Search

Background and Objectives Although several studies have compared the characteristics of Ramsay Hunt syndrome (RHS) with Bell’s palsy (BP), the differences in comorbid symptoms and prognosis according to symptoms have not been determined. This study therefore evaluated the differences in otologic symptoms and prognosis between patients with these two conditions.Subjects and Method The medical records of 118 patients with RHS and 215 patients with BP were retrospectively reviewed. Factors compared in these two groups included otologic symptoms, general health condition, electroneurography (ENoG) and House-Brackmann grades.Results Age, sex, body mass index, lipid profiles, ENoG, rate of diabetes, and side of palsy did not differ significantly between patients with RHS and BP (p>0.05). The rates of hearing disturbance, tinnitus, vertigo, and postauricular pain were significantly higher in RHS (p0.05). Additionally, in patients with facial paralysis, diabetes was associated with hearing disturbance and vertigo symptoms and dyslipidemia was associated with postauricular pain (p

الملخص: يعتبر شلل العصب الوجهي عند الأطفال حالة سريرية نادرة يمكن أن تؤدي إلى مضاعفات خطيرة. بسبب ندرة حدوثه، هذه الأورام خاصة في الزاوية المخيخية الجسرية، يمكن ألا تُلحظ. نبلغ عن حالة ورم في الزاوية المخيخية الجسرية عند طفل ذكر عمره ۸ أعوام حضر بشلل العصب الوجهي في الجانب الأيمن من نوع العصبون الحركي السفلي. كما أظهر الفحص رأرأة ثنائية خفيفة. ولكن، تم تضليله بالتشخيص الأولي بشلل بيل، كان هناك تأخير في إجراء التصوير بالرنين المغناطيسي التشخيصي للدماغ، والذي أظهر ورم كبير في الزاوية المخيخية الجسرية. لاحقا، وبعد ستة أسابيع من حضوره الأولي، مات الطفل من المرض. توضح هذه الحالة أن الفحص السريري الدقيق حتى في الحالات التي تبدو بسيطة أمرا ضروريا لتجنب أخطاء التشخيص. Abstract: Facial nerve paralysis in children is a rare clinical condition that can lead to serious complications. Due to their rare occurrence, tumours, especially in the cerebellopontine angle, may be overlooked. We report a case of cerebellopontine angle tumour in an 8-year-old boy who presented with a right-sided lower motor neuron type of facial nerve palsy. Further examination showed a mild bilateral nystagmus. However, misled by the initial diagnosis of Bell's palsy, there was a delay in performing diagnostic magnetic resonance imaging of the brain, which showed a large mass in the cerebellopontine. Subsequently, six weeks after his initial presentation, the boy succumbed to the disease. This case illustrates that careful clinical examination, even in a seemingly simple case, is imperative to avoid diagnostic errors.

Bell’s palsy is characterized by rapid, unilateral paralysis of cranial nerve VII and is the most common cause of acute facial paralysis, although the pathogenesis of the condition is poorly understood. Bell’s palsy can be managed by the nurse practitioner in primary care, and the majority of clients achieve full recovery. Appropriate diagnosis through history and physical examination to exclude other causes allows for timely diagnosis, intervention, and patient reassurance. Pharmacologic and adjunctive treatment is available to shorten the duration and improve symptoms. Nurse practitioners should be able to identify circumstances in which referral to a specialist for intervention and follow-up may be appropriate.

Bell's palsy is an idiopathic, unilateral facial paralysis, caused by a malfunction anywhere along the facial nerve's peripheral portion, from the pons distally. Bell's palsy is treated by removing the cause of nerve injury, strengthening the face muscles, and restoring facial function. Physical therapy in the form of neuromuscular electrical stimulation (NMES), massage and facial exercises is used as adjuvant to hasten recovery. The aim of this study is to access of role of neuromuscular electrical stimulation (NMES) treatment in Bell’s palsy patients. A detailed neurological assessment of three patients was done with emphasis on facial muscles and severity of paralysis was graded according to House Brackmann scale (HBS). Conventional physiotherapy was given in the form of electrical stimulation, facial massage, exercises and functional re-education on a daily basis. Patients were assessed at weekly and 1months after the treatment. They experienced complete recovery within 1month follow-up, no recurrence was observed and all patients have normal facial movement. Physiotherapy in the form of NMES and facial exercises has a effective role in the early management of Bell’s palsy. Keywords: Bell’s palsy; neuromuscular electrical stimulation; House Brackmann scale; physiotherapy.

The purpose of this review is to report the knowledge for otolaryngologists on standard of care, latest advances, interesting new findings and controversies about the treatment of Bell's palsy. This review is focusing on the acute phase of the disease. The chronic phase, with incomplete, incorrect or no recovery of the palsy, is described briefly. Treatment with prednisolone alone within 72 hours after onset still is the cornerstone of the treatment. The role of antivirals still is unclear. Since 2009 no new and breakthrough clinical trials with influence on the treatment standards have been performed. A study to clarify the role of prednisolone treatment in children is ongoing. Patient-related outcome measures like the Facial Clinimetric Evaluation Scale and the Facial Disability Index are important tools to assess the subjective severity of the disease and psychosocial impact of Bell's palsy next to the motor deficits. Simplified subjective electronic grading systems like the eFACE and first automated image analysis systems have been introduced. Studies clarifying the role of antivirals for severe cases are urgently needed as well as studies on the role of salvage second line therapy after insufficient response to initial corticosteroid treatment. An international consensus on the outcome measures in diagnostics and follow-up is also needed.

Bell's palsy is the term given to an idiopathic lower motor neurone facial nerve paresis or paralysis. It is of rapid onset, almost always unilateral, and may be associated with facial or retro-auricular pain or otalgia. It is the most common diagnosis associated with facial nerve palsy; a GP will see a case approximately every 2 years in practice in the United Kingdom. Early diagnosis and steroid treatment increase the likelihood of full recovery, whereas ocular complications can be prevented by lubricants and lid taping. Over 70% of patients recover within a year. Options to improve facial appearance and function, in those who do not experience a complete recovery, include surgery.

