Shafshak T S
Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Eura Medicophys. 2006 Mar;42(1):41-7.
There are evidences to support recommending the early intake of prednisone (in its appropriate dose of 1 mg/kg body weight for up to 70 or 80 mg/day) or the combined use of prednisone and acyclovir (or valacyclovir) within 72 h following the onset of paralysis in order to improve the outcome of Bell's palsy (BP). Although there may be a controversy about the role of physiotherapy in BP or facial palsy, it seemed that local superficial heat therapy, massage, exercises, electrical stimulation and biofeedback training have a place in the treatment of lower motor facial palsy. However, each modality has its indications. Moreover, some rehabilitative surgical methods might be of benefit for some patients with traumatic facial injuries or long standing paralysis without recovery, but early surgery in BP is usually not recommended. However, few may recommend early surgery in BP when there is 90-100% facial nerve degeneration. The efficacy of acupuncture, magnetic pellets and other modalities of physiotherapy needs further investigation. The general principles and the different opinions in treating and rehabilitating facial palsy are discussed and the need for further research in this field is suggested.
有证据支持在面瘫发作后72小时内推荐早期服用泼尼松（适当剂量为1mg/kg体重，每日最高70或80mg）或联合使用泼尼松与阿昔洛韦（或伐昔洛韦），以改善贝尔面瘫（BP）的预后。尽管物理治疗在贝尔面瘫或面瘫中的作用可能存在争议，但局部浅表热疗、按摩、运动、电刺激和生物反馈训练似乎在治疗下运动神经元性面瘫中占有一席之地。然而，每种方式都有其适应症。此外，一些康复手术方法可能对一些面部创伤或长期面瘫未恢复的患者有益，但通常不建议在贝尔面瘫中早期手术。然而，当面神经变性达90%-100%时，少数人可能会推荐在贝尔面瘫中早期手术。针灸、磁珠和其他物理治疗方式的疗效需要进一步研究。本文讨论了面瘫治疗和康复的一般原则及不同观点，并提出了该领域进一步研究的必要性。
