This article is not a case report. The examination, evaluation, and intervention sections are purposely abbreviated. A year-old woman was referred to our clinic with the diagnosis of Bell palsy, a unilateral facial palsy of unknown etiology. Upon observing the facial asymmetry, the patient was concerned that she was having a stroke. The patient saw her primary care physician who diagnosed her as having Bell palsy after having ruled out a tumor, stroke, and Lyme disease by physical examination, magnetic resonance imaging studies, and laboratory tests including blood work. The physician prescribed acyclovir and prednisolone and suggested a consultation with a physical therapist for management of her facial muscle weakness.
Neuromuscular electrical stimulation and shortwave diathermy in unrecovered Bell palsy
Functional electrical stimulation (FES) for facial nerve palsy | STIWELL
This study aimed to investigate the optimal and safe intensity for facial nerve stimulation during middle ear surgery. Thirty-seven patients who had their facial nerve exposed prior to surgery were prospectively enrolled in this study, and electromyography EMG recordings were obtained from the orbicularis oculi and orbicularis oris muscles. Four pigs were also enrolled in an animal study, and continuous stimulation was performed on the facial nerves of the pigs for 10 minutes. The EMG responses were measured and the pathologic outcomes of the facial nerve after stimulation were determined. In the human study, the mean intensity of the minimal electrical stimulation threshold was 0. A linear correlation was observed between stimulus intensity and response amplitude for intensities below 0.
Objective: The purpose of this study was to assess clinical and neurophysiological changes after 6 mos of transcutaneous electrical stimulation in patients with unresolved facial nerve paralysis. Design: A pilot case series of 10 consecutive patients with chronic facial nerve paralysis either of idiopathic origin or because of herpes zoster oticus participated in this open study. All patients received below sensory threshold transcutaneous electrical stimulation for 6 mos for their facial nerve paralysis. Assessments of the facial nerve function were performed using the House-Brackmann clinical scale and neurophysiological measurements of compound motor action potential distal latencies on the affected and nonaffected sides. Patients were tested before and after the intervention.
Targeted activation of facial muscles can be improved with the help of electrical stimulation and biofeedback Volk et al. The EMG-triggered programmes enable unwanted movement of other muscle groups to be avoided when executing the movement. FES is excellent in combining with other facial therapies, such as mirror therapy or emotional stimuli, which are applied to increase the activity of facial muscles. If the defects are located in the facial nerve lower motor neuron , the STIWELL can be used to individually stimulate denervated muscles by means of appropriate current forms, frequencies, and pulses. Treating facial muscles is of great importance in the treatment of neurological patients, since they are often a source of major psychological strain.