Even though no definitive link has been established, Bell's palsy has been described as a potential side effect of SARS-CoV-2 mRNA vaccines in a few reports, and the US Food and Drug Administration has recommended strict surveillance of its occurrence in the vaccinated general population. We present the case of a previously healthy 35-year-old female patient who developed Bell's palsy 12 h after receiving the first dose of the mRNA-1273 vaccine. Her general practitioner performed the diagnosis, and corticosteroid treatment was initiated, with slow symptoms improvement. The neurologist's evaluation and a contrast-enhanced brain Magnetic Resonance Imaging revealed a subtle enhancement of the left facial nerve, confirming the diagnosis of Bell's palsy.

Objective. This report is the first one to describe the possibility to use “self‐administered” photobiomodulation (PBM) for Bell’s palsy (BP) treatment. Background. BP is a peripheral disorder of the facial nerve causing sudden paralysis of unilateral facial muscles, and PBM has been successfully suggested for its treatment without any side effect. This is the first case report where a laser device was successfully used at home by the patient herself to treat BP opening new perspectives on the therapy of this disease. Methods. This report describes the “at-home PBM” treatment performed on a 15-year-old girl who presented BP consisting of acute pain on the right side of her face, difficulty in biting and dripping saliva from the right side of her lips. The treatment was performed twice a day by cutaneous applications, each of 15 minutes (total fluence 48 J/cm2) in an area corresponding to the parotid gland by a device emitting at 808 nm at 250 mW output power. Results. Two weeks after PBM treatment, performed at home twice a day by the patient herself without any kind of pharmacological therapy, the complete disappearing of the disease was noticed with no side effects. Conclusion. With the limitations due to a single case report and with the need of further clinical trials to confirm it, “at-home PBM” seems to represent a good and safe approach to the treatment of BP.

Background: Bell’s palsy (BP) is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis and idiopathic, unilateral or bilateral paralysis of the facial nerve without any associated disorders. Aim: To evaluate the effect of health educational guidelines on knowledge and practices of mothers having children with Bell's Palsy. Design: A quasi-experimental research design was used. Setting: This study was conducted at physical therapy department of Beni-Suef Hospital. Subject: 100 mothers and their children were selected randomly. Tools: Two tools were used for data collection, Tool1: A Self-administered questionnaire: Developed by the researchers and used to assess characteristics of mothers and their children also mothers’ knowledge about Bell's palsy (pre, post, and at follow up) phases of guidelines implementation. Tool2: An observational checklist (pre/post and follow up tests) to evaluate mothers’ practices in relation to their children with Bell's palsy such as pain relieving, eye care, follow up with doctor, mouth and dental hygiene, maintaining muscle tone and facial palsy yoga exercise. Results: There were highly statistically significant differences (P

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.

Background: In this retrospective study, we aimed to determine which diagnostic tests were associated with an improvement in Bell’s palsy symptoms. Methods: There were 30 patients who visited Kyung Hee University Korean Medicine Hospital from April 1, 2017 to February 29, 2020, and who received East-West collaboration treatment for Bell’s palsy. The tests included electroneurography (ENoG), electromyography (EMG), hematology, and heart rate variability (HRV) results which were used to determine if any test correlated with improvement of Bell’s palsy symptoms. Results: The initial severity of symptoms did not correlate with the tests performed, with the exception of mean corpuscular hemoglobin concentration (p = 0.013). For both ENoG for oculi degeneration and mean EMG tests, the rate of nerve degeneration showed a significant negative correlation with the improvement of Bell’s palsy symptoms. Amongst the HRV test indicators, the square root of the mean of the sum of the squares of differences between the adjacent normal R-R wave interval, the standard deviation of intervals, total power, very low frequency, and high frequency of the wave was negatively correlated with improvement of Bell’s palsy symptoms. Similarly, glycosylated hemoglobin Type A1c (HbA1c) and erythrocyte sedimentation rate (ESR) showed a negative correlation with improvement of symptoms of Bell’s palsy. With the exception of HbA1c and ESR, the remaining hematology test results showed no significant difference when comparing before and after treatment. Conclusion: ENoG, EMG, HRV test, HbA1c, and ESR negatively correlated with improvements in Bell’s palsy symptoms and may determine the prognosis of Bell’s palsy.

There were 26 Bell’s palsy cases at the Jecheon Hospital of Korean medicine, Semyung University from February 1, 2019, to February 28, 2021 reviewed. One group (A group) was treated with Bamboo salt pharmacopuncture and cervi cornu parvum pharmacopuncture (CC) pharmacopuncture in the paralyzed side of the face, and the other (B group) group was treated with Soyum pharmacopuncture, and hominis placenta (HP) pharmacopuncture. Amid a paucity of studies that have used bamboo salt and CC pharmacopuncture to treat Bell’s palsy, this study aimed to demonstrate possibility of treatment effect on Bell’s palsy. In addition, this study was to see if the effect of determine a change in pharmacopuncture was changed according to the progress of Bell’s palsy symptoms was effective. Bell’s palsy was improved in each group. Altough there were no significant differences in improvement between two groups, Bamboo salt pharmacopuncture and CC pharmacopuncture could be expected to be effective on the paralyzed face. Furthermore, it is effective to switch pharmacopuncture according to the progress of Bell’s palsy.

