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Naguib LE, Abdel Azim GS, Elazab SA, Mohamed HS. Ultrasonography as diagnostic and prognostic tool and Therapeutic role of repetitive peripheral magnetic stimulation in acute idiopathic facial nerve palsy. J Ultrasound 2024; 27:707-714. [PMID: 38910221 PMCID: PMC11333389 DOI: 10.1007/s40477-024-00927-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
PURPOSE Repetitive Peripheral Magnetic Stimulation [rPMS] is a non-invasive tool that has a potential therapeutic role in many musculoskeletal disorders. We aimed to demonstrate the therapeutic efficacy of high frequency [rPMS] in acute Idiopathic Facial Nerve Palsy [IFP]. And to study the role of neuromuscular ultrasonography in acute idiopathic facial palsy. METHODS Forty patients, aged above 18 years, diagnosed with unilateral acute [within 7 days of onset] idiopathic facial palsy were enrolled and randomly divided into intervention group [20 patients] and control group. Both groups underwent clinical examination, assessment of facial nerve disability by House-Brackmann grading [HBG] score and Facial Disability Index [FDI] score, ultrasonography of facial nerve of both normal and affected sides at baseline and after 6 weeks, medical treatment and routine rehabilitation therapy. The intervention group were subjected to 10 sessions of high frequency r PMS [5/week for 2 successive weeks] on the affected side. RESULTS Both [HBG] and [FDI] showed more significant improvement in the intervention group in comparison to the control group after 6 weeks follow up. Ultrasonographic measures of facial nerve in the affected side were significantly larger than non-affected side at baseline. However, those measures significantly decreased after 6 weeks follow up. Surprisingly, the intervention group showed more significant decrease in facial nerve dimeter at proximal portion [without sheath] in comparison to control group. CONCLUSION high frequency r PMS have an adjuvant role in treatment of acute idiopathic facial palsy. Also, ultrasonography has beneficial role in evaluation and prognosis of [IFP].
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Affiliation(s)
- Laila Elmously Naguib
- Neurology Department, Faculty of Medicine-for Girls, Al-Azhar University, Cairo, Egypt
| | - Ghada Saed Abdel Azim
- Neurology Department, Faculty of Medicine-for Girls, Al-Azhar University, Cairo, Egypt.
| | - Seham Abdallah Elazab
- Rheumatology and Rehabilitation Department, Faculty of Medicine-for Girls, Al-Azhar University, Cairo, Egypt
| | - Hadeir Said Mohamed
- Neurology Department, Faculty of Medicine-for Girls, Al-Azhar University, Cairo, Egypt
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Xu L, Guo T, Sheng X, Du H, Tang Y. Predictive Value of the Neutrophil-to-Lymphocyte Ratio and C-Reactive Protein in Patients with Idiopathic Facial Nerve Palsy. Int J Gen Med 2024; 17:2635-2642. [PMID: 38863739 PMCID: PMC11166163 DOI: 10.2147/ijgm.s458808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/01/2024] [Indexed: 06/13/2024] Open
Abstract
Objective This study aims to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in patients with idiopathic facial nerve palsy. Methods The clinical data of patients with idiopathic facial nerve palsy were retrospectively analyzed. After three months of follow-up, patients were divided into good prognosis and poor prognosis, and the correlation between NLR, CRP and idiopathic facial nerve palsy was analyzed. Results Negative correlation of NLR with Portmann score in idiopathic facial nerve palsy (r=-0.788, P<0.05); In contrast to the group with poor prognosis, patients in good prognosis group had low levels of body mass index (BMI), NLR, and C-reactive protein (CRP), and high Portmann score (P<0.05); Multivariate logistic regression analysis showed Portmann score (OR=1.268, 95% CI (1.005-1.616)), NLR (OR=0.262, 95% CI (0.128-0.533)) and CRP levels (OR=0.949, 95% CI (0.895-0.989)) were risk factors of poor prognosis for patients with idiopathic facial nerve palsy. The area under the receiver operator characteristic (ROC) curve of NLR and CRP levels in predicting poor facial nerve function was 0.764 and 0.697, the specificity was 85.5% and 75.0%, and the sensitivity was 74. 0% and 76.0%, respectively. The ROC curve of the combined diagnosis was 0.829, the specificity was 80.7%, and the sensitivity was 82.0%. Conclusion Elevated NLR and CRP are associated with a poor prognosis of idiopathic facial nerve palsy and can serve as an indicator for clinical prognosis, and can be widely used in clinical.
