） were cured, 120 （5.3%） effective, 33 （ 1.5% ） improved, and 15 （0.7%） failed. The total effective rate was 99.3%. Of the 75 cases in control group, 46 （61.3%） were cured, 16 （21.3%） effective, 9 （12.0%） improved, and 4 （5.4%） ineffective. The total effective rate was 94.6%. The cure rate and the total effective rate of treatment group were significantly higher than those of control group respectively （x^2=29.379, P〈0.01; x^2 =5. 716, P〈0. 025）. Conclusion： The therapeutic effect of integrated approaches （medication, acupuncture, electromagnetic ＋ ultrashort wave ＋ ultrasonic wave ＋ medium-frequency wave irradiation） is significantly superior to that of simple acupuncture therapy in treating peripheral facial paralysis.

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

PERIPHERAL FACIAL PARALYSIS TREATED BY MULTI-DIRECTIONAL NEEDLING

Objective：To search for an effective therapy in treating peripheral facial paralysis. Methods： One hundred and eight patients were randomly divided into treatment group （n = 68） and control group （n = 40）. The multi-directional needling technique was used by selecting Jiache （颊车 ST 6）, Yangbai （阳白 GB 14） and Dicang （地仓 ST 4） in the treatment group, and the traditional acupuncture technique with conventional needle selection was used in the control group. The treatment was given once daily with 10 treatments constituting a therapeutic course, and 2 courses of treatment were given in both the groups. Results： After the treatment, of the 68 and 40 cases in treatment and control groups, 56 （82.3%） and 28 （70.0%） were cured, 11 （16.2%） and 8 （20.0%） improved in clinical symptoms and signs, 1 （1.5%） and 4 （10.0%） failed, with the total effective rate being 98.5% and 90.0% respectively, and the therapeutic effect of treatment group was significantly superior to that of control group （ P 〈 0.05）. Conclusion： The multi-directional needling is an effective therapy for treating peripheral facial paralysis.

Bilateral Peripheral Facial Paralysis Combined with HIV Meningitis During Acute HIV-1 Infection: A Case Report

Here we reported a Chinese case of bilateral peripheral facial paralysis(PFP) in human immunodeficiency virusc(HIV) infected population. A 38-year-old homosexual male patient was referred to our hospital for bilateral facial paralysis. 21 days prior to admission he had developed high fever, chills, headache, fatigue, general malaise, nausea and vomiting. Neurological examination revealed bilateral ptosis of lower lip and cheeks, as well as failure of bilateral eyes closure. Analysis of cerebrospinal fluid(CSF) revealed pleocytosis, a marked rise of micro total protein and a marked rise of intrathecal lgG synthesis. The result of HIV-1 serology was positive by ELISA and that was confirmed by western blot. His CD4^+ cell count was 180 cells/mm^3. HIV-1 viral load in CSF was almost 10 times higher than that in plasma. The patient's condition improved steadily and experienced complete resolution of bilateral PFP after 2 months.

TREATMENT OF 46 CASES OF PERIPHERAL FACIAL PARALYSIS WITH HAND ACUPUNCTURE,MOXIBUSTION AND ELECTROACUPUNCTURE

In the present paper, the therapeutic effect of hand acupuncture, moxibustion and electroacupuncture (EA) is observed in the treatment of 46 cases of peripheral facial paralysis (treatment group) and compared with that of Western medicines (prednisone, Vitamin B1 and B12, dibazol) in other 42 facial palsy patients. Acupoints used are Fenchi (GB 20), Yifeng (TE 17), Taiyang (LR 3), Yangbai (GB 14), Cuanzhu (BL 2), Yingxiang (LI 20), Dicang (ST 4), Shuigou (GV 26), Chengjiang (CV 24), Xiaguan (ST 7) and Jiache (ST 6). Following 20 - 30 sessions of treatment, results show that the therapeutic effect of treatment group is significantly superior to that of Western medicine group and the therapeutic duration of the former group is shorter.