Bell’s palsy (BP) is the most frequently diagnosed acute partial or complete paralysis of the facial nerve which has an unclear etiology and mostly affects one side of the face. Adverse weather conditions are considered to increase the likelihood of developing BP. The retrospective study included 199 BP patients aged 2–82 years that presented to the Ear, Nose, and Throat (ENT) clinics at Kumluca State Hospital and Serik State Hospital, Antalya, Turkey and received treatment between January 2017 and December 2020. The 199 patients comprised 106 (53.3%) men and 93 (46.7%) women with a mean age of 42.23 ± 12.99 years. The highest incidence of BP was observed in winter (December-February) (35%), followed by fall (23%), summer (22%), and spring (20%) (p

Introduction: Bell’s palsy is the most common facial nerve disorder. The clinical symptoms of Bell’s palsy include facial muscle paralysis, difficulty in eating, drinking and talking. Bell’s palsy management is still controversial. Many patients recover spontaneously; some require medicines like corticosteroids, antiviral drugs and other managements. Aim: To study the effectiveness of Bell’s palsy management that has been followed in our institution. Materials and Methods: This analysis had carried out from June 2016 to June 2019at SRM Medical College Hospital and Research Institute, Chennai. Total of 30 patients with Bell’s palsy who had admitted in the Department of Otorhinolaryngology had enrolled in this study. All the patients underwent thorough clinical examination and laboratory investigation, and the results were statistically analyzed and discussed. Results: Out of 30 patients, 16(53%) patients were males, and 14(47%) patients were females. 53.3% of patients had onset of symptoms after 48 hours. There was a statistical significant improvement in House-Brackman scale on 6 months follow-up. Conclusion: The therapeutic measures for Bell’s palsy if initiated within 72 hours of onset aids in bringing better outcome and improves the quality of life in patients. Keywords: Bell’s palsy, HouseBrackman scale, Corticosteroids, Paralysis.

Background Bell’s palsy is an acute idiopathic paralysis of the facial nerve. The disease is caused by many viruses like Herpes simplex virus-1, Varicella zoster, Epstein-bar virus, Cytomegalovirus, Usutu virus, Human immunodeficiency virus, etc. Literature has reported few cases of COVID-19 patients with Bell’s palsy as the only major neurological manifestation indicating the possible role of another virus in the etiopathogenesis of Bell’s Palsy. This paper aims to evaluate the reported cases of COVID-19 positive patients, presented with Bell’s palsy as the only major neurological manifestation from March 2020 to December 2020, and to investigate the association of SARS-CoV2 and Bell’s palsy. Materials and methods A systematic review of the published literature was performed using an electronic search in PubMed/Medline, Science Direct, Web of Science, Embase, J- STAGE, Google Scholar, China National Knowledge Infrastructure (CKNI) and Scopus databases, from March 2020 to Dec 2020 using keywords like ‘COVID-19’, ‘SARS-CoV-2’, ‘Coronavirus’, ‘Bell’s palsy’, ‘Facial nerve’, ‘First’, ‘Only’,‘ Neurological’, ‘Manifestation’. The studies reviewed were case series and case reports regarding the subject. Results Search strategy revealed thirteen articles from March 2020 to Dec 2020 with a total of 20 cases of COVID-19 with Bell’s palsy as the only major neurological manifestation. Conclusion Evidence of Bell’s palsy as the only major neurological manifestation in COVID-19 patients signifies an important clinical finding but robust research is needed to investigate their association and the exact mechanisms by which SARS-CoV2 causes Bell’s Palsy.

The new coronavirus SARS-CoV-2 is a single-stranded RNA virus of the Coronaviridae family and is clinically manifest with respiratory symptoms. However, patients have been described with symptoms and complications from the nervous system, as well as skin manifestations in the form of various rashes. In our clinical case of coronavirus infection (SARS-CoV-2), this is pneumonia with respiratory failure of the 1st degree, moderate severity and Bell’s palsy in combination with skin rashes in the form of an urticarial rash in a 58-year-old woman. Clinical features of cutaneous and neurological symptoms were prior to the development of respiratory symptoms. The presented clinical case showed that COVID-19, before the development of respiratory symptoms, can manifest itself with peripheral paralysis of the facial nerve and be combined with skin rashes, which can complicate the timely diagnosis of a viral disease.

Summary Objective To assess botulinum toxin treatment for buccinator muscle synkinesis including: how often the synkinesis was troublesome; who benefitted and how from the treatment; and what were the adverse effects, ideal dosage, and injection site. Subjects and Methods Facial palsy (FP) patients and patients with hemifacial spasms who were attending for multiple site botulinum-toxin treatment for facial sequelae were assessed for buccinator synkinesis. The study group comprises those experiencing buccinator synkinesis with associated bothering symptoms who were willing to try injection also to the buccinator muscle. Results During 9/2017–12/2019, 126 different patients with facial sequelae were treated with multiple-site botulin-toxin injections by the author. Of them, 83 (66%) received injection also for buccinator synkinesis and 66/82 (80%) wanted to continue with the buccinator injections. The most remarkable results were seen with FP patients biting the mucus membrane of their cheek: usually the biting ceased totally. Patients with powerful hemifacial cheek spasms also experienced cessation of the spasms, contrasting any previous treatments. Adverse effects were mostly mild: slight weakness of the corner of the mouth or additional leakage of saliva or liquids. Only a few patients experienced more pronounced adverse effects. The most posterior contracting part of the buccinator muscle proved to be the best site for the injection. Conclusions Buccinator synkinesis was very common and its treatment gave many patients additional relief from facial sequelae symptoms. Professionals treating patients with synkinesis and hemifacial spasms should add well-tolerated buccinator injections to their repertoire of injection sites.

Bell's palsy is palsy of the seventh cranial nerve resulting from a dysfunction in the peripheral part of the seventh cranial nerve at the level of the pons or distal. This paper presents a case of a 24-year-old female patient who reported to the Department of Oral Medicine and Radiology with the chief complaint of loss of sensation on the right side of her face for 2 days. The clinical examination reveals gross facial asymmetry, loss of wrinkles when frowning, inability to close the right eye, and deviation of the smile line to the left. The exact etiology was not identified, so unilateral idiopathic Bell's palsy was diagnosed on the right side of her face. The patient was recommended steroids, antivirals, and multivitamins, followed by facial exercise. Full recovery was achieved 6 weeks after the presentation.

