This study aims to report on treatment outcomes and related factors in Bell\'s palsy patients by analyzing Electronic Medical Records (EMR) data. To assess the impact on the duration until improvement in House-Brackmann grading post-onset, we conducted an analysis of inpatient records for Bell\'s palsy patients admitted to a traditional Korean medicine hospital from 2018 to 2022. A total of 1049 subjects were included in the analysis. Contributing factors to a duration of more than 14 days until improvement in HB Grade included age 40 or above, male gender, an initial period of more than 7 days from onset to admission, a history of past recurrence, and the indication for adjunctive therapy. To generalize the adaptation of adjunctive traditional Korean medicine treatment indications to treatment outcomes, larger-scale studies encompassing a broader patient population will be necessary.

OBJECTIVE: This paper describes a new surgical procedure with electrical stimulation of the facial nerve for unresolved Bell\'s palsy and compares the facial nerve recovery with another group who underwent traditional middle cranial fossa decompression.
RESULTS: All patients with total unilateral facial paralysis had surgery by the senior author 3 months from onset of Bell\'s Palsy. Surgical decompression was performed in 13 patients between 1992-2012 (Group 1). Surgical exposure with intraoperative electrical stimulation of the facial nerve in the peri-geniculate region was performed in 47 patients between 2012-2022 (Group 2). The facial recovery at 1 month and 3 month were significantly better in Group 2. The degree of synkinesis was significantly less in Group 2. The trans-mastoid electrical stimulation of the facial nerve is less invasive, requires no hospital stay, and less time off work compared to the middle cranial fossa approach. The earlier facial movement at one month results in less long-term unwanted faulty regeneration or synkinesis.

Lyme neuroborreliosis is a rare zoonosis which can be difficult to diagnose, in particular in low endemic areas. We here report the case of a 35-year-old man presenting with disabling back pain preceded by facial monoplegia, which was wrongly treated as Bell\'s palsy (paralysis a frigore) and then as post-traumatic lumbosciatica. The onset of facial diplegia allowed for a definitive diagnosis. The patient was treated with ceftriaxone and symptoms gradually improved.

OBJECTIVE: 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.
CONCLUSIONS: 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].

Idiopathic facial paralysis is the most common type of facial nerve injury, accounting for approximately 70% of peripheral facial paralysis cases. This disease can not only lead to a change in facial expression but also greatly impact the psychology of patients. In severe cases, it can affect the normal work and life of patients. Therefore, the research on facial nerve injury repair has important clinical significance. In order to study the mechanism of this disease, it is necessary to carry out relevant animal experiments, among which the most important task is to establish an animal model with the same pathogenesis as human disease. The compression of the facial nerve within the petrous bone, especially the nerve trunk at the junction of the distal end of the internal auditory canal and the labyrinthine segment, is the pathogenesis of idiopathic facial paralysis. In order to simulate this common disease, a compression injury model of the main extracranial segment of the facial nerve was established in this study. The neurological damage was evaluated by behavioral, neuroelectrophysiological, and histological examination. Finally, 50 g constant force and 90 s clamp injury were selected as the injury parameters to construct a stable idiopathic facial paralysis model.

The purpose of the study was to assess the effects of a novel technique involving facial stretching of the unaffected side along with a structured exercise for the affected side on facial symmetry and facial functions as compared to conventional exercise. A hospital-based parallel-group randomized trial was completed among patients with acute Bell\'s palsy in Mangalore, India. Participants were randomized to receive facial stretching and a structured exercise program (experimental group) or the conventional exercise regimen (conventional group). Primary outcomes were facial symmetry and voluntary movement; assessed by the Sunnybrook Facial Grading System (SFGS). Both regimens were given for 3 weeks, with baseline, 10th day, and 20th day assessments. Out of 31 participants screened, 24 were eligible and 12 participants each were assigned to experimental and conventional groups. Change scores revealed greater improvement in the SFGS score (p = 0.002) for the experimental group participants. Facial stretching and structured exercise program exhibited promising results in enhancing facial symmetry and function in acute Bell\'s palsy when compared to conventional exercise regimen.