CLINICAL OBSERVATION ON STAGE-AIDED TREATMENT OF 62 CASES OF PERIPHERAL FACIAL PARALYSIS WITH ACUPUNCTURE,MOXIBUSTION AND CUPPING

Objective: To probe the best therapy for peripheral facial paralysis. Methods: A total of 122 cases of facial paralysis patients were randomized into treatment group (n=62, treating the disease by stages) and control group (n=60). For patients at the acute stage in treatment group, main point Yifeng (TE 17) was pricked first, followed by performing cupping and moxibustion, for patients at the resting stage, main point Hegu (LI 4) was punctured with reducing needling method, combined with other acupoints in the light of the concrete situations. For patients at the restoration stage, main point Zusanli (ST 36) was punctured with reinforcing method in combination with seven-star-needle tapping at the local affected region. Patients of control group were treated with routine method by puncturing Fengchi (GB 20), Yifeng (TE 17), Jiache (ST 6), Hegu (LI 4), Taichong (LR 3), etc.. The treatment was conducted once daily, with 10 days being a therapeutic course. Results: Following 3 courses of treatment, of the 62 cases in treatment group, 44 (70.9%) were cured, 12 (19.4%) had remarkable improvement in their symptoms and signs, 6 (9.7%) had amelioration, with the cure plus markedly effective rate being 90.3%; of the 60 cases in control group, 30 (50.0%) were cured, 12 (20.0%) had apparent improvement, 16 (26.7%) had amelioration, and the rest 2 (3.3%) failed in the treatment, with the cure plus markedly effective rate being 70.0%. Ridit analysis showed that the cure rate and cure plus markedly effective rate of treatment group were significantly higher than those of control group (P<0.05). Conclusion: Stage-aided acupuncture treatment is superior to routine treatment for facial palsy.

80 CASES OF PERIPHERAL FACIAL PARALYSIS TREATED BY ACUPUNCTURE WITH VIBRATING SHALLOW INSERTION

Eighty cases of peripheral facial paralysis were treated by acupuncture with vibrating shallow insertion. The total effective rate was 98.75% and cure rate 88.75%. There was no significant difference in therapeutic effect as compared with the conventional electroacupuncture method (P > 0.5), suggesting that shallow puncture by vibratings can also yield satisfactory therapeutic results.

CLASSIFICATION, PROGRESSIVE STAGE AND COMBINED TREATMENT OF PERIPHERAL FACIAL PARALYSIS

A combined method using acupuncture,Chinese herbs and Western medicine inthe treatment of peripheral facial paralysis is formulated from the author’s clinical experience duringmore than 20 years period.Two stages and four types are divided separately according to the develop-ment of the disorder and the lesion level of the facial nerve。which are different from the classificationsin the common textbooks.Out of the whole series of 718 cases,99.58％of the patients got cured andno one had been treated ineffectively.

CLINICAL OBSERVATION ON TREATMENT OF PERIPHERAL FACIAL PARALYSIS WITH DIFFERENT NEEDLING METHODS

Purpose: To observe the clinical therapeutic effect of different needling methods in the treatment of peripheral facial paralysis. Methods: A total of 158 cases of peripheral facial palsy patients are randomly divided into treatment group (n=116 cases, who are treated by penetration needling method) and control group (n=42 cases, who are treated with traditional acupuncture method). In treatment group, main acupoint pairs for penetration needling are Yangbai (GB 14) -Yuyao (EX-HN 4), Tongziliao (GB 1) -Taiyang (EX-HN 5), Jiache (ST 6) -Dicang (ST 4) and Chengjiang (CV 24) -Jiachengjiang (EX-HN) on the affected side, and in control group, the main acupoints used are Yifeng (TE 17), Yangbai (GB 14), Sibai (ST 2), Dicang (ST 4), Jiache (ST 6), Jingming (BL 1) and Chengjiang (CV 24). The treatment is given once daily with 10 sessions being a therapeutic course. Results: After 3 courses of treatment, the cure rates of treatment group and control group are 81.8% and 66.7% separately, showing a significant difference between two groups (P<0.05). The total effective rates of treatment and control groups are 96.5% and 88.1% separately, presenting a significant difference between two groups (P<0.01). Conclusion: The therapeutic effect of penetration needling method is better than that of traditional acupuncture method.

