中西医结合治疗特发性面神经麻痹30例临床体会

特发性面神经麻痹是由于茎乳突孔内面神经非化脓性炎症引起，其原因不明，可能为病毒感染导致面神经水肿受压引起循环障碍、轴突髓鞘变性而致，患者常呈急性起病，且病情迅速发展。作者采取中西医结合的方法治疗特发性面神经麻痹患者30例，取得了较好的疗效，报告如下。     

茎乳孔注射药物治疗面神经麻痹神经电生理评价

目的观察茎乳孔内注射药物治疗急性面神经麻痹的疗效。方法以临床表现、面肌肌电图及面神经传导速度为指标。茎乳孔内注射药物治疗,观察40例急性面神经麻痹患者的疗效,并以40例常规治疗作对照。结果治疗组与对照组治疗前后症状比较,相差显著;治疗组与对照组平均治疗次数比较相差显著;两组治疗前患侧神经传导速度比较相差不显著;两组治疗后患侧神经传导速度比较相差显著;两组治疗后肌电图结果比较相差显著。结论茎乳孔内注射药物治疗急性面神经麻痹疗效显著。     

茎乳孔注射药物治疗面神经麻痹神经电生理评价

目的 观察茎乳孔内注射药物治疗急性面神经麻痹的疗效。方法 以临床表现、面肌肌电图及面神经传导速度为指标。茎乳孔内注射药物治疗，观察40例急性面神经麻痹患的疗效，并以40例常规治疗作对照。结果 治疗组与对照组治疗前后症状比较，相差显；治疗组与对照组平均治疗次数比较相关显；两组治疗前患侧神经传导速度比较相差不显；两组治疗后患侧神经传导速度比较相差显；两组治疗后肌电图结果比较相差显。结论 茎乳孔内注射药物治疗急性面神经麻痹疗效显。     

中西医结合治疗周围性面瘫的疗效观察

<正>周围性面瘫为茎乳孔内面神经的急性非化脓性炎症所引起的外周神经麻痹,为临床常见、多发病,主要表现为同侧面部所有表情肌弛缓性瘫痪,其中以贝尔氏(bell’s)面瘫最多见,为原发性周围性     

茎乳孔内药物注射治疗特发性面神经麻痹临床观察--附58例报告

特发性面神经麻痹(面神经炎)是由茎乳孔内面神经急性非化脓性炎症而引起。若治疗不及时，往往会留有不同程度的后遗症。1998年3月～2002年3月，我科在传统治疗的基础上并用茎乳孔内药物注射治疗该病，取得了满意的疗效，报道如下。     

耳穴疗法加TDP治疗面神经麻痹50例

面神经麻痹又名“面神经炎”,是由于面神经在茎乳孔内发生急性非化脓性炎症,使之水肿、受压而导致的周围性面神经麻痹。近年来笔者采用耳穴疗法加TDP治疗此病,效果显著,现报告如下。1临床资料1.1一般资料本组50例,男29例,女21例;年龄最小12岁,最大75岁;病程最短者2d,最长者90d;所有病例均为门诊或住院患者,诊断明确,40岁以上作脑CT鉴别诊断。该病发病急,一侧面部表情肌突然瘫痪,     

牵正散加味联合针灸治疗面瘫54例临床观察

<正>面瘫也称周围性面神经麻痹,主要是指茎乳突孔内面神经的急性非化脓性炎症引起的病症,主要表现为面部表情肌瘫痪、前额皱纹消失、眼裂扩大、鼻唇沟变浅、口角歪向健侧、患侧抬眉困难、吃饭藏食、漱口漏水、眼角流泪等症状。导师刘敏勇采用牵正散加味联合针灸治疗患者54例,治疗效果满意。     

割敷治疗周围性面神经麻痹疗效分析

面神经麻痹是以颜面表情肌群运动功能障碍为主要特征的一种常见病，根据病因及病变部位的不同，分为中枢性面神经麻痹和周围性面神经麻痹。在临床上则多为以病发较急的”贝尔氏”麻痹（BellPalsy），即周围性面神经麻痹最为多见，它是指原因不明的茎乳突孔（面神经管）急性非化脓性面神经炎引起的周围性面肌瘫痪。冬春季节好发。通过十几年的临床实践，采用中药穴位割敷治疗周围性面神经麻痹总结报告如下。     

高压氧并针刺治疗面神经炎疗效观察

面神经炎又称特发性面神经麻痹，系因茎乳突孔内面神经的急性非化脓性炎症引起的周围性面神经麻痹，诱发因紊可为感受风寒、病毒和自主神经缺血水肿。面神经炎相当于中攻学的“口僻”，“口眼歪斜”等，现代多称为“面瘫”。我科自2002年2月～2006年5月采用高压氧和并针刺治疗面神经炎。取得了较好疗效，报告如下：     

心理疏导对特发性面神经麻痹康复的影响

特发性面神经麻痹，也称Bell麻痹．由面神经非化脓性炎症引起。临床表现为病侧面部的表情肌动作完全或部分丧失，并可有饮食、言语和情绪表达等方面的功能障碍，其明显的面部异样，可引发一些心理方面的问题。我们对28例特发性面神经麻痹患者在进行常规治疗的基础上，辅以心理疏导，旨在观察心理疏导对特发性面神经麻痹康复效果的影响，现报道如下。     