Affecting the seventh cranial nerve, known as Bell's palsy and its neuropathy. It is a disfiguring disorder with significant impact on patient’s physical mental and social health. It is normally caused by inflammation caused by traumatic, infectious, inflammatory or compressive conditions, and cranial nerve edema may lead to compression and eventual ischemia. In comparison with the central cause peripheral cause leads to more serious form of Bell’s palsy. The symptoms usually include reduced production of tears, altered taste, facial pain, otalgia and aural pressure. the recovery is usually complete while in some cases incomplete recovery is seen. For treating Bell’s palsy a multidisciplinary approach is required to completely return back to normal. A case of female patient whose age 43 year old came to the right hemifacial palsy department has been identified. There was a affected movement of right side eyebrows and affected right forehead movement during clinical evaluation, spontaneously opening and closing of the right eye, difficulty to close the right eye. No conclusive etiology could be traced out after a series of investigations, hence diagnosed as right side Bell’s palsy. We address the clinical characteristics and modalities of care for Bell’s palsy in this article. Education, facial muscle strengthening exercise, eye defense exercises, modalities and acupuncture were included in the physiotherapy intervention.

Facial nerve palsy is the disease of cranial nerve. From the total number of cases, 60 to 75 % of Bell's palsy cases are idiopathic form of facial palsy. Facial nerve palsy results in weakness of facial muscles, atrophy, asymmetry of face and also disturbs the quality of life. Bell’s palsy occurs in every class of population affecting people of all the age groups but the most common age group affected is 15 - 50 years with equal sex prediliction accounting 11 - 40 cases per 100,000. If facial palsy is not treated properly then it may result in variety of complications like motor synkinesis, dysarthria, contractures of facial muscles, and crocodile tear. Currently facial paralysis treatment consists of combination of pharmacological therapy, facial neuromuscular re-entrainment physiotherapy or surgical intervention by static and dynamic facial reanimation techniques. Physiotherapy treatment is effective for treating facial paralysis with minimal complications and can be individualized. Bell's palsy is the idiopathic form of facial nerve palsy which accounts for 60 to 75 % of cases and male to female ratio is 1:3.1 The aetiology of facial paralysis is not yet thoroughly understood. Cases of varicella-zoster, mononucleosis, herpes simplex virus, mumps and measles have demonstrated good serology in several reports for their association but still stands unclear. 2 Peripheral facial nerve palsy may be idiopathic (primary cause) or Bell’s palsy (secondary). Causes of the secondary unilateral facial nerve palsy are diabetes, stroke, Hansen's disease, herpes simplex infection, birth injury, trauma, tumour, Guillain-Barre syndrome, and immune system disorders. Causes of the bilateral facial nerve palsy are leukemia, brainstem encephalitis, leprosy, and meningitis. The most prominent current theories of facial nerve paralysis pathophysiology include the reactivation of herpes simplex virus infection (HSV type 1). Current facial paralysis treatment consists of a combination of pharmacological therapy, facial neuromuscular re-entrainment physiotherapy or surgical intervention by dynamic and static facial reanimation techniques.7 This is a diagnosed case of right facial nerve palsy which was treated under physiotherapy department with proper rehabilitation protocol.

BACKGROUND: Bell's palsy is a lower motor neurone facial weakness of unknown aetiology, although reactivation of a virus within the facial nerve has been proposed. METHODS: A prospective study was conducted of Bell's palsy cases presenting to our paediatric ENT unit over a 19-week period, from February to June 2020. Patients were invited for severe acute respiratory syndrome coronavirus-2 antibody testing. A text-message questionnaire was sent to other ENT centres to determine their observational experience. RESULTS: During the study period, 17 children presented with Bell's palsy, compared with only 3 children in the same time period in the previous year (p < 0.0001). Five patients underwent severe acute respiratory syndrome coronavirus-2 antibody testing, the results of which were all negative. Four out of 15 centres questioned perceived an increased incidence in paediatric Bell's palsy. CONCLUSION: Clinicians are encouraged to be vigilant to the increase in paediatric Bell's palsy seen during the coronavirus disease 2019 pandemic, which may represent a post-viral sequela of coronavirus disease 2019.

Objective: This study aimed to evaluate the prognostic importance of diabetes mellitus, hematologic and biochemical test findings including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation response index and triglyceride-glucose index in patients with Bell’s palsy and to compare these results with healthy subjects.Material and Methods: The study included 75 patients with incomplete Bell’s palsy.and 24 healthy subjects as the control group. Patients were divided into two groups as diabetes mellitus and non- diabetes mellitus patients. Complete blood count, biochemical tests including glucose, liver and renal function tests and blood lipid profile were analyzed from all the subjects and neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation response index and triglyceride-glucose index values were calculated from these results.Results: Neutrophil-to-lymphocyte ratio and systemic inflammation response index values were higher in patients with Bell’s palsy when compared with the control group. Triglyceride-glucose index was positively correlated with recovery time in all patients and the diabetes mellitus group. It was also positively correlated with prognosis in non- diabetes mellitus patients. High neutrophil-to-lymphocyte ratio was predictive for delayed recovery time only in non- diabetes mellitus patients.Conclusion: Our results indicated that diabetes mellitus didn’t influence severity, recovery time and prognosis of Bell’s palsy. High triglyceride levels and triglyceride-glucose index values were associated with long recovery time in patients with Bell’s palsy. For both diabetes mellitus and non- diabetes mellitus patients, House-Brackmann facial nerve grading scale-initial was the best parameter to predict the prognosis. Neutrophil-to-lymphocyte ratio and systemic inflammation response index values were significantly higher in patients with Bell’s palsy., Amaç: Bell palsili hastalarda, diyabetin prognostik önemini, nötrofil-lenfosit oranı, trombosit-lenfosit oranı, sistemik inflamasyon yanıt indeksi dahil hematolojik ve biyokimyasal test bulgularını değerlendirmek, ayrıca Bell palsili hastalarda trigliserid-glikoz indeksini değerlendirmek ve bu sonuçları sağlıklı deneklerle karşılaştırmaktır.Gereç ve Yöntemler: Çalışmaya, Bell palsisi komplet olmayan 75 hasta ve kontrol grubu olarak 24 sağlıklı birey dahil edildi. Hastalar diyabet olan ve diyabet olmayan olarak iki gruba ayrıldı. Tüm deneklerden tam kan sayımı, glikoz, karaciğer ve böbrek fonksiyon testleri gibi biyokimyasal testler ve kan lipid profili analiz edildi ve bu sonuçlardan nötrofil-lenfosit oranı, trombosit-lenfosit oranı, sistemik inflamasyon yanıt indeksi ve trigliserid-glikoz indeksi değerleri hesaplandı.Bulgular: Nötrofil-lenfosit oranı ve sistemik inflamasyon yanıt indeksi değerleri Bell palsili hastalarda kontrol grubuna göre daha yüksekti. Trigliserid-glikoz indeksi, tüm hastalarda ve diyabet grubunda iyileşme süresi ile pozitif korelasyon gösterdi. Trigliserid-glikoz indeksi ayrıca diyabet olmayan hastalarda prognoz ile pozitif korelasyon gösterdi. Yüksek nötrofil-lenfosit oranı, sadece diyabet olmayan hastalarda gecikmiş iyileşme süresi için öngörücüydü.Sonuç: Sonuçlarımız, diyabetin Bell palsinin şiddetini, iyileşme süresini ve prognozunu etkilemediğini gösterdi. Nötrofil-lenfosit oranı ve sistemik inflamasyon yanıt indeksi değerleri Bell palsili hastalarda anlamlı olarak yüksekti. Yüksek trigliserid seviyeleri ve trigliserid-glikoz indeksi değerleri Bell palsili hastalarda uzun iyileşme süresi ile ilişkilendirildi. Hem diyabet hem de diyabet olmayan hastalar için, the House-Brackmann facial nerve grading scale-initial prognozu tahmin etmek için en iyi parametreydi.