With the continuous progress of technology, the subject of life science plays an increasingly important role, among which the application of artificial intelligence in the medical field has attracted more and more attention. Bell facial palsy, a neurological ailment characterized by facial muscle weakness or paralysis, exerts a profound impact on patients\' facial expressions and masticatory abilities, thereby inflicting considerable distress upon their overall quality of life and mental well-being. In this study, we designed a facial attribute recognition model specifically for individuals with Bell\'s facial palsy. The model utilizes an enhanced SSD network and scientific computing to perform a graded assessment of the patients\' condition. By replacing the VGG network with a more efficient backbone, we improved the model\'s accuracy and significantly reduced its computational burden. The results show that the improved SSD network has an average precision of 87.9% in the classification of light, middle and severe facial palsy, and effectively performs the classification of patients with facial palsy, where scientific calculations also increase the precision of the classification. This is also one of the most significant contributions of this article, which provides intelligent means and objective data for future research on intelligent diagnosis and treatment as well as progressive rehabilitation.

OBJECTIVE: To establish and validate a clinical prediction model of acupuncture and moxibustion for Bell\'s palsy so as to provide a tool for predicting the effect of acupuncture and moxibustion on Bell\'s palsy.
METHODS: A total of 269 patients with Bell\'s palsy were collected from department of acupuncture, moxibustion and tuina, Shengli Oilfield Central Hospital, neurology department, Shenxian County Central Hospital and department of rehabilitation medicine, Dongying Municipal Hospital of TCM from June 2018 to June 2023. All of these cases were treated with acupuncture and moxibustion. Of them, 182 cases, from department of acupuncture, moxibustion and tuina, Shengli Oilfield Central Hospital and neurology department, Shenxian County Central Hospital, were randomized into a training group (128 cases) and an internal validation group (54 cases); 87 cases from department of rehabilitation medicine, Dongying Municipal Hospital of TCM were assigned to an external validation group. The clinical data of all of the cases were extracted from the electronic medical record information platform. Using SPSS25.0 and R4.2.3, through univariate and multivariate Logistic regression analysis, the independent factors influencing the effects of acupuncture and moxibustion on Bell\'s palsy were identified. By means of internal and external validations, the receiver operating characteristic curve (ROC), the goodness-of-fit curve (GFC) and the decision curve analysis (DCA) were plotted. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the model were calculated; and its comprehensive performance was evaluated.
RESULTS: The results of the multivariate Logistic regression analysis showed that the independent factors for the unsatisfactory effect on Bell\'s palsy were advanced age, severe symptoms before treatment, no use of steroids within 72 h of onset, and lack of acupuncture-moxibustion therapy during the acute phase or single acupuncture-moxibustion protocol (P<0.05, P<0.01). Based on these factors, nomogram model and online columnar plot prediction tool (https://bmuchen.shinyapps.io/dynnomapp/) were established. The area under the ROC curve of the model was 0.921 (95% CI: 0.877, 0.966), 0.876 (95% CI: 0.787, 0.966), and 0.846 (95% CI: 0.766, 0.926) in the training group, the internal validation group, and the external validation group, respectively, indicating good predictive value. The model showed a satisfactory calibration curve alignment. The decision threshold in the range of 0 to 0.8 provided clinical benefits for participants. The model exhibited the sensitivity from 65.9% to 88.0%, the specificity ranging from 77.3% to 90.7%, the accuracy from 77.8% to 85.9%, the positive predictive value from 83.3% to 90.1%, and the negative predictive value from 70.8% to 78.7%. The comprehensive evaluation indicated a satisfactory clinical application value of the model.
CONCLUSIONS: The clinical prediction model of acupuncture and moxibustion for Bell\'s palsy is valuable in its practice and promotion to a certain extent. The predicted results are conductive to clinicians\' judgement of the effect of acupuncture and moxibustion for this disease and making effective and high-quality clinical decisions, as well as formulating the optimal therapeutic regimen.
目的：构建并验证针灸治疗贝尔面瘫的临床预测模型，为针灸治疗贝尔面瘫的疗效预测提供工具。方法：纳入2018年6月至2023年6月于胜利油田中心医院针灸推拿科、莘县中心医院神经内科和东营市中医院康复科就诊，并以针灸为主要治疗方式的贝尔面瘫患者269例，将胜利油田中心医院针灸推拿科、莘县中心医院神经内科182例患者随机分为训练组（128例）和内部验证组（54例），东营市中医院康复科患者作为外部验证组（87例），通过电子病历信息平台提取患者临床资料。采用SPSS25.0和R4.2.3软件，通过单因素和多因素Logistic回归分析，筛选出针灸治疗贝尔面瘫疗效的独立影响因素。并通过内部验证和外部验证的方式，绘制受试者工作特征曲线（ROC）、拟合度曲线和临床决策曲线（DCA），计算模型的灵敏度、特异度、准确度、阳性预测值和阴性预测值，全面评估模型的整体性能。结果：多因素Logistic回归分析结果显示，高龄、治疗前病情重、未在发病72 h内使用激素治疗、急性期未进行针灸和针灸方案单一是针灸治疗贝尔面瘫疗效不佳的独立影响因素（P<0.05，P<0.01）。基于此构建了列线图模型和在线列线图预测工具（https://bmuchen.shinyapps.io/dynnomapp/）。模型在训练组、内部验证组和外部验证组的ROC曲线下面积（AUC）分别是0.921（95%CI：0.877，0.966）、0.876（95%CI：0.787，0.966）和0.846（95%CI：0.766，0.926），具有良好的预测价值。模型与校准曲线贴合较好。决策曲线阈值在0~0.8之间时，可为临床参与者提供临床获益。模型的灵敏度在65.9%~88.0%、特异度在77.3%~90.7%、准确度在77.8%~85.9%、阳性预测值在83.3%~90.1%、阴性预测值在70.8%~78.7%，综合评估该模型的临床应用价值较好。结论：针灸治疗贝尔面瘫的临床预测模型具有一定的实际应用价值和可推广性，预测结果可以辅助临床医师对针灸治疗贝尔面瘫的疗效进行判定，做出有效优质的临床决策，制定最佳的治疗计划。.

