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Hinojosa

Peripheral Facial Paralysis

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Involves swelling of cranial nerve VII or facial nerve due to a viral infection or immune disease. This swelling creates ischemia and compression of the nerve within the fallopian canal.

Symptoms vary from mild weakness to total paralysis of one side of the face and may include, but are not limited to, drooping the eyelid and corner of the mouth, dryness of the eye and / or mouth and decreased sensation of flavor.
Bell’s palsy is the most common cause of peripheral facial paralysis 3,4 and represents more than 50% of all cases of facial paralysis.
It affects approximately 40,000 Americans each year and affects men and women aged 15 to 60 years equally. The facial component of cranial nerve VII travels from its motor nucleus in the lower part of the protuberance, beyond the olive and within the cerebellopontine angle.

From there, it enters the internal acoustic meatus and travels through the facial canal in the boulder along with the cranial nerve VIII and the labyrinthine artery.

Here it is wrapped in an Arachnoid-lined dura case.
After leaving the internal acoustic meatus, the facial nerve travels through the falciform aqueduct in the temporal bone until its termination in the stylomastoid foramen.
When it emerges from the stylomastoid foramen, the facial nerve travels towards the branch of the lower jaw, where it divides into the temporofacial and cervicofacial branches.
The anatomical pathway that travels the facial nerve and how it interacts with the structures along that pathway.
For example, Blum reported that intracranial mechanical stress can affect the bones of the skull and meninges, which can lead to neuropathies by entrapment.
This is especially true of the facial nerve because of its relationship to the arachnoid and the dura mater.

Chiropractic care has a potential role. The purpose of this case study is to describe the effect of chiropractic care of a patient with chronic Bell’s palsy.

Report of a case A 47-year-old woman presented to a chiropractic clinic in June 2009 with a complaint of sinus pressure and congestion on the right side due to Bell’s palsy.

The lateral canthus of her right eye and the right corner of her mouth were noticeably sagging, and she reported an intermittent tingling sensation on the right side of her face.

She stated that her nasal pressure and congestion were present every day and that they got worse with the onset of menstruation each month. Bell’s palsy of the patient began and she was medically diagnosed in April 2004.

At that time, she reported experiencing muscle spasms and trismus on the right side of the face. These symptoms caused him to experience food and fluids that fall from the right side of his mouth when he eats and drinks, as well as difficulty speaking. His doctor prescribed gabapentin (Neurontin, Pfizer, New York, NY) and an eye lubricant, and recommended drinking cold water and using azithromycin (Z-Pak, Pfizer) if his condition worsened. In addition, a consultation with a neurologist was ordered.

The neurologist stated that his was a permanent condition and that there was no treatment. According to the patient, the doctor agreed and concluded the treatment. During the patient’s chiropractic examination, the ranges of cervical movement were within normal limits with a feeling of “traction” in the right trapezius in flexion and the left trapezius in right lateral flexion.

Reflexes of the upper extremities were all +3 bilaterally. The muscle tests of the left upper extremity produced ratings of +4 except the deltoid, which was +3.
The muscle tests of the right upper extremity obtained grades of +2, except the biceps, triceps and deltoids, which were +4.
Palpation of the neck revealed fixation, swelling and tense and sensitive fibers at the C1 / 2 levels on the right.

Tenuous and tender fibers were also found at levels C5-T2 on the right. The right trapezius and the rhomboid were contracted.
The muscle tests of the left upper extremity produced ratings of +4 except the deltoid, which was +3.
The muscle tests of the right upper extremity obtained grades of +2, except the biceps, triceps and deltoids, which were +4.

Palpation of the neck revealed fixation, swelling and tense and sensitive fibers at the C1 / 2 levels on the right.
Tenuous and tender fibers were also found at levels C5-T2 on the right.
The right trapezius and the rhomboid were contracted.
Tenuous and tender fibers were also found at levels C5-T2 on the right.
The right trapezius and the rhomboid were contracted.
Tenuous and tender fibers were also found at levels C5-T2 on the right.

The right trapezius and the rhomboid were contracted.

Bells Palsey

CHIROPRACTIC TREATMENT

The initial treatment plan consisted of chiropractic manipulation (CMT), interferential muscle stimulation and hydroceleration in the neck and trapezius bilaterally 3 times a week for 5 weeks, peripheral facial paralysis followed by 1 time a week for 4 weeks. The CMT consisted of a high-speed, low-amplitude technique while the patient rested in the supine position of the C1 and C7 vertebrae and a high-speed, low-amplitude technique while the patient was lying face down (diversified) of the T2 and T6 vertebrae.

Improvements were observed in the patient’s condition and in general health after the first visit, and she reported that she slept more deeply. After her third visit, the patient reported that her sinuses were clearer, which facilitated breathing. In addition, the oppression on the right side of his face was reduced. In reviewing the subjective findings on the sixth visit, she reported that her children had commented that “her smile went higher to the right”. The right corner of the patient’s mouth was more even with the left side at the time of visual inspection. The patient continued to report a decrease in sinus pressure during the next 2 weeks. A significant decrease in sinus pressure was reported and a significantly greater facial tone was visualized on his 17th visit.

