Background: Despite no significant advantage being demonstrated for its use and no standardization of treatment guidelines, electrical stimulation is still applied by therapists to treat facial paralysis. The aim of this investigation was to determine whether electrical stimulation therapy for patients with acute or chronic facial nerve paralysis improves time to, and rates of full recovery and facial function compared with no intervention.
Method: A systematic review of randomized and quasi-randomized controlled trials through Scopus, Medline, PEDro, Embase, CINAHL, Pubmed, and Cochrane Library search engines for studies published up until August 2016. Reference lists were reviewed for further studies. Review Manager was used to extract data and review quality of the studies. Studies were assessed for randomization of participants, allocation concealment, blinding of participants, assessors and physiotherapists, presence and reporting of outcome data.
Results: Five studies were included for analysis – four during acute recovery and one in chronic facial nerve paralysis. In acute facial nerve paralysis, two studies found no benefit of electrical stimulation and two studies found improvement. A meta-analysis on changes in the House–Brackmann Score after treatment, rates of full recovery and time to full recovery showed no statistically significant difference between intervention and control groups. In chronic facial nerve paralysis, one study found improvements after extensive electrical stimulation on the Facial Paralysis Recovery Profile.
Conclusions: There is no evidence to support the use of electrical stimulation during the acute phase of recovery after Bell’s palsy and there is low-level evidence for patients with chronic symptoms. Furthermore, there is no evidence available on the use of electrical stimulation for other causes of facial nerve paralysis. 相似文献
A patient with an 11 year history of paroxysmal nocturnal hemoglobinuria presented with severe abdominal pain. On admission, the hematocrit value was 30 per cent and unchanged from repeated measurements during the previous three years. Abdominal angiography identified extensive thromboses of the splenic and portal venous systems. After initial improvement on heparin therapy, the patient experienced additional abdominal crises. A ruptured and multifragmented spleen was removed at the time of exploratory laparotomy. Postoperatively, after a several days' interval of improvement, the patient experienced additional thrombotic episodes of the abdomen, upper extremities and cerebral cortex. The latter was associated with disabling nerve paralysis. With continuous intravenous heparin plus steroid therapy, the patient's condition improved progressively. Despite the numerous thrombotic episodes during the prolonged hospital course, no hemolytic episodes were observed. This is the first report of documented splenic rupture in a patient with paroxysmal nocturnal hemoglobinuria. 相似文献
The records of 207 patients evaluated and treated for breast abnormalities during a 10-yr period were reviewed. Patients ranged in age from 1 wk through 16 yr. Seventy-eight per cent were female. Operative procedures were performed in 134 patients (64%). Most common diagnoses were fibroadenoma, premature thelarche, and precocious puberty in the females, and pubertal gynecomastia in the males. Age and sex separate patients into natural subgroups. In females beyond the neonatal period, premature thelarche and precocious puberty are the most likely cause of breast enlargement. Breast biopsy is only rarely indicated for a distinct mass lesion in the prepubertal breast. Mass lesions in the breast of adolescent females require excisional biopsy. In the male, pubertal gynecomastia is the most common form of breast enlargement and only occasionally requires subcutaneous mastectomy for cosmetic and psychologic reasons. Careful evaluation of all children with breast enlargement is indicated to uncover underlying causes and to avoid unnecessary operative procedures. 相似文献
The etiologies of Bell’s palsy and brachial neuritis remain uncertain, and the conditions rarely co-occur or reoccur. Here we present a woman in her twenties who had several relapsing-remitting episodes with left-sided facial palsy and brachial neuropathy. The episodes always started with painful left-sided oral blisters. Repeat PCRs HSV-1 DNA from oral vesicular lesions were positive. Extensive screening did not reveal any other underlying cause. Findings on MRI T2-weighted brachial plexus STIR images, using a 3.0-Tesla scanner during an episode, were compatible with brachial plexus neuritis. Except a mannose-binding lectin deficiency, a congenital complement deficiency that is frequently found in the general Caucasian population, no other immunodeficiency was demonstrated in our patient. In vitro resistance to acyclovir was tested negative, but despite prophylactic treatment with the drug in high doses, relapses recurred. To our knowledge, this is the first ever reported documentation of relapsing-remitting facial and brachial plexus neuritis caused by HSV-1. 相似文献