BACKGROUND: Bell\'s palsy is an idiopathic peripheral nerve palsy involving the facial nerve. Pregnancy, diabetes mellitus and hypertension are the risk factors for Bell\'s palsy. However, the association between hypertensive disorders and Bell\'s palsy during pregnancy or the puerperium remains unclear. This systematic review will comprehensively summarise the literature and evaluate the association between Bell\'s palsy and hypertensive disorders during pregnancy or the puerperium.
METHODS: Systematic searches of PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials will be undertaken using prespecified search strategies. Observational studies (cross-sectional studies, cohort studies, case reports and series case reports) written in English that investigate the association between hypertensive disorders of late pregnancy and Bell\'s palsy during pregnancy or the puerperium will be included. Different authors will independently conduct the eligible study selection, perform data extraction and appraise the quality of included studies. Subgroup analysis will be carried out based on the age of pregnant women (≤35 years old, >35 years old), parity (primipara, multipara) and fetus number (singleton or multiple-gestation pregnancy).
BACKGROUND: This review will be based on published literature, and thus there is no requirement for ethics approval. The results of this study will aid in the knowledge of the relationship between Bell\'s palsy during pregnancy or the puerperium and hypertensive disorders of late pregnancy. The results of this systematic review will be shared through publication in a peer-reviewed journal with good visibility for the field of obstetrics and presentations at academic conferences.
UNASSIGNED: CRD42023422902.

Neurolymphomatosis (NL) is a rare complication of non-Hodgkin\'s lymphoma, characterized by the infiltration of lymphoma cells into the peripheral nerves. A 54-year-old woman initially presented with right facial palsy without any other significant symptoms and was diagnosed with Bell\'s palsy. Despite initial improvement, her condition recurred, prompting further evaluation. Magnetic resonance imaging (MRI) revealed contrast enhancement from the tympanic segment to the surface of the masseter muscle along the right facial nerve and an adjacent mass lesion. Biopsy of the mass revealed a diagnosis of T-cell/histiocyte-rich large B-cell lymphoma. Chemotherapy resulted in complete resolution of facial palsy. Follow-up MRI confirmed the absence of contrast enhancement along the facial nerve. Facial palsy was considered to be caused by NL. This case was classified as that of primary NL because the facial palsy was the first manifestation of a hematologic malignancy. Recurrent facial palsy, which is atypical in Bell\'s palsy, led to further evaluation with MRI, which finally resulted in the diagnosis of malignant lymphoma. In cases of recurrent facial palsy, clinicians should consider various diagnoses, including that of NL, and advocate early imaging tests and biopsy, if possible, for accurate diagnosis and improved outcomes.