The use of the facial clinimetric evaluation scale as a patient-based grading system in bell's palsy

2013 ◽  
Vol 123 (5) ◽  
pp. 1256-1260 ◽  
Author(s):  
Jia Hui Ng ◽  
Raymond Yeow Seng Ngo
Keyword(s):  
Bell’S Palsy ◽  
Grading System ◽  
Bell's Palsy ◽  
Facial Clinimetric Evaluation Scale

Comparing the effectiveness of mime therapy and neuromuscular re-education in improving facial symmetry and function in acute Bell's palsy: a pilot randomised clinical trial

2021 ◽  
Vol 28 (3) ◽  
pp. 1-8
Author(s):  
Arnold Fredrick D'Souza ◽  
Sydney Roshan Rebello
Keyword(s):  
Clinical Trial ◽  
Randomised Clinical Trial ◽  
Bell’S Palsy ◽  
Patient Comfort ◽  
Grading System ◽  
Bell's Palsy ◽  
Facial Symmetry ◽  
System P ◽  
And Function ◽  
Facial Clinimetric Evaluation Scale

Background/aims Untreated Bell's palsy may lead to disability and reduced quality of life, while early intervention can improve prognosis. This pilot randomised clinical trial aims to compare the effectiveness of mime therapy and neuromuscular re-education in improving facial symmetry and function in patients with acute Bell's palsy. Methods A total of 20 patients diagnosed with Bell's palsy were included in this study after meeting the inclusion criteria. Patients were randomly divided into two groups of ten. Group A received mime therapy while group B received neuromuscular re-education. Each participant received 12 sessions of the respective treatment over 2 weeks and was assessed for facial symmetry and function using the Sunnybrook Facial Grading System and the Facial Clinimetric Evaluation Scale respectively. Results Although both mime therapy and neuromuscular re-education showed highly significant improvements within each group for both the Sunnybrook Facial Grading System (P=0.005) and Facial Clinimetric Evaluation Scale (P=0.005); they showed no difference between each group for the Sunnybrook Facial Grading System (P=0.212) and Facial Clinimetric Evaluation Scale (P=0.97). Conclusions Mime therapy and neuromuscular re-education are equally effective in the recovery of facial symmetry and function in acute Bell's palsy. Physiotherapists can choose between either technique based on their skills and preference or based on patient comfort and expectation.

Prognostic Factors Associated With Recovery in Children With Bell’s Palsy

2019 ◽  
Vol 34 (14) ◽  
pp. 891-896 ◽  
Author(s):  
Elif Karatoprak ◽  
Sila Yilmaz
Keyword(s):  
Prognostic Factors ◽  
Facial Nerve ◽  
Bell’S Palsy ◽  
Steroid Treatment ◽  
Grading System ◽  
Bell's Palsy ◽  
Early Recovery ◽  
Laboratory Findings ◽  
Distribution Width ◽  
Factors Affecting

Objectives: The aim of the study was to determine the prognosis of children with Bell’s palsy and analyze the prognostic factors affecting early recovery. Methods: The records of children with a diagnosis of Bell’s palsy were retrospectively analyzed. Demographic and clinical features including age, gender, House-Brackmann Facial Nerve Grading System House-Brackmann Grading Scale (HBGS) grade at admission and follow-up, and the dosage and onset of steroid treatment were reviewed. Laboratory findings such as red blood cell distribution width and neutrophil-to-lymphocyte ratio were noted. The patients who were recovered within the first month (early recovery) were compared with the patients who were recovered after first month (late recovery) in terms of demographic, clinical characteristics, laboratory findings and treatment modalities in order to determine the risk factors affecting early recovery. Results: A total of 102 children (65 girls and 37 boys) with a mean age of 10.37 ± 4.2 years were included in the study. The complete recovery was detected in 101 children (%99) with Bell’s palsy. Statistically significant difference was found in terms of dosage and time of onset of steroid treatment ( P = .04, P = .035, respectively) and House-Brackmann Facial Nerve Grading System grade on the 10th day ( P = .001) between the early and late recovery groups. Conclusion: The prognosis of Bell’s palsy in children was very good. The prognostic factors affecting the early recovery were being House-Brackmann Facial Nerve Grading System grade 2 or 3 on the 10th day and receiving steroid treatment in the first 24 hours. Neutrophil-to-lymphocyte ratio and red blood cell distribution width were not found to be predictive factors for early recovery.