Electrophysiologic evaluation of the facial nerve in Bell's palsy. A review

Facial nerve paralysis is the most common mononeuropathy and idiopathic facial paralysis (Bell's palsy) the most common seventh nerve disease electromyographers may be asked to evaluate. The electrophysiologic method of choice to assess the facial nerve is side-to-side evoked amplitude comparison with the affected side expressed as a percentage of the nonaffected side. This examination should be performed on days 3, 5, 7, 9, 11 and 13 after onset of paralysis. If the percentage of surviving axons falls below 10% within the first 14 days, an incomplete recovery is suggested. Electromyography may assist in prognosticating a functional return, determining neural conduction across the site of injury and following reinervation in the recovery period. The persistence or early return of an absent R1 component of the blink reflex may qualitatively suggest a satisfactory functional outcome in facial paralysis. Supramaximally exciting the facial nerve at the stylomastoid foramen and comparing the clinical response on the affected and nonaffected side, maximum stimulation test, can also predict eventual seventh nerve return. Observing a minimal twitch, utilizing the nerve excitability test or measuring the facial nerve latency have yielded poor correlations with functional return and are of limited usefulness in the prognostication of acute facial palsies. Trigeminal somatosensory evoked potentials can be employed to evaluate the status of the trigeminal nerve as approximately 50% of patients with Bell's palsy also have lesions involving the fifth nerve. Side-to-side amplitude comparison and electromyography are the two most valuable electrophysiologic methods of assessing facial nerve functioning.     

茎乳孔和星状神经节同时注射药物治疗面神经炎临床研究

目的探讨茎乳孔和星状神经节同时注射药物治疗面神经炎的临床疗效。方法将起病至就诊时间为120d内的300例患者随机分为两组(单数为第1组、双数为第2组),每组150例。第1组采用茎乳孔和同侧星状神经节同时注射药物治疗;第2组采用激素、B族维生素、扩血管药物、理疗、按摩、针灸、中医中药等治疗。并对两组的疗程和治疗效果进行临床观察和对比分析研究。结果两组疗程和治疗效果差异有统计学意义,第1组的疗程明显短于第2组,治愈率明显高于第2组,后遗症明显少于第2组,取得显著效果。结论茎乳孔和同侧星状神经节同时注射药物治疗面神经炎,在治疗上有协同作用,能使面神经功能较快恢复,疗效确切,治愈率高,后遗症少。     

Facial nerve paralysis

Bell's palsy, an idiopathic facial nerve palsy, is the most common cause for acute facial nerve paralysis. Bell's palsy is not synonymous with facial nerve paralysis but is a diagnosis of exclusion for acute onset of idiopathic facial nerve paralysis. The differential diagnosis for facial nerve paralysis should be considered to correctly evaluate and give appropriate therapy in a timely fashion for the treatable causes of facial nerve paralysis. The status of facial nerve paralysis should be monitored by repeat electrical examinations, preferably ENoG. Most importantly, no one treatment is appropriate for all patients with facial nerve paralysis.     

神蜂精刮痧治疗周围性面瘫42例

Background: Peripheral facial paralysis is a common disease with facial nerve paralysis, facial mimetic muscle dyscinesia, and deviation of the eye and mouth. It is commonly considered that peripheral facial paralysis might be correlated with virus infection, rheumatism, ischemia, immunity. Pathological changes included edema, denaturation, atrophy, and ischemia of facial nerve. In traditional Chinese medicine, peripheral facial paralysis is caused by stagnation of qi and blood, malnutrition of channels and vessels, and cizhongbusou. Curing rheumatism, warming yang and supplementing qi, relaxing stagnation, regulating qi and blood should be emphasized in treatment. Guasha belongs to massage and is characterized by easy operation, and reliable therapeutic effect. Guasha can stimulate nerve strongly, improve metabolism, and enhance immunity and promoting blood circulation. " Head is the center of all yangs" . According to principle of acupoint selection along channels, guasha of channels distributed in neck, shoulder, hand, and region with yang channels of hand and foot, in combination with external wasp cream with antiinflammation and removing stagnation, self local massage,and functional exercise of facial muscles are effective in improving blood circulation of head and face,remove edema of facial nerve,promote recovery of facial muscles.     

