Evaluation of the vascular contacts of the facial nerve on three-dimensional fast imaging employing steady-state acquisition MRI in Bell's palsy

AbstractIn Bell’s palsy, electrodiagnosis by electroneurography (ENoG) is widely used to predict a patient’s prognosis. The therapeutic options for patients with poor prognostic results remain controversial. Here, we investigated whether early intervention with intratympanic steroid therapy (ITST) is an effective treatment for Bell’s palsy patients with poor electrodiagnostic test results (≤ 10% electroneurography value). Patients in the concurrent ITST group (n = 8) received the standard systemic dose of prednisolone (410 mg total) and intratympanic dexamethasone (16.5 mg total) and those in the control group (n = 21) received systemic prednisolone at the standard dose or higher (average dose, 605 ± 27 mg). A year after onset, the recovery rate was higher in the ITST group than in the control group (88% vs 43%, P = 0.044). The average House-Brackmann grade was better in the concurrent ITST group (1.13 ± 0.13 vs 1.71 ± 0.16, P = 0.035). Concurrent ITST improves the facial nerve outcome in patients with poor electroneurography test results, regardless of whether equivalent or lower glucocorticoid doses were administered. This may be ascribed to a neuroprotective effect of ITST due to a higher dose of steroid reaching the lesion due to dexamethasone transfer in the facial nerve.

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When paediatric facial nerve paralysis is not a Bell's palsy: A case of cerebellopontine angle tumour

Journal of Taibah University Medical Sciences ◽

10.1016/j.jtumed.2021.08.008 ◽

2021 ◽

Author(s):

Meriam T. Ismail ◽

Razlina A. Rahman ◽

Nur S. Idris

Keyword(s):

Facial Nerve ◽

Cerebellopontine Angle ◽

Bell’S Palsy ◽

Facial Nerve Paralysis ◽

Bell's Palsy ◽

Nerve Paralysis ◽

Cerebellopontine Angle Tumour

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Facial Nerve Paralysis Induced by Herpes Simplex Virus in Mice: An Animal Model of Acute and Transient Facial Paralysis

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949510400713 ◽

1995 ◽

Vol 104 (7) ◽

pp. 574-581 ◽

Cited By ~ 80

Author(s):

Toshiaki Sugita ◽

Yasuo Fujiwara ◽

Shingo Murakami ◽

Yoshinari Hirata ◽

Naoaki Yanagihara ◽

...

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Facial Nerve ◽

Facial Paralysis ◽

Bell’S Palsy ◽

Facial Nerve Paralysis ◽

Bell's Palsy ◽

Vacuolar Degeneration ◽

Nerve Paralysis ◽

Simplex Virus

We have been the first to succeed in producing an acute and transient facial paralysis simulating Bell's palsy, by inoculating herpes simplex virus into the auricles or tongues of mice. The KOS strain of the virus was injected into the auricle of 104 mice and the anterior two thirds of the tongue in 30 mice. Facial paralysis developed between 6 and 9 days after virus inoculation, continued for 3 to 7 days, and then recovered spontaneously. The animals were painlessly sacrificed between 6 and 20 days after inoculation for histopathologic and immunocytochemical study. Histopathologically, severe nerve swelling, inflammatory cell infiltration, and vacuolar degeneration were manifested in the affected facial nerve and nuclei. Herpes simplex virus antigens were also detected in the facial nerve, geniculate ganglion, and facial nerve nucleus. The pathophysiologic mechanisms of the facial paralysis are discussed in light of the histopathologic findings, in association with the causation of Bell's palsy.

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Aetiological Profile of Facial Nerve Palsy Seen in Nigerian Tertiary Hospital

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i06/877 ◽

2020 ◽

Vol 5 (06) ◽

Author(s):

Gabriel Toye Olajide ◽

Waheed Atilade Adegbiji ◽

Akinwale Olaleye Akinbade ◽

Anthony Oyebanji Olajuyin ◽

Paul Olowoyo

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Road Traffic ◽

Neck Region ◽

Bell’S Palsy ◽

Facial Nerve Paralysis ◽

Bell's Palsy ◽

Female Ratio ◽

Nerve Paralysis

Background/Aim: Facial nerve palsy may cause facial asymmetry, functional and cosmetic impairment, and therefore imposes great psychological and social problems on the individual with the condition. The aim of this paper was to highlight the aetiological profile of facial nerve palsy (FNP) in two tertiary institutions in Ekiti, southwest, Nigeria. Methods: This was a retrospective review of patients with facial nerve palsy seen and treated at Ear, Nose & Throat (ENT) clinic. All folders and registers of patients diagnosed with facial nerve palsy from January 2010 to December 2019 in the central, ENT and Dental medical records departments were retrieved and reviewed. The information extracted included the socio-demographic characteristics of the patients, clinical presentation, type and aetiology of FNP, side affected, diagnosis/impression, nature of impairment, type of lesion, onset of the disease, treatment and outcome. Results: Of 76 patients analysed, 48(63.2%) were males and 28(36.8%) were females given a male to female ratio of 1:1.7. Their age ranged between 5 to 72 years with a mean of 39.83 ± 17.58 SD. The age range 21-40 years was most commonly affected, representing 31 (40.8%). The commonest cause of facial nerve paralysis was Bell’s palsy in 32(42.1%), followed by trauma 28(36.9%). Of the 28 (36.9%) that was caused by trauma, road traffic injury constituted 15(53.6%). Half (50.0 %) of the lesion affected right side of the face. Seventy (92.1%) was treated medically. Majority (37.0%) presented within one week of their symptoms. All the patients presented with deviation of mouth, followed by inability to close eye in 70 (92.1%). Higher proportion (88.2%) of our patients had lower motor neuron lesion. Conclusion: This study found that majority of our patients was young adults. Bell’s palsy was a major cause of facial nerve paralysis followed by trauma. Most of our patient presented early and did well on conservative treatment. High index of suspicion is essential especially when patients present with injuries involving head and neck region.

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