Sánchez DJR, Lorenzo VRM, Aguilar RF

Language: Spanish
References: 12
Page: 66-72
PDF size: 555.35 Kb.

ABSTRACT

Introduction: So far there is no effective treatment for patients with chronic peripheral facial paralysis (PFP). Objective: A prospective controlled study was conducted to examine the efficacy of PFP muscle retraining in addition to oral alpha-lipoic acid administration. Material and methods: Case patients: 18 patients with subacute or chronic facial paralysis (at least one month to several years), eight patients with grade V according to the House Brackmann classification, six patients with grade IV and four patients with grade III were included. Control patients: seven patients, four patients with grade IV by House Brackmann classification, three patients with grade III functioned as controls receiving conventional treatment: vitamins and massages. Comorbidities: 10 patients with diabetes mellitus (DM2), hypertension, eight patients combined HBP and DM2. 12 patients with a mean evolution of two years and one to eight years of experience, glycated hemoglobin with x of 7.5 and 6.5 to 10.9%. All patients were treated with alpha lipoic acid at a dose of 600 mg daily for four months. And in addition to muscle retraining, muscle by muscle. Results: Cases: eight patients from grade V descended to grade III, after two months of treatment, they achieved complete recovery at four months. Six patients with grade IV and four patients with grade III recovered ad integrum after two months. Control patients with conventional treatment dropped one point from grade IV at two months and another point at six months, and their almost total recovery was achieved up to one year. Statistics. With high significance at a level of 0.5 (p < 0.05). Especially in the measurement of facial expression, comparing cases and controls (p < 0.05). Conclusions: These results demonstrate that muscle retraining (muscle-by-muscle massage therapy) for peripheral facial nerve palsy, including mirror feedback in combination with alpha lipoic acid, is a clinically effective treatment in patients with subacute and chronic facial paralysis.

REFERENCES

1. Zeng L, Alongkronrusmee D, van Rijn RM. An integrated perspective on diabetic, alcoholic, and drug-induced neuropathy, etiology, and treatment in the US. J Pain Res. 2017;10:219-228.

2. Juster-Switlyk K, Smith AG. Updates in diabetic peripheral neuropathy. F1000Res. 2016;5:F1000 Faculty Rev-738. doi: 10.12688/f1000research.7898.1.

3. Bromberg MB. Peripheral neurotoxic disorders. Neurol Clin. 2000;18(3):681-894.

4. Goetz CG, Pappert EJ. Textbook of Clinical Neurology. Philadelphia: WB Saunders Co; 1999.

5. Pourmand R. Diabetic neuropathy. Neurol Clin. 1997;15(3):569-576.

6. Sugimoto K, Murakawa Y, Sima AA. Diabetic neuropathy--a continuing enigma. Diabetes Metab Res Rev. 2010;16(6):408-433.

7. Zochodne DW. Diabetic polyneuropathy: an update. Curr Opin Neurol. 2008;21(5):527-533.

8. Casas-Rodera P, Lassaletta L, González T, Sarriá MJ, Gavilán J. Técnicas reconstructivas del nervio facial. Acta Otorrinolaringológica Española. 2007;58(4):133-137. doi: 10.1016/S0001-6519(07)74898-7.

9. Gastol J, Kapusta P, Polus A et al. Epigenetic mechanism in search for the pathomechanism of diabetic neuropathy development in diabetes mellitus type 1 (T1DM). Endocrine. 2020;68(1):235-240.

10. Altaf QA, Ali A, Piya MK, Raymond NT, Tahrani AA. The relationship between obstructive sleep apnea and intra-epidermal nerve fiber density, PARP activation and foot ulceration in patients with type 2 diabetes. J Diabetes Complications. 2016;30(7):1315-1320.

11. Balliet R, Shinn JB, Bach-y-Rita P. Facial paralysis rehabilitation: retraining selective muscle control. Int Rehabil Med. 1982;4(2):67-74.

12. Perkins BA, Olaleye D, Bril V. Carpal tunnel syndrome in patients with diabetic polyneuropathy. Diabetes Care. 2002;25(3):565-569.