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=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

Bell's palsy is an acute peripheral paralysis of the facial nerve of unknown etiology. The facial nerve is the seventh cranial nerve. One part of the facial nerve is the motor fibers that innervate the facial muscles. The facial nerve emerges from the brain between the posterior edge of the pons and the medulla oblongata with two roots. The main motor nucleus is responsible for the voluntary control of facial muscles. There are central and peripheral paresis of the facial nerve. Central paresis occurs during а stroke. Peripheral paresis (unilateral muscle weakness of the entire half of the face) develops when the facial nerve is affected from the motor nucleus to the exit from the stylomastoid foramen. Among the various localizations of damage to the peripheral part of the facial nerve, the most common is Bell's palsy as a result of edema and compression of the nerve in the bone canal. Clinical symptoms of facial nerve neuropathy are characterized by acute paralysis or paresis of facial muscles: smoothed skin fold on the affected side of the face; swelling of the cheeks; an inability to close the eyelid, Bell's symptom; facial muscle weakness. The degree of damage is determined by the House Brackmann scale. Treatment with glucocorticosteroids, antiviral drugs, physiotherapy procedures. Purpose — to present a clinical case of a patient with Bell's palsy as an example of delayed diagnosis, treatment and, as a result, long-term restoration of the facial muscles functions. Clinical case. The boy after suffering from the flu, began to complain of acute ear pain, vomiting, lack of movement in the right half of the face, dizziness, insomnia. Asymmetry of the face, lack of movement of the right side of the face, inability to completely close the right eye, a symptom of sailing on the right, muscle weakness were revealed during examination. The general condition of the patient improved, facial expressions were restored, sleep was normalized after hormonal, metabolic therapy, physiotherapy procedures. Conclusions. The article describes a case of inflammation of the facial nerve or Bell's palsy in a teenager who developed on the background of the flu. Timely diagnosis and treatment of the above pathology is the key to a satisfactory prognosis for the restoration of facial expressions, prevention of negative consequences of the the disease. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: facial nerve, Bell's palsy, flu, inflammation.

Bell’s palsy, also known as acute idiopathic lower motor neuron facial paralysis, is characterized by sud-den onset paralysis or weakness of the muscles to one side of the face controlled by the facial nerve. In contemporary science, administration of steroids is the treatment of choice for complete facial palsy. Cer-tain Panchakarma procedures and internal Ayurvedic medicines have been proved to be beneficial in the management of Ardita vata. The present report deals with a case of 62-year-old male patient diagnosed as Ardita vata was treated with various Panchakarma procedures like Nasya, Shirobasti, Kukkutanda Swedana, Dashmoola Ksheer Dhoom, Gandoosh and oral Ayurveda medicines. Criteria of assessment was based on the scoring of House-Brackmann Facial Nerve Grading scale. After completion of Ayurveda treatment, the patient Shown almost complete recovery without any adverse effects. This case is an evi-dence to demonstrate the effectiveness of Ayurveda treatment in case of Ardita vata (Bell’s palsy).

Introduction Contemporary epidemiological data on Bell's palsy are crucial to clarify disease burden and improve management strategies. We aimed to examine the epidemiology of, and factors associated with, Bell's palsy treated with steroids in Korea. Methods Using the National Health Insurance claims data from 2008 to 2018, we determined the incidence, recurrence rate, and management trends of Bell's palsy treated with steroids. We defined Bell's palsy cases based on diagnostic codes and concurrent treatment with steroids. Results The incidence of Bell's palsy showed an increasing trend (from 23.0 per 100 000 persons in 2008 to 30.8 per 100 000 persons in 2018). Age (60-69 y), sex (men), and month (January) were risk factors of Bell's palsy. The recurrence rate of Bell's palsy over the 11-y period was 1.5%. Male sex (hazard ratio [HR], 1.1; 95% confidence interval [CI], 1.0-1.2) and physiotherapy (HR, 0.9; 95% CI, 0.8-0.99) were independently associated with the recurrence of Bell's palsy. During the study period, the use of electrodiagnostic testing steadily increased, whereas that of physiotherapy steadily decreased, and antiviral therapy fluctuated,. Discussion The incidence and recurrence rates presented in this study are comparable with those reported in earlier studies that included patients with Bell's palsy, regardless of the use of steroids, and documented an increase in the burden of Bell's palsy. Further randomized controlled trials are required to ascertain the long-term effects of physiotherapy on recurrent Bell's palsy.

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.

