How long to treat peripheral palsy of N. Facialis by acupuncture - electromyographic study

Department of Neurology
Charles Univ., Hradec Kralove Czech Republic

The aim of the study was to find out how long to continue acupuncture treatment (ACU) of the peripheral palsy of n. facialis and if it is useful to continue treatment even after complete clinical recovery of the palsy.

The authors have examined in detail both clinically and electrophysiologically 17 patients (12 male, 5 female) by EMG examination at the start of the treatment, at the time of complete clinical recovery of the facial motility and also. after an interval post clinical recovery. The classical and stimulating EMG for m. frontalis, m. levator alae nasi et labii maxillaris, m. triangularis menti and stimulating EMG of m. nasalis were evaluated.

At the time of complete clinical recovery of the paresis there remain on average

· mild pathology at classical EMG examination of all examined muscles
· mild to moderate demyelinization nerve lesion (prolonged DML, widened M response)
· mild to moderate axonal nerve lesion (decreased amplitude of M response)
· the most sensitive indicator of all observed parameters is decrease of amplitude of M response m. nasalis remaining on average more than 2 months after complete clinical recovery

Conclusions:

a) Period and degree of clinical and electrophysiological recovery of paresis n. facialis are mainly dependent on the intensity of nerve damage (neurapraxia/ axonothmesis)

b) Minimally, each patient should be examined 2 x by EMG - after the culmination of paresis; and at time of complete clinical recovery

c) ACU treatment should be continued even after the complete clinical recovery (depending on EMG finding), on average longer than 2 months

d) Each patient is to be considered and treated individually


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