背景:周围性面瘫(PFP)是一种具有多种病因的面瘫,包括特发性原因(贝尔麻痹),感染,创伤,和遗传因素。传统的治疗包括抗病毒药物,皮质类固醇,和物理治疗。然而,新疗法,如低水平激光治疗(LLLT),正在出现有希望的结果。
方法:本病例系列报道了2例PFP患者接受LLLT联合维生素B1、B6和B12补充剂治疗。第一例涉及一名因病毒感染而患有PFP的52岁女性。第二例是一名33岁的男性,他在创伤性脑损伤后患上了PFP。两名患者每两周接受一次LLLT治疗,从面部切痕沿面神经通路瞄准10个点。使用的激光设备是TheraphyEC(DMC,圣卡洛斯,SP,巴西),在用水和肥皂清洁面部后,每个点接收垂直于皮肤施加的4焦耳能量,以去除可能干扰的脂质。维生素B的给药使用NeUROBIONTA片剂(维生素B1维生素B6维生素B12;宝洁公司,圣地亚哥,智利),每天服用一片,持续30天。
结果:经过六到七次会议,2例患者面部肌肉功能和面部整体对称性均有显著改善.在第一种情况下,肌肉张力和面部运动有所改善,患者报告面部毁容减少。在第二种情况下,观察到面部活动度和对称性显着恢复,患者感觉异常降低,肌肉功能恢复。
结论:这些发现表明LLLT,结合维生素B1,B6和B12补充剂,可以有效改善PFP患者的面部肌肉功能和对称性。非侵入性和易于应用使LLLT成为PFP治疗的可行选择。有必要进行更大样本量和标准化方案的进一步研究以确认这些结果并将LLLT确立为PFP的标准治疗。
BACKGROUND: Peripheral Facial Palsy (PFP) is a facial paralysis with various etiologies, including idiopathic causes (Bell\'s palsy), infections, trauma, and genetic factors. Traditional treatments involve antiviral medications, corticosteroids, and physiotherapy. However, new therapies, such as Low-Level Laser Therapy (LLLT), are emerging with promising results.
METHODS: This case series reports on two patients with PFP treated with LLLT combined with Vitamin B1, B6, and B12 supplementation. The first case involved a 52-year-old female with PFP due to a viral infection. The second case was a 33-year-old male who developed PFP following a traumatic brain injury. Both patients received LLLT sessions every two weeks, targeting 10 points along the facial nerve pathway from the facial notch across the face. The laser device used was the Theraphy EC (DMC, Sao Carlos, SP, Brazil), with each point receiving 4 Joules of energy applied perpendicular to the skin after cleaning the face with water and soap to remove lipids that could interfere. The administration of Vitamin B was done using NEUROBIONTA tablets (Vitamin B1 + Vitamin B6 + Vitamin B12; Procter & Gamble, Santiago, Chile) with one tablet taken daily for 30 days.
RESULTS: After six to seven sessions, both patients showed significant improvement in facial muscle function and overall facial symmetry. In the first case, improvements were noted in muscle tonicity and facial movements, with the patient reporting reduced facial disfigurement. In the second case, notable recovery in facial mobility and symmetry was observed, with the patient experiencing decreased paresthesia and restored muscle functionality.
CONCLUSIONS: These findings suggest that LLLT, combined with Vitamin B1, B6, and B12 supplementation, may effectively improve facial muscle function and symmetry in PFP patients. The non-invasive nature and ease of application make LLLT a viable option for PFP treatment. Further studies with larger sample sizes and standardized protocols are necessary to confirm these results and establish LLLT as a standard treatment for PFP.