INTRODUCTION: Adverse events associated with vaccine administration can manifest in the oral cavity and orofacial region. Hence, the aim of this study was to compare the orofacial adverse effects of two recently authorised COVID-19 vaccines, namely BNT162b2 and mRNA-1273. METHODS: Publicly available data on BNT162b2 and mRNA-1273 vaccines were accessed from the relevant regulatory authorities in the United States, Canada, European Union and United Kingdom. Both patient/recipient information and healthcare professional fact sheets for each of these drugs were manually searched to find their orofacial adverse effects. RESULTS: Adverse events affecting the orofacial region were reported for both vaccines. These were rare and included acute peripheral facial paralysis (Bell's palsy), facial swelling, and swelling of the lips, face or tongue associated with anaphylaxis. There was heterogeneity in the acknowledgement of vaccine-related adverse events in North America compared with Europe. CONCLUSION: Globally, there are inconsistencies in the description of adverse effects presenting in the orofacial region of the COVID-19 vaccines BNT162b2 and mRNA-1273. We believe that awareness of these orofacial manifestations will improve recognition, management and reporting of vaccine-related adverse effects.

Peripheral facial nerve damage is the most common condition of all cranial nerve damage; this nerve innervates the face in motor, sensory and parasympathetic ways. Bell’s palsy prevents patients from functioning normally by disturbing the speech function, eating and facial expressions. It can also lead to severe infl ammation of the eyeball and consequently to blindness. The study focuses on the influence of appropriately selected physical procedures on the time over which facial palsy affects a patient. The use of therapeutic methods such as: electrotherapy, heat treatment, facial massage, kinesitherapy and fi llers were also presented Comprehensive rehabilitation therapy based on the cooperation of doctors, physiotherapists and cosmetologists signifi cantly improves the results of pharmacological treatment and shortens convalescence time.

BACKGROUND AND OBJECTIVES: Facial nerve paralysis, because of the dysfunctional problems that can occur at the level of a very special part of the patients body, who gives their personality needs special consideration. Peripheral facial palsy is the most frequent cranial neuropathy, and can origin from various kinds of damage to the seventh cranial nerve. Idiopathic facial palsy or Bell's palsy is the most frequent cause of facial paralysis occurs in 15 - 30 Persons per 100,000 per year. METHODS: 30 subjects having facial disability who full lled with the inclusion criteria and randomly assigned. Group A and B with 15 subjects in each group. Group A subjects are treated with conventional therapy and Group B subjects are treated with Neuromuscular reeducation techniques for 4 weeks. The outcome of this intervention was measured with Facial Disability Index (FDI). These recorded before and after the session of 4 weeks of intervention. RESULTS: Statistical analysis of the data revealed that within group comparison both groups showed signicant reduction of facial disability in conventional therapy and Neuromuscular re-education. CONCLUSION: Finally the study concluded that 4 weeks of training program with Neuromuscular re-education showed signicant improvement when compared to conventional therapy.

Arditais a medical condition causing the Vakratha[deviation] of Mukha ardha and leads to facial asymmetry and malfunction. It occurs due to aggravated Vatadosha. It has been included in Vataja Nanatmaja Vyadhi. It can be correlated to facial palsy in modern which carries similar complaints to Ardita of deviation of half of the face with sensory & motor impairment on the affected side. Acharya Sushruta and Charaka mentioned Nadi sweda in the Ardita chikitsa sootra. The modified form of Nadisweda itself is Ksheera Dhooma. As there is a weakness of Facial nerve in Bell’s palsy and the same moist heat is indicated in Bell's palsy by modern medicine. This effect is ensured by Swedana and it has the capacity to stimulate the nerve centres and increases the tactile sensibility. It is seen that Ksheeradhooma is having good efficacy on Ardita. Keywords: Ardita, Ksheera dhooma, bell’s Palsy

Bell’s palsy, or idiopathic facial paralysis, is a peripheral facial palsy of unknown cause that presents as sudden, unilateral weakness of the muscles of the face. Prompt treatment of Bell’s palsy is critical in order for patients to achieve complete recovery of facial function. Delays in diagnosis and management can result in permanent facial defects. A number of clinical practice guidelines (CPG) exist to guide clinical decision-making in patients presenting with idiopathic facial paralysis. However, to date, there has been no comprehensive review of the methodological rigor and quality of these CPGs. Thus, the objective of the authors is to appraise the existing CPGs to ensure safe and effective practices. A total of eight guidelines met the inclusion criteria and were appraised. Only two CPGs achieved an overall rating of ‘High’, having five or more quality domains scoring > 60%. Across the CPGs, the domains of rigor of development, stakeholder involvement, and applicability has the lowest overall scores with 48.1%, 43.9%, and 43.1%, respectively. Based on the AGREE II instrument, the methodological rigor and quality of CPGs for Bell’s palsy is low to average. In particular, future guidelines for Bell’s palsy should look to the quality domains of rigor of development, stakeholder involvement, and applicability as the greatest opportunities for improvement.

Lyme disease is a tick-borne illness that occurs in stages, multiple organs and tissue with highly variable clinical presentation. Most commonly, it presents with seventh cranial nerve palsy, often mimicking stroke and atypical rash (erythema migrans). Atypical presentations include abdominal pain, ileus/pseudo-obstruction and constipation thought to be due to autonomic dysfunction. Other less common presentations include Syndrome of Inappropriate Antidiuretic Hormones (SIADH). Lyme disease should be a differential when a patient presents from Lyme endemic areas with abdominal pain, constipation and SIADH in the setting of other causes of gastrointestinal and renal symptoms ruled out. Here we present a case of multisystem involvement in a single patient with Lyme Disease along with neuroborreliosis (neurological manifestation of Lyme disease).

Bell’s palsy (BP) or otherwise known as idiopathic facial nerve palsy is a form of paralysis or weakness of one side of the face. Physiotherapy interventions accelerate recovery, improve facial function and reduce the occurrence of complications. The aim of this review was to study in the modern literature the effect of different physiotherapy interventions for the treatment and improvement of BP symptoms. Method: We reviewed the literature in all modern databases, for the period 2015 - 2021, for studies related to the effect of different physiotherapy interventions on the symptoms of patients with BP. Inclusion criteria were: to refer to patients with BP, to contain experimental and control groups and the studies to be clinical trials. Results: Out of the 114 papers that included in their title and abstract the search terms, only 10 were included in our literature review. In the studies, the average sample was 41.2 patients with a distribution of 10 to 94 individuals. Conclusions: The results of the studies showed a great improvement of the facial function, faster recovery and in particular an improvement of the facial symmetry when a program of the Proprioceptive Neuromuscular Facilitation (PNF) method or the Kabat technique is applied in combination with nerve stimulation. In general, facial exercises seem to play an important role in improving the functioning of facial muscles when combined with other techniques or methods, while the application of acupressure massage seems to significantly reduce the underlying symptoms of paralysis and help improve the affected side.

