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Related Experiment Videos

[Idiopathic facial paralysis]

S R Wolf1

  • 1Klinik und Poliklinik für Hals-Nasen-Ohrenkranke, Friedrich-Alexander-Universität Erlangen-Nürnberg.

HNO
|November 17, 1998
PubMed
Summary
This summary is machine-generated.

Nicolaus Anton Friedreich first described facial paresis in 1797. Early, intensive diagnosis and combined therapy, including cortisone and virostatic agents, improve outcomes for Bell's palsy, while electrical stimulation is not recommended.

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Area of Science:

  • Neurology
  • Ophthalmology
  • Infectious Diseases

Context:

  • Acute idiopathic facial paresis, commonly termed Bell's palsy, was historically attributed to Sir Charles Bell, but Friedreich first described it in 1797.
  • Improved diagnostics now identify inflammatory causes like Herpes simplex virus type I and Borrelia burgdorferi.
  • Clinical assessment, especially in children, can underestimate paresis severity; "incomplete eyelid closure" is an unreliable indicator of nerve function.

Purpose:

  • To review the historical context, diagnostic challenges, and therapeutic strategies for acute idiopathic facial paresis.
  • To emphasize the importance of electromyography (EMG) for assessing severe cases.
  • To provide recommendations for early, combined treatment and rehabilitation.

Summary:

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  • Electromyography (EMG), particularly needle EMG, is crucial for evaluating severe facial paresis due to the unreliability of clinical signs like incomplete eyelid closure.
  • Recommended early combined therapy includes cortisone, virostatic agents, hemorrheologic substances, and possibly antibiotics for disfiguring cases.
  • Rehabilitation strategies like facial exercises and massage are beneficial, while surgical decompression remains controversial and electrical stimulation is discouraged.

    • Impact:

    • Highlights the need for precise diagnosis and early intervention in managing facial nerve disorders.
    • Suggests a multimodal therapeutic approach for better patient outcomes.
    • Underscores the necessity for further research and multicenter studies to refine treatment protocols.