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Bell's Palsy (bell's + palsy)

Distribution by Scientific Domains

Medical Sciences	90%

Selected Abstracts

Using Cochrane reviews for oral diseases

ORAL DISEASES, Issue 7 2010
HV Worthington
Oral Diseases (2010) 16, 592,596 Objectives:, To provide readers with information about the Cochrane Oral Health Group and how the reviews on oral diseases have contributed to guideline developments and the commissioning of trials. Materials and methods:, Examples have been selected from the reviews published on The Cochrane Library. Descriptions are given of how these reviews have been used in guideline development and commissioning of trials. Readers are updated on reviews focused on the management of oral cancer and the new venture of diagnostic test reviews. Results:, Reviews on the management of oral diseases due to cancer treatments have been included in guidelines and changed practice in the UK. Cochrane reviews on Bell's Palsy have led to a randomised controlled trial which has changed the evidence base. The Cochrane review on recall intervals between routine appointments has input into the NICE guideline and resulted in a randomised controlled trial to look at different intervals including a risk-based interval. Conclusion:, We hope this article will give readers information on the work of the Cochrane Oral Health Group and insight into the diversity of reviews in oral diseases. The reviews are successfully being used to change practice and as background for the funding of large-scale clinical trials. [source]

Blepharokymographic Analysis of Eyelid Motion in Bell's Palsy

THE LARYNGOSCOPE, Issue 2 2007
Seung-Ho Choi MD
Abstract Objective: To present characteristics of eyelid motion measured by blepharokymography in Bell's palsy patients and to discuss possible roles and limitations of blepharokymography. Study Design. Retrospective analysis. Methods: The study included 72 patients with Bell's palsy who presented to the Department of Otolaryngology at Asan Medical Center, Seoul, Korea, between April 2002 and March 2005, and who underwent both electroneuronography and blepharokymography. Parameters of eyelid motion were measured using revised blepharokymography. Correlations between blepharokymography and electroneuronography or House-Brackmann grade were examined by Spearman rank correlation and Kendall's ,-b correlation, respectively. Results: Compared with the normal side, all parameters of eyelid motion except opening time were decreased on the palsy side, with peak closing velocity showing the greatest difference (40.2%). On average, paralytic eyelids moved down 6.5 mm in 277 ms with a peak velocity of 55.4 mm/s, whereas normal eyelids moved down 9.7 mm in 214 ms, with a peak velocity of 142.6 mm/s. Subtle paralytic eyelid motion or "lid lag" could be objectively documented by blepharokymography to have longer and gentler downward slopes in displacement curves. Most blepharokymographic parameters correlated with ocular electroneuronography and House-Brackmann grade. Conclusions: Slow or incomplete closure of paralytic eyelids can be graphically and numerically analyzed by blepharokymography. Blepharokymography may be useful for evaluating status, predicting prognosis, and assessing effects of rehabilitative procedures, including gold weight implants in patients with facial palsy. [source]

The Impact of a Concurrent Trauma Alert Evaluation on Time to Head Computed Tomography in Patients with Suspected Stroke

ACADEMIC EMERGENCY MEDICINE, Issue 3 2006
Esther H. Chen MD
Background: Emergency department (ED) overcrowding threatens quality of care by delaying the time to diagnosis and treatment of patients with time-sensitive diseases, such as acute stroke. Objective: The authors hypothesized that the presence of a trauma alert evaluation would impede the time to head computed tomography (hCT) in patients with stroke-like symptoms. Methods: This was a secondary analysis of prospectively collected data on patients with potential stroke who received an hCT in an urban trauma center ED from January 1, 2004, to November 30, 2004. Structured data collection included historical and examination items, National Institutes of Health (NIH) stroke scale score, laboratory and radiographic results, and final diagnosis. Admitted patients were followed in hospital. Patients who presented within one hour following a trauma evaluation were compared with patients who presented without concurrent trauma for triage time until completion of hCT. Chi-square, t-tests, and 95% confidence intervals (95% CIs) were used for comparisons. Results: The 171 patients enrolled had a mean (± standard deviation) age of 60.7 (± 7) years; 60% were female; and 58% were African American. Of these, 72 patients had a significant cerebrovascular event (38 [22%] ischemic stroke, 25 [15%] transient ischemic attack, seven [4%] intracranial hemorrhage, one [0.6%] subarachnoid hemorrhage, and one [0.6%] subdural hematoma). The remaining diagnoses included 4.6% migraine, 2.3% seizure, 2.9% syncope, 2.3% Bell's palsy, and 2.9% vertigo. There was no significant difference in time to hCT in patients who presented during a trauma activation and those who did not (99 minutes [interquartile range (IQR) = 24,156] vs. 101 minutes [IQR = 43,151.5]; p = 0.537). In subgroup analysis of patients with a significant cerebrovascular event, times to hCT were also similar (24 minutes [IQR = 12,99] vs. 61 minutes [IQR = 15,126]; p = 0.26). Conclusions: In the authors' institution, the presence of concurrent trauma evaluation does not delay CT imaging of patients with potential stroke. [source]