Bell's palsy is defined as an idiopathic unilateral facial nerve paralysis, usually self-limiting. Bell's palsy was first described by Charles Bell and is the most common cause of acute facial nerve paralysis (>80%). Immune, infective and ischemic mechanisms are all believed to play a role in the development of Bell’s palsy, but the precise cause remains unclear. From corticosteroids to botulinum injections, wide therapeutic approaches have been employed for treating bell’s palsy. Here, a case management and brief review of bell’s palsy is discussed. Keywords: Palsy, Idiopathic, Ischemic, Botulinum.

Objectives Facial nerve decompression is a salvage treatment for Bell's palsy patients for whom a poor prognosis is anticipated with standard medical treatment. The transmastoid approach is a frequently performed approach, but it remains unknown if this surgery is effective when the ossicular chain is preserved. This study aimed to determine the efficacy of facial nerve decompression using the transmastoid approach in Bell's palsy. Design, setting and participants This retrospective study included patients who had undergone transmastoid facial nerve decompression with ossicular chain preservation and patients who met the criteria for surgery, but received only medical treatment between January 2007 and May 2019, at a single centre. Main outcome measures Attainment of House-Brackmann grade I at 12 months after onset of facial palsy. Results The recovery rate to House-Brackmann grade I in the decompression group in the early phase (≤18 days after onset) was higher than that of the medical treatment group, although the difference was not significant (70% vs 47%, P = .160). However, within this early surgery group, a subgroup of cases with ≥95% facial nerve degeneration demonstrated a significant improvement in recovery rate (73% vs 30%, P = .018). Among surgeries performed in the late phase (≥19 days), only a subgroup with ≥95% facial nerve degeneration was available for analysis, and the difference in recovery rate was not significant compared with medical treatment alone (26% vs 30%, P = 1.00). Post-surgical hearing evaluation demonstrated that average hearing deterioration was 1.3 dB which was non-significant, suggesting this procedure does not cause hearing loss. Conclusions Transmastoid facial nerve decompression with ossicular chain preservation in the early phase after symptom-onset is an effective salvage treatment for severe Bell's palsy with ≥95% facial nerve degeneration.

Facial nerve palsy might be observed for various reasons. The majority of facial paralysis appears as idiopathic or Bell palsy. Of the patients, approximately 80-85% experience spontaneous and complete recovery within the first three months in Bells palsy. However, it is an accepted fact that these patients should be diagnosed correctly and initiated treatment in the early period. The study aimed to make a retrospective analysis of the treatment modalities and results of patients diagnosed with Bells Palsy in a tertiary hospital clinic and discuss the subject in the light of current literature. [Med-Science 2020; 9(4.000): 802-6]

Small but interesting evidences suggest that facial rehabilitation for acute Bell Palsy (BP) could improve facial outcomes in patients who benefited from optimal medication, but whose symptoms are still severe two weeks after BP's onset.This study aimed to provide preliminary evidence of the long-term effects of a new facial retraining based on motor imagery and mirror therapy, the Mirror Effect Plus Protocol (MEPP).Twenty BP patients received the standard medication for acute BP and were then randomly allocated to the treatment (MEPP) or control group, if their palsy was still at least moderate-to-severe at 14 days post onset. Three blind independent assessors graded the patients' evolution until 6 months after onset.Significant differences between the groups were not found for any measured variable; however, a trend toward better recovery was found in the treatment group for every measured variable. This trend grew bigger for patients with severe or total BP.This study suggests a promising effect of the MEPP on acute severe to total BP but requires further investigation with a larger number of participants.Facial rehabilitation should be considered as an adjunct to medication for acute and most severe degrees of BP.

Purpose To analyze various hematological parameters in pediatric population with Bell's palsy (BP) and to determine the most valuable parameter as a prognostic marker. Methods Fifty-nine patients with BP under 18 years were enrolled, and patients were divided into three groups: recovery group (49 cases), non-recovery group (10 cases) and controls (65 healthy children). Age, white blood cell (WBC), hemoglobin (Hbg), mean platelet volume (MPV), red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and C-reactive protein-to-albumin ratio (CAR) were determined and compared between groups. Additionally, the receiver operating characteristics (ROC) analysis was carried out, and the most valuable marker to demonstrate the prognosis among these parameters was investigated. Results While mean age was found as 10.69 +/- 5.76 years, 28 (47.5%) female and 31 (52.5%) male pediatric patients were determined to be followed up due to BP in our hospital. When such parameters age, mean Hbg, MPV and RDW were examined, no significant difference was detected between groups. However, compared controls with recovery and non-recovery groups, WBC, NLR, PLR and CAR were found to be significantly higher, respectively (p < 0.05). Median CAR and NLR values were found to be significantly higher in non-recovery group, compared to those in recovery group (p = 0.001, p = 0.012, respectively). However, when median WBC and PLR were examined between recovery and non-recovery groups, no significant difference was observed (p > 0.05). Conclusion High NLR and CAR values in pediatric BP may be related to poor prognosis in such patients. CAR, however, is a more valuable parameter than NLR in terms of indicating poor prognosis.

