Bell's palsy: aetiology, clinical features and multidisciplinary care.

Bell's palsy is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis. Immune, infective and ischaemic mechanisms are all potential contributors to the development of Bell's palsy, but the precise cause remains unclear. Advancements in the understanding of intra-axonal signal molecules and the molecular mechanisms underpinning Wallerian degeneration may further delineate its pathogenesis along with in vitro studies of virus-axon interactions.

Prognostic factors in herpes zoster oticus (ramsay hunt syndrome).

Objectives: To determine if an accurate prognosis can be made in patients with Herpes zoster oticus (HZO), facial nerve outcomes were assessed at 1-year after onset and compared with symptoms and signs at presentation.

Study Design: Individual retrospective cohort study of 101 records in a case series (level of evidence: Level 2b).

Methods: Symptoms, signs, audiology, and treatment records were analyzed to determine their association with facial nerve outcome at 1 year.

Infective causes of facial nerve paralysis.

Objective: To review the functional recovery in a cohort of patients with facial nerve paralysis (FNP) due to infective cause.

Study Design: Retrospective review based on patients identified from a prospectively maintained database of patients with FNP. The case notes of identified patients were reviewed.

Bilateral conjugacy of movement initiation is retained at the eye but not at the mouth following long-term unilateral facial nerve palsy.

Voluntary eyelid closure and smiling were studied in 11 normal subjects and 11 patients with long-term unilateral facial nerve palsy (FNP). The conjugacy of eyelid movements shown previously for blinks was maintained for voluntary eye closures in normal subjects, with movement onset being synchronous in both eyes. Bilateral onset synchrony of the sides of the mouth was also observed in smiling movements in normal subjects.

Physiotherapy rehabilitation of the smile after long-term facial nerve palsy using video self-modeling and implementation intentions.

Objective: To improve smiling after long-term facial nerve palsy (FNP). Physiotherapy rehabilitation of an adapted (more symmetrical) smile was investigated in FNP subjects 1 year post-onset, using video self-modeling (video replay of only best adapted smiles) and implementation intentions (preplanning adapted smiles for specific situations).

Study Design And Setting: Prospective, blinded clinical trial.

Reliability of the "Sydney," "Sunnybrook," and "House Brackmann" facial grading systems to assess voluntary movement and synkinesis after facial nerve paralysis.

Objective: To investigate the extent of within-system reliability and between-system correlation for the "Sydney" and "Sunnybrook" systems of grading facial nerve paralysis, and to examine the interobserver reliability and agreement of the "House Brackmann" grading system.

Study Design: A fixed-effects reliability study in which 6 otolaryngologists viewed videotapes of patients with facial nerve paralysis.

Setting: University and medical Centers.

Expression of emotion and quality of life after facial nerve paralysis.

Objective: To investigate the facial expression of emotion and quality of life in patients after long-term facial nerve paralysis.

Study Design: Cross-sectional.

Setting: Facial nerve paralysis clinic.

Three-dimensional quantification of the symmetry of normal facial movement.

Objective: This study examined the right to left symmetry of the displacement of three-dimensional movement of the human face.

Methods: Displacement data on 42 subjects was collected and analyzed with the Expert Vision Motion Analysis System. Right and left three-dimensional facial displacements were quantified.