REVIEW ON ACUPUNCTURE TREATMENT OF PERIPHERAL FACIAL PARALYSIS DURING THE PAST DECADE

Facial paralysis or Bell’s palsy is acommon disease that frequently attacksadults aged 20--40 years, especially women.According to traditional Chinese medicine,the pathogenesis is believed to be due to in-vasion of the channels and collaterals

A SURVEY OF ACUPUNCTURE TREATMENT FOR PERIPHERAL FACIAL PARALYSIS

Peripheral facial paralysis,a commondisease referring mainly to Bell’s palsy,iscaused by peripheral nerve malfunction dueto the effect of cold and wind,the exactcause of which still remains unascertained.

ELECTRIC NEEDLE THERAPY FOR PERIPHERAL FACIAL PARALYSIS

From 1986 to 1995, the author treated 60 cases of peripheral facial paralysis, of which 50 cases were treated with electric needles and 10 cases in the control group with filiform needles.

THE STUDY ON THE RELATION BETWEEN THE LOCATION OF NERVE LESION IN PERIPHERAL FACIAL PARALYSIS AND THE THERAPEUTICAL EFFECT OF ACUPUNCTURE

Due to the difference of the plane of facial nerve lesion,facial paralysis can be classifiedinto nudear paralysis,paralysis of cerebellopontine angle,Hunt’s palsy,Bell’s palsy and simple facialneuritis.The authors treated 78 cases of the of the latter 3 types,compared the therapeutical effect after 2courses of treatment,and meanwhile made dynamic electromyographic observation between the tragusand the quadrate musde of upper lip for those with Bell’s palsy and Hunt’s palsy.The result showsthat acupuncture has a fair effect in treating peripheral facial paralysis and simple facial neuritis andthe myoelectric recovery in Bell’s palsy is quicker than that in Hunt’s palsy.It is suggested that thehfeher the pane of the facial nerve lesion is,the more unsatisfactory the effect is,and the effect ismore favorable otherwise.

OBSERVATION ON THE EFFECT OF SHALLOW NEEDLING FOR TREATMENT OF PERIPHERAL FACIAL PARALYSIS IN 80 AFRICANS

This paper is a summary of 150 cases of facial paralysis in African black people treated with shallow needling and mild needling manipulation. After 3 courses of treatment, of the 80 cases in the shallow-needling group, 71 (88. 8% ) were cured, 5 (6. 3% ) had marked improvement, 3 (3. 7% ) had improvement and 1 (1. 2% ) failed; Of the 70 cases in traditional-needling group, 61 (87. 1 % ) were cured, 6 (8. 6% ) had evident improvement, 2 (2. 9% ) had improvement and 1 (1. 4 % ) had no striking change. Statistical analysis showed no significant difference between the two groups in the therapeutic effect (P >0. 5 ), indicating both the traditional needling method and shallow needling were effective in treatment of facial paralysis in black people. In addition, earlier treatment was very important in healing facial palsy; and the cure rate was higher in younger patients ard those with light severity.

ELECTRO-ACUPUNCTURE TREATMENT OF ACUTE STAGE PERIPHERAL FACIAL PARALYSIS

The use of electro-acupuncture in treatingperipheral facial paralysis during the acute stagehas been a controversial issue among acupunc-turists.Since 1970,100 cases of acute stage peri-pheral facial paralysis(1-10 days after onset)have been treated with electro-acupuncture witha curs rate of 84% and an effective rate of 100%,no cases showing aggravation of symptoms aftertreatment.Electro-acupuncture is therefore usefulin the treatment for acute stage peripheral facialparalysis.