Background and purpose Using functional magnetic resonance imaging (fMRI), we explored cortical activation in patients with acute Bell's palsy (BP) and analyzed its correlates with clinical status in the acute phase, and with 6-month outcome. Methods Twenty-four right-handed patients with acute BP within 15 days of onset and 24 healthy controls underwent fMRI during performance of unilateral active (hemi-smiling) and passive lip movement tasks with both the paretic and the normal lip. The degree of paresis was evaluated during the acute stage and at the 6-month follow up using the House-Brackmann (HB) grading scale. Complete recovery was defined as HB grade II or less at the end of the 6-month period. The difference in the HB grade (ΔHB) between the acute stage and the 6-month follow up was used to evaluate clinical improvement. Results There were 24 patients with unilateral acute BP. HB grades ranged from III to VI. At 6 months, 11 patients (46%) had completely recovered and 12 (50%) were partially improved. Compared with healthy subjects, BP patients had a significantly greater activation of the frontal areas and the insula ipsilateral to the paretic side. In BP patients, there was an inverse correlation between the activation of the ipsilateral hemisphere when moving the paretic side and the degree of paresis at baseline. An association was also observed between activation and clinical outcome (both complete recovery and ΔHB). Conclusions In patients with BP, fMRI may represent a useful tool to predict long-term outcome, guide therapeutic approach, and monitor treatment response.

This review aimed to compare the effectiveness of Korean medicine (KM) with Korean-Western integrative medicine (KWIM) at treating Bell’s palsy. A literature search of several databases for relevant randomized controlled trials was performed. Six studies that compared KM with KWIM to treat Bell’s palsy were included in this review. Acupuncture and steroids were the most commonly used treatments in KWIM. A comparison of the effectiveness of KW with KWIM did not produce consistent results. Both KM and KWIM were useful intreating Bell’s palsy. KWIM was more effective than KM when the Western medicine was a steroid and was given in the early stages of treatment. However, these findings are limited due to the low quality and number of included studies. KM and KWIM are both effective in Bell’s palsy, and KWIM is more effective than KM. However, more high-quality randomized controlled trials are required.

The association between pregnancy-associated Bell’s palsy (PABP) and gestational hypertension (GHT), preeclampsia (PE), and eclampsia (EC) remains inconclusive. We aimed to study the characteristics of PABP cases and the neonatal outcomes at our institution. All cases diagnosed with PABP from 2006 to 2016 were identified. Demographic and clinical characteristics including maternal age, previous medical and obstetric illnesses, gestational age at the onset of PABP, the development of PE/EC, GHT, gestational diabetes mellitus (GDM), treatment and outcomes, as well as neonatal health indices and anomalies were described. Eight patients with PABP were identified. Most of the cases were first- or second-gravidity pregnancies. PABP occurred during the third trimester except for one case in whom PABP developed 2 days postpartum. No PABP case associated with EC was found. PE was found in only one case in whom GHT occurred in a previous pregnancy. Moreover, GHT combined with GDM was found in a case with previous GHT. The recovery of PABP was satisfactory. Previous obstetric complications are associated with the current PE, GHT and GDM. Facial weakness recovers favorably regardless of treatment and the neonatal outcomes are overall satisfactory.

Facial nerve palsy is a common condition affecting both genders and all age group. However, its incidence in pregnant females needs greater care. It may affect only lower half of the face or full one side of the face or in extreme condition bilateral sides. Symptoms include deviation of angle of mouth towards sound side, flattening of nasolabial folds, loss of forehead wrinkles and inability to completely close the eyelid along with loss of taste on anterior two third of tongue. Here we present a rare case report of facial nerve palsy in a pregnant woman in third trimester of pregnancy. She was offered an evidence based physiotherapy treatment regime along with pharmacological treatment and she recovered; however late complication of “Ptosis” was reported.

Bell's Palsy is the most frequent acute neuropathy of cranial nerves; it has been associated in various reports to herpes viruses. In a prospective study we searched the presence of DNA from five herpes viruses (HSV-1 and 2, VZV, EBV and HHV-6) in 79 patients at the acute phase of Bell's Palsy. Results were related with various parameters; age, gender and clinical outcome. We found the significant presence (p˂0.001) of HSV-1 and VZV in 39% and 42% of patients. However, a large percentage of cases were negative. When comparisons were made between subgroups according to gender and age no differences were found with viral findings nor with clinical outcome of palsy, which was of clinical remission in most cases (78%). Our results suggest that herpes viruses might participate in the complex mechanisms of autoimmunity of Bell's Palsy but not as determinant etiological element.

BACKGROUND: Up to now there is not enough evidence that supports the use of electrotherapy in the treatment of Bell’s palsy. OBJECTIVE: Through a systematic review, we aimed to verify whether the use of electrotherapy is effective for treating Bell’s palsy or peripheral paralysis. METHODS: Publications were searched in PubMed, EBSCO and Web of Science. The present systematic review included studies that analyzed the electrotherapy as a therapeutic method for treating individuals with Bell’s palsy, in order to recover the function of facial muscles. RESULTS: Seven studies involving a total of 131 cases and 113 controls were included in this systematic review. In the studies analyzed, patients received electrotherapy combined with other treatments such as hot-wet facial napkins, massages and muscle reeducation. Although the effect of electrotherapy alone was not evaluated, the use of electrotherapy combined with other treatments produced a significant improvement in the individuals evaluated. CONCLUSIONS: Due to the diverse methodologies used and the small number of individuals included in the studies, we could not fully prove the efficacy of electrotherapy for treating Bell’s Palsy. Future studies with larger samples and homogenous populations should be performed to obtain conclusive results.

ObjectiveThis study aimed to investigate the possible association between recurrent facial nerve palsy and migraines.MethodThis study was a prospective case series with a two-year follow-up at an academic, tertiary referral centre and included patients with at least four episodes of recurrent lower motor neuron facial nerve palsy. All patients underwent standardised diagnostic tests.ResultsFour patients fulfilled the inclusion criteria. The patients were all female with an average age at presentation of 40.75 years (range, 33–60 years) and an average age at the initial episode of 14 years (range, 12–16 years). The number of episodes varied between six and nine. All patients had at least one episode of facial nerve palsy on the contralateral side. Two patients were diagnosed and treated for migraine with aura remaining asymptomatic following prophylactic medication for migraines.ConclusionThe results raise the possibility of an association between recurrent facial nerve palsy and migraines. Prospective studies in patients with even fewer episodes of facial nerve palsy could shed more light on this association.