Yanagihara Facial Nerve Grading System as a Prognostic Tool in Bell’s Palsy

2014 ◽  
Vol 35 (9) ◽  
pp. 1669-1672 ◽  
Author(s):  
Naohito Hato ◽  
Takashi Fujiwara ◽  
Kiyofumi Gyo ◽  
Naoaki Yanagihara
Keyword(s):  
Facial Nerve ◽  
Bell’S Palsy ◽  
Grading System ◽  
Bell's Palsy ◽  
Prognostic Tool

Lip-Length and Snout Indices in Bell's Palsy: a Comparison with the House Grading System

1991 ◽  
Vol 111 (3) ◽  
pp. 1065-1069
Author(s):  
C. Jansen ◽  
P. P. Devriese ◽  
F. G. I. Jennekens ◽  
H. J. A. Wijnne
Keyword(s):  
Bell’S Palsy ◽  
Grading System ◽  
Bell's Palsy

scholarly journals Nerve conduction study in rehabilitation of patients with residuals and complications of long-standing Bell's palsy

2018 ◽  
Vol 27 (3) ◽  
pp. 39-45
Author(s):  
A. Pashov
Keyword(s):  
Facial Nerve ◽  
Facial Expressions ◽  
Reference Electrode ◽  
Bell’S Palsy ◽  
Grading System ◽  
Standard Protocol ◽  
Bell's Palsy ◽  
Facial Muscles ◽  
Detailed Assessment ◽  
Time Required

From every 100 cases of Bell’s palsy (idiopathic peripheral facial palsy) from 15 to 30 will not recover completely. Some residuals will remain, and some complications will develop. As residuals, one can name weakness of facial muscles, asymmetry of facial expressions, distortion of taste, hyperacusis, dry eye. Possible complications of long-standing Bell’s palsy (BP) are also numerous: contractures of facial muscles, pathological synkinesis, mass movements, crocodile tears, facial pains, headaches, emotional disbalance etc. Unresolved cases of Bell’s palsy require rehabilitation programs that will address both the issues of general nerve regeneration, complications and irregularities in mimetic movements, and psycho-emotional state of long-standing Bell’s palsy patients. There are several methods and systems to assess the condition of facial nerve and functioning of facial muscles. These scales and systems are either therapist- or patient-graded: House-Brackmann Facial Grading system, Sunnybrook Facial Grading system, Facial Clinimetric Evaluation Scale (FaCE Scale), Synkinesis Assessment Questionnaire (SAQ) and several others. At the same time, to compose a well-balanced and focused rehabilitation program, next to subjective assessments and test-photos of standard facial expressions, it is important to have an objective, instrumentally-measured picture of facial nerve recovery, as well as of the physiological ability of mimetic muscles to perform facial movements, to reflect emotions and to produce articulated speech. In that respect, the surface EMG or Nerve Conduction Study (NCS) is the modality of choice. NCS-examination is non-invasive and is relatively easy to perform. It records Compound Muscle Action Potentials (CMAPs) in response to external stimulation. The analysis of recorded graphs allows to evaluate the level of regeneration and maturity of recovering axons in main branches of the facial nerve. At the same time, the standard protocol of NCS does not offer a detailed assessment of each particular muscle of facial expression. It also requires additional time to swap the active electrode position when changing stimulation side from right to left and vice versa. At Crystal Touch Bell’s palsy clinic, we have developed an amended NCS protocol that addresses all mentioned issues. To allow a more detailed assessment of facial muscles, we have added mm.zygomatici (major et minor) and m.depressor anguli oris to the list of measured facial muscles. In order to perform a more focused stimulation and to receive a more “clean” motor responses from facial muscles, we changed the position of stimulating electrode. In the standard protocol, stimulating electrode is placed either pre- or post-auricularly. In Crystal Touch protocol, we position the stimulating electrode above each particular nerve branch that innervates the measured muscle. Therefore, we use six positions of stimulating electrode that correspond to the six measured facial muscles: m.frontalis, m.orbicularis oculi pars superioris, m.nasalis et m.levator labii superioris, mm.zygomatici (major et minor), m.orbicularis oculi pars superioris, m.depressor anguli oris et m.mentalis. To save time required for the examination, instead of placing reference electrode on the nasal bridge (standard protocol), we use contralateral electrode over the same as measured muscle, as a reference electrode. As there are no anastomoses between left and right facial nerves, stimulation of facial nerve on one side will not evoke CMAPs in contralateral facial muscles. This simple amendment allows to save about 15% of total time required for the examination. In this article we also briefly touch the following issues: distortion in reciprocal inhibition of facial muscles-antagonists, forming of the pathological mimetic patterns in the motor cortex due to lack of proprioceptive feedback during long recovery, and the necessity to further investigate from the electrotechnical, engineering and functional point of view the hypothesis of aberrant regeneration as possible cause of facial synkinesis.

Recurrent Bell’s Palsy

1974 ◽  
Vol 7 (2) ◽  
pp. 407-409
Author(s):  
W. Hugh Powers
Keyword(s):  
Bell’S Palsy ◽  
Bell's Palsy

Late Surgical Decompression of Facial Nerve in Bell's Palsy: A Case Report

2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
L. M. Marques ◽  
J. Pimentel ◽  
P. Escada ◽  
G. Neto D'Almeida
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Bell’S Palsy ◽  
Surgical Decompression ◽  
Bell's Palsy
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