Bell's palsy during interferon therapy for chronic hepatitis C infection in patients with haemorrhagic disorders

HAEMOPHILIA, Issue 2 2000
Ogundipe
Two adult patients with life-long severe haemorrhagic disorders commenced on interferon-,2b therapy for chronic hepatitis C infection. Both developed Bell's palsy several weeks after commencing therapy, They were started on steroids and, in addition, the first patient discontinued interferon-,2b therapy while the second patient elected to continue with therapy. In both cases facial paralysis improved over the ensuing weeks. Bell's palsy is often idiopathic but has been reported. in association with herpesviruses. It is not a recognised complication of chronic hepatitis B or C infection, or interferon-,2b therapy. However, the interferons are associated with numerous adverse reactions including various neuropsychiatric manifestations and neurological syndromes. There are several reports of nerve palsies, including optic tract neuropathy, occurring during interferon therapy, and immune-based mechanisms are thought to play a role in the aetiopathogenesis. No reports of Bell's palsy in association with interferon therapy were identified in our literature search, although one possible case has been reported to the Committee of Safety in Medicine. Although Bell's palsy in our patients may have occurred by chance, a neuropathic effect of interferon-,2b on the facial nerve cannot be excluded and we urge physicians using interferons to be aware of this potential side-effect. [source]

Treating nerves: a call to arms

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2008
Richard A. C. Hughes
Abstract The process of proving that new treatments for peripheral nerve diseases work has often been slow and inefficient. The lack of adequate evidence for some existing treatments has been highlighted by Cochrane systematic reviews. This article uses four different conditions to illustrate the need for more research. Both corticosteroid injections and surgical decompression of the median nerve are efficacious in carpal tunnel syndrome, but whether corticosteroid injections avoid the need for operation needs to be discovered. Corticosteroids are efficacious for Bell's palsy, but the role of antiviral agents needs clarification, which should come from ongoing trials. Intravenous immunoglobulin (IVIg) and plasma exchange are both efficacious in Guillain-Barré syndrome, but corticosteroids are not. More trials are needed to discover the best dose of IVIg in severe cases and whether mild cases need treatment. In chronic inflammatory demyelinating polyradiculoneuropathy, corticosteroids, IVIg and plasma exchange are all efficacious, at least in the short term, but trials are needed to discover whether and which other immunosuppressive agents help. The Peripheral Nerve Society has formed a standing committee, the Inflammatory Neuropathy Consortium (http://pns.ucsd.edu/INC.htm), to facilitate the trials needed to answer the remaining questions in the inflammatory neuropathies. [source]

Sequential case series analysis for pharmacovigilance

JOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2009
Mounia N. Hocine
Summary., The self-controlled case series method is used to evaluate drug safety, particularly the safety of paediatric vaccines with respect to rare adverse reactions. We propose a group sequential version of the method for prospective surveillance of drug safety. We focus on the surveillance of new vaccines. We develop methods that are based on the sequential probability ratio test applied at predetermined surveillance intervals, using both simple and composite alternative hypotheses. We investigate the properties of the methods analytically in a simple setting and by simulations in more realistic scenarios. The methods are applied to data on influenza vaccine and Bell's palsy, and to data on measles, mumps and rubella vaccine and bleeding disorders. [source]

Blepharokymographic Analysis of Eyelid Motion in Bell's Palsy

Prognostic value of electroneurography in Bell's palsy and Ramsay,Hunt's syndrome

CLINICAL OTOLARYNGOLOGY, Issue 2 2006
D.-H. Lee
Objectives:, This study evaluated the accuracy of electroneurography to predict the prognosis of Bell's palsy and Ramsay,Hunt's syndrome. Design:, A retrospective, institutional review board-approved study. Setting:, A secondary referral and a university-based centre. Participants:, The patients had been treated for a sudden onset unilateral facial paralysis over the past 10 years (1994,2004). This retrospective study included only those patients who had been followed up for at least 3 months or if they had reached a complete recovery before then. Main outcomes measures:, House,Backmann grade versus electroneurography value. Results:, The recovery rates to House,Brackmann grade II or better were 95% in those with Bell's palsy and 84% in those with herpes zoster oticus. The electroneurography value of the recovery and non-recovery groups from those with either Bell's palsy or herpes zoster oticus was similar. The logistic regression model between the electroneurography values and the probability of recovery showed no correlation in those with Bell's palsy or with herpes zoster oticus. This study did not identify the proper electroneurography value that had enough appropriate sensitivity and specificity to predict the prognosis of paralysis accurately in Bell's palsy or in herpes zoster oticus patients. Conclusion:, Electroneurography performed between day 7 and 10 for Bell's palsy or day 10 and 14 for herpes zoster oticus does not provide accurate information on the prognosis or recovery rate of the facial paralysis. [source]