After the patient’s initial treatment plan was completed, a chiropractic re-evaluation was performed. Palpation of the neck revealed a reduced fixation at the C1 / 2 levels and that the fibers stretched and swollen at C1 / 2 to the right had completely decreased. Tensile and sensitive fibers at levels C5-T2 on the right had been reduced, and the right trapezius and the rhomboid muscles were no longer contracted.

The patient then began receiving chiropractic adjustments once a month. At 3 months, the patient’s right eye was approximately 50% open, and the right corner of her mouth was approximately 50% higher than at the start of care. The patient had sinus infections until the fifth and sixth month without symptoms of Bell’s palsy. Seven months after the start of care, the patient reported that she no longer experienced sinus infections and that her optometrist discovered that her “vision was better” after a routine check-up. After the physical examination, her right eye was more open and her smile improved 10 months after starting to take care.

During the following 4 months of care, the patient’s improvement stabilized; and experienced little change in the symptoms of Bell’s palsy. At 15 months, the patient reported less tension in her face and neck and visualized her “smile extending more”. At 16 months after starting to care, the corners of the patient’s mouth were even; and his right eye was open twice more than at the beginning of attention. A simple film radiographic study of his spine was performed Cervicothoracic The anteroposterior view (Fig 3) showed a 20% reduction in levoscoliosis C2-C7 from 10 ° to 8 °. The lateral cervical view (Fig 4) showed a 20% increase in the angle of the atlas from 5 ° to 6 °.

Approximately 71% of patients with Bell’s palsy will recover normal function of the facial muscle with the treatment, 13% will have a slight weakness and 16% will experience moderate weakness, which will cause important facial dysfunction.

Medical treatment usually consists of antiviral and anti-inflammatory medications. Randomized clinical trials have shown that monotherapy with acyclovir (antivirals) is lower than monotherapy with prednisone (anti-inflammatory). Acyclovir and prednisone together are better than prednisone alone. The surgical intervention has not shown any positive effect. Transmastoid decompression should only be considered if a tumor is suspected.

Chiropractic treatment of Bell’s palsy has been shown to be successful, as reported in limited and published case studies. Alcantara et al 11 reported that a 49-year-old woman with Bell’s palsy for approximately 10 days presented for chiropractic care. This patient received 37 chiropractic adjustments during a period of 6 months. The patient reported symptomatic relief in the cervical and facial regions after only 1 week. The patient noticed that her facial pain had disappeared after 20 visits and that the motor functions, such as closing the right eye, smiling, raising the right eyebrow and blowing the cheeks, had returned. Shrode reported that 2 male adolescents separately presented Bell’s palsy, one with a 2-day onset and the other 8 days. Both received high voltage pulsed galvanic current for the muscles of the face and CMT for the fixation of the cervical spine. The patient of 2 days of onset received 16 treatments during a period of 6 weeks with total remission at 6 weeks. The 8-day initiation patient received 9 treatments during a 3-week period with total remission at 3 weeks. Frach et al 13 reported similar results in the treatment of 2 patients with Bell’s palsy. One was a 10-day, 18-year-old woman with Bell’s palsy, and the other was a 37-year-old, 25-day-old man with Bell’s palsy. The treatment of the female patient consisted of mechanical strength, manual assisted chiropractic technique and high voltage galvanic therapy. She was released from care without symptoms after 5 treatments. The treatment of the male patient consisted of mechanical strength, manually assisted high voltage galvanic therapy and self-administered facial muscle exercises. This patient reported an improvement of 60% to 70% in Bell’s palsy symptoms after 9 treatments and discontinued attention at that time. A patient who has Bell ‘

There are numerous theories as to why Bell’s symptoms of Bell’s palsy responded favorably to chiropractic care. From an anatomical point of view, the upper cervical adjustment could have changed the tension of the arachnoid and the dura, thus reducing possible neuropathy by entrapment. As the cranial nerve VII leaves the stylomastoid foramen, local trapping may occur due to trapezius muscle tension that originates, in part, from the external occipital protuberance and the inner third of the superior curve of the occipital bone. Tension of the sternocleidomastoid muscle, which is inserted into the external surface of the mastoid process and the outer half of the superior line of the occipital bone, can also create local trapping of the facial nerve. It is theorized that cervical manipulation can help reduce tension within these muscles by restoring adequate biomechanical function and reducing nerve root compression.

There is a relationship between the facial nerve and the autonomous communicating branches in the upper cervical spine. 4,12,14 As early as 1910, DD Palmer reported how “misaligned” cervical vertebrae can alter the sympathetic nerve impulses of the facial nerve, causing facial paralysis.

taken from www.reflexologiapodal.review

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