Acupuncture and Kinesio Taping for the acute management of Bell’s palsy: A case report

BackgroundBell’s palsy is an idiopathic, acute peripheral palsy of the facial nerve that supplies the muscles of facial expression. Despite an expected 70% full recovery rate, up to 30% of patients are left with potentially disfiguring facial weakness, involuntary movements, or persistent lacrimation. The most frequently used treatment options are corticosteroids and antiviral drugs. However, accompanying clinical conditions, such as uncontrolled diabetes, hypertension, gastrointestinal disturbances, polypharmacy of geriatric patients, and significant sequelae ratios, indicate the need for safe and effective complementary therapies that would enhance the success of the conventional interventions.Case summaryA 26-year-old female presented with numbness and earache on the left side of the face; these symptoms had been ongoing for 8–10 h. Physical examination revealed peripheral facial paralysis of House-Brackmann grade III and corticosteroid-valacyclovir treatment was initiated. On the same day, Kinesio Taping was applied to the affected nerve and muscle area with the aim of primarily neurofacilitation and edema-pain relief. On the fifth day, acupuncture treatment was started and was continued for 3 consecutive days. A physical therapy program was administered for the subsequent 10 days. At the 3-week follow-up examination, Bell’s palsy was determined as grade I, and the treatment was stopped.ConclusionAcupuncture and Kinesio Taping, in conjunction with physical therapy modalities, are safe and promising complementary therapies for the acute management of Bell's palsy. However, further large scale and randomized controlled studies are necessary to assess whether these complementary interventions have significant additive or synergistic effect for complete recovery of patients with Bell’s palsy.     

迷走神经阻滞入路的相关解剖结构研究

目的：对迷走神经阻滞入路相关结构及其毗邻关系进行解剖学观测,为迷走神经阻滞入路和预防并发症的发生提供解剖学基础。方法：对60个成人颅骨（120侧,其中男60侧,女60侧）和30侧成人头、颈部标本迷走神经的毗邻结构进行解剖学观测。结果：迷走神经阻滞进针的深度（乳突尖至颈静脉孔外侧缘的距离）：男性左侧为24.5±0.5mm(17.0—30.2mm),右侧为24.9±0.7mm(19.5—30.4mm);女性左侧为23.1±0.4mm(16.0—28.5mm),右侧为22.7±0.6mm(13.0—28.3mm)。观测获得了乳突尖至茎乳孔的距离,茎乳孔至颈静脉窝外侧缘的距离。颈静脉孔的变异情况,迷走神经在颈静脉孔内、外与其他结构的关系。结论：可以乳突为标志作为预测颈静脉孔位置深度的参考数据。穿刺时,应注意避免误伤面神经和颈内静脉。     

贝尔麻痹患者早期瞬目反射、面神经电图的改变及其与面神经功能损害的关系

目的探讨贝尔麻痹患者早期瞬目反射、面神经电图的改变及其与面神经功能损害相关性。方法对25 例贝尔麻痹早期患者进行瞬目反射与面神经电图检测,比较其阳性率,并分别根据其检测结果分为轻-中度损害、重度损害;同时按House-Blackmann(H-B)面神经功能评价分级标准进行面瘫程度评估,Ⅰ级为正常,Ⅱ~Ⅲ级为轻-中度、Ⅳ~Ⅵ级为重度。结果H-B面瘫分级评估,轻-中度面瘫占44%,重度面瘫占56%。瞬目反射检测阳性率达100%,其中轻-中度损害占28%,重度损害占72%;瞬目反射检测与H-B面瘫分级评估一致(P>0.05)。面神经电图检测阳性率52%,其中轻-中度损害占44%,重度损害占8%,与H-B面瘫分级评估不一致(P<0.05)。结论瞬目反射较面神经电图能更好反映贝尔麻痹早期损害情况。     

Unilateral facial paralysis occurring in an infant with enteroviral otitis media and aseptic meningitis

We report the case of a four month old infant presenting to the Emergency Department (ED) with irritability and facial asymmetry following a recent bout of gastroenteritis. Physical examination revealed a unilateral peripheral facial nerve paralysis. Common in older children and adults, facial nerve palsy has rarely been described in infancy. Although historically associated with a variety of inflammatory and infectious causes, the pathogenesis remains unclear. In this infant we were able to successfully identify an underlying acute enteroviral infection. Coxsackie B5 was isolated from the middle ear fluid, cerebrospinal fluid (CSF), nasopharyngeal and rectal swabs. After myringotomy drainage of the middle ear fluid and placement of pneumatic equalization tubes, there was rapid and complete resolution of facial paralysis.     

周围性面瘫神经定位与针刺疗效的关系

目的探讨周围性面瘫神经定位与针刺疗效的关系。方法周围性面瘫患者92例,其中单纯性面神经炎型36例、Bell氏面瘫46例、Hunt氏面瘫10例,采用针刺配合药物进行治疗。结果单纯性面神经炎型治愈率较Bell氏面瘫和Hunt氏面瘫高,Hunt氏面瘫治愈率最低。结论周围性面瘫神经损伤的部位越高,治愈率越低。     

The facial nerve: anatomy and common pathology.

The seventh cranial nerve is responsible for much of what makes us individual--the facial expression worn by each individual. The facial nerve (CN VII) is commonly divided into 4 segments for examination: the nucleus and tracts, the cistemal segment that traverses the internal auditory canal, the intratemporal segment (through the bony facial nerve canal), and the peripheral segment. Immediately on leaving the temporal bone at the stylomastoid foramen, the peripheral segment of CN VII becomes much more complicated to follow and is essentially invisible to imaging. Each segment of the facial nerve may be involved by differing pathology. In this report we break down the facial nerve into more easily understood divisions and cover the common pathology of each of these segments.