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Affiliation(s)
- Longdong Xu
- Department of Neurology, Changshu NO.5 People’s Hospital, Changshu, Jiangsu, 215500, People’s Republic of China
| | - Tingting Guo
- Department of Neurology, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, Jiangsu, 215200, People’s Republic of China
| | - Xihua Sheng
- Department of Neurology, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, Jiangsu, 215200, People’s Republic of China
| | - Huaping Du
- Department of Neurology, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, Jiangsu, 215200, People’s Republic of China
| | - Ying Tang
- Department of Neurology, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, Jiangsu, 215200, People’s Republic of China
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Abdelnaby R, Mohamed KA, ELgenidy A, Dardeer KT, Bedewy MM, Sonbol YT, Elmenawi KA, Elsaeed EM, Kotbe MS, Shabib AS, Heikal HA, Gawish HM, Barakat MH, Tawfik EA. Sonographic reference values of cranial nerve size: A Systematic Review and Meta-analysis. Muscle Nerve 2022; 66:329-335. [PMID: 35765722 DOI: 10.1002/mus.27670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION/AIMS Ultrasonography of the cranial nerves has recently gained attention in assessing inflammatory, compressive or degenerative neuropathies. However, sonographic reference values of cranial nerves have received less attention than those of peripheral nerves. This systematic review and meta-analysis aimed to provide current evidence of sonographic reference values for cranial nerve size. METHODS By searching Medline (via PubMed), Scopus, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, we conducted a systematic review and meta-analysis of studies that reported ultrasound measurements of the facial, spinal accessory, and hypoglossal nerves in healthy adults. We included studies that reported either the sonographic cross-sectional area (CSA) or the nerve diameter; the included nerves were sub-grouped according to the site of nerve measurement. RESULTS Fourteen studies with a total of 661 participants and 1437 ultrasound nerve measurements met the inclusion criteria. The anatomical sites for each nerve were combined to provide single nerve mean measurements. We found an overall mean nerve diameter of 0.80 mm for the facial nerve, 0.63 mm for the spinal accessory nerve, and 1.82 mm2 for the hypoglossal nerve CSA. DISCUSSION This meta-analysis provides reference values for the diameter and cross-sectional area of the facial, spinal accessory, and hypoglossal nerves at different sites, which can be used as guidance in clinical practice to detect pathological changes in cranial nerve size in cranial neuropathies. We recommend further validation in large-scale studies as well as standardization of the scanning protocols.
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Affiliation(s)
- Ramy Abdelnaby
- Department of Neurology, RWTH Aachen University, Pauwels Street 30, Aachen, Germany
| | | | | | | | | | | | | | - Eman Mohammed Elsaeed
- Department of Human anatomy and embryology, Faculty of Medicine, Port Said University, Port Said, Egypt
| | | | | | | | | | | | - Eman A Tawfik
- Department of Physical Medicine & Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Baek SH, Kim YH, Kwon YJ, Sung JH, Son MH, Lee JH, Kim BJ. The Utility of Facial Nerve Ultrasonography in Bell's Palsy. Otolaryngol Head Neck Surg 2019; 162:186-192. [PMID: 31870206 DOI: 10.1177/0194599819896298] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study aimed to investigate the utility of facial nerve ultrasonography in the functional and structural assessment of early-stage Bell's palsy and the prognostic value of facial nerve ultrasonography in Bell's palsy. STUDY DESIGN Prospective longitudinal study. SETTING Single center, a university-affiliated neurology clinic. SUBJECTS AND METHODS Patients with unilateral Bell's palsy who had visited our clinic within 3 days of symptom onset were enrolled in this study. Demographic information and House-Brackmann grade were collected. Electrophysiologic studies and facial nerve ultrasonography were then performed. The facial nerves on each side were scanned longitudinally with a 5- to 12-MHz probe. The diameter of the facial nerves with and without the sheath was measured at the proximal and distal portions. Follow-up examinations, including House-Brackmann grade analysis, electrophysiologic studies, and facial nerve ultrasonography, were performed after 2 months. RESULTS Fifty-four patients with unilateral Bell's palsy were enrolled, and 22 underwent the follow-up examinations. The diameters of the facial nerves were larger on the affected side than on the unaffected side at the proximal and distal portions (P < .01). On the affected side, the enlarged facial nerve at the proximal portion had decreased in size after 2 months (P < .05). The initial ultrasonography findings were positively correlated with the initial severity of Bell's palsy, but they did not predict prognosis. CONCLUSION Ultrasonography could be a useful tool for evaluating the facial nerve in Bell's palsy. Nevertheless, further studies are needed to demonstrate its prognostic value.
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Affiliation(s)
- Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoo Hwan Kim
- Department of Neurology, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Ye-Ji Kwon
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Joo Hye Sung
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Myeong Hun Son
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jung Hun Lee
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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