TREATMENT OF PERIPHERAL FACIAL PARALYSIS WITH PICK-PRICK AND CONNECTING-ACUPUNCTURE

Peripheral facial paralysis may occur inall ages,but particularly in the young.Thedisease is characterized by a wry mouth andinability to close the eyes.For many years,the author used pick-prick andconnecting-acupuncture in treatment of thismalady with good therapeutic results,as re-ported in the following.

Peripheral facial paralysis treated with acupuncture-moxibustion by stages: a multi-central large-sample randomized controlled trial

Objective To explore the best intervention time of peripheral facial paralysis （Bell＇ s palsy） treated with acupuncture-moxibustion and the clinical superiority of acupuncture-moxibustion by stages. Methods Multi- central large-sample randomized controlled trial was carried out. Nine hundred cases of Bell＇ s palsy were randomly divided into 5 treatment groups, named as acupuncture by stages group, acupuncture by stages with moxibustion group, acupuncture by stages with electroacupuncture group, acupuncture by stages with line-puncture on muscle region of meridian group and acupuncture without stages group. Four sessions of treatment were required in each group. The clinical curative effects of groups were assessed by House-Brackmann Scale, Facial Disability Index Scale and Degree of Facial Nerve Paralysis Scale during the enrollment, after 4 sessions of treatment, and during 1 and 3 months of follow-up after treatment. The systematic analysis of curative effects was provided in view of the intervention time and nerve localization of disease separately. Results The cure rates of intervention treatment were 50.1% （223/445） in acute stage and 52.1% （162/311） in resting stage, superior to that of 25.9% （35/135） in recovery stage （both P〈0.001）. There was no statistically significant differences in comparison of curative effect in 5 solutions at the same stage （all P〉0.05）. The effect of treatment intervened at acute stage was superior to that at recovery stage in acupuncture by stages group and acupuncture without stages group （both P〈0.01）. There were statistically significant differences in curative effect of the localization above and below chorda tympani nerve in acupuncture by stages with line-puncture on muscle region of meridian group （P〈0.01）. The curative effect of the localization below chorda tympani nerve was superior to that above the nerve. Conclusion The best intervention time for Bell＇ s palsy is at acute stage and resting stage, meaning 1 to 3 weeks after occurrence. All 5 solutions are clinical superiorities to Bell＇s palsy. Under the condition of limited medical sources, the simple filiform needle puncture is recommended at acute stage. For the patients with the disorder above chorda tympani nerve, line-puncture on muscle region of meridian is not recommended.

Comparison on the therapeutic effect of acupuncture on 60 cases of peripheral facial paralysis at different stages

Objective To investigate the difference in the therapeutic effect of different methods in the treatment of peripheral facial paralysis （PFP） at different stages. Methods Sixty cases of PFP at different stages were divided into a treatment group and a control group according to the sequence for visit, and 30 patients were included in each group. The patients in the treatment group were treated by using drugs, acupuncture （shallow puncture and subexcite） and microwave therapy during the acute stage, and they were subjected to electroacupuncture （EA） （heavy stimulation and penetration needling）, acupoint injection, electrotherapy and massage during the convalescence stage. In contrast, the patients in the control group were treated simply with drugs, and the therapeutic methods during the convalescence stage were the same to those for the treatment group, and the therapeutic effect of the two groups was observed after three treatment courses. Results The total effective rate in the treatment group was 100.0% （30/30）, the cured rate after one treatment course was 48.2% （13/27）, the cured rate after two treatment courses was 44.4% （12/27）, and the cured rate after three treatment courses was 7.4% （2/27）. The total effective rate in the control group was 90.0% （27/30）, the cured rate after one treatment course was 5.5% （1/18）, the cured rate after two treatment courses was 27.8% （5/18）, and the cured rate after three treatment courses was 66.7% （12/18）. The therapeutic effect and the treatment courses for healing of the treatment group were significantly better than those in the control group （P0.05）. Conclusion the therapeutic effect of different therapeutic methods on PFP is remarkable.