Schneider Nicole, Shih Susana, Rundquist Lily, Llanio Lis, Kurian Asha, Ring Ashley, Barry Patrick
Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA.
Osteopathic Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA.
Cureus. 2024 Aug 20;16(8):e67334. doi: 10.7759/cureus.67334. eCollection 2024 Aug.
Bell's palsy (BP) is a rapid-onset neurological disorder causing unilateral facial paralysis, affecting approximately 40,000 people annually in the United States. Suggested treatments for BP include corticosteroids, facial therapy, and osteopathic manipulative treatment (OMT) in order to improve symptoms; however, some people with BP have spontaneous resolution. A 52-year-old female with left-sided facial paralysis and drooping for the past four months due to BP presented to the osteopathic treatment center. For the first three weeks after developing BP, the patient had soreness when attempting to move her facial features, but on later treatments, she only experienced weakness on the left side of her face. The patient's facial sensation was intact bilaterally, but she was unable to move her left eyebrow, eyelid, cheek, and lip. OMT focused on the intraoral musculature, the cervical spine, and cranial treatment utilizing osteopathic techniques such as osteopathic cranial manipulative medicine (OCMM), direct myofascial release, soft tissue, balanced ligamentous tension, and muscle energy. Utilizing the Facial Disability Index (FDI) questionnaire and the Sunnybrook facial grading system (SFGS), an improvement in facial paralysis was seen due to both OMT and physical therapy (PT) treatments. It is difficult to discern which treatments helped the patient the most (OMT, PT, or at-home exercises); however, the patient's improvement was notable. This case study demonstrates that OMT, PT, and at-home exercises may positively contribute toward the improvement of BP symptoms by addressing cranial and muscular somatic dysfunctions of the head and neck. The treatment, which included techniques such as muscle energy and intraoral myofascial release, resulted in significant improvements in facial function and grading scores. One limitation of the study is that, however unlikely, chronic BP may resolve spontaneously, which may have contributed to the patient's progress. While OMT, PT, and at-home exercises contributed to the patient's recovery, further research is needed to substantiate the effectiveness of OMT, PT, and at-home exercises in treating BP.
贝尔麻痹（BP）是一种起病迅速的神经系统疾病，可导致单侧面部瘫痪，在美国每年约有4万人受其影响。BP的建议治疗方法包括使用皮质类固醇、面部治疗和整骨手法治疗（OMT）以改善症状；然而，一些BP患者会自行康复。一名52岁女性因BP导致左侧面部瘫痪和下垂四个月后到整骨治疗中心就诊。在患BP后的前三周，患者试图移动面部特征时会感到酸痛，但在后来的治疗中，她仅左侧面部感到无力。患者双侧面部感觉均正常，但无法移动左眉、眼睑、脸颊和嘴唇。OMT专注于口腔内肌肉组织、颈椎和颅骨治疗，采用整骨技术，如整骨颅骨手法医学（OCMM）、直接肌筋膜松解、软组织、平衡韧带张力和肌肉能量技术。通过面部残疾指数（FDI）问卷和桑尼布鲁克面部分级系统（SFGS）发现，OMT和物理治疗（PT）均使面部瘫痪情况有所改善。很难辨别哪种治疗对患者帮助最大（OMT、PT或家庭锻炼）；然而，患者的改善是显著的。本案例研究表明，OMT、PT和家庭锻炼可能通过解决头颈部的颅骨和肌肉躯体功能障碍，对改善BP症状产生积极作用。包括肌肉能量和口腔内肌筋膜松解等技术在内的治疗方法，使面部功能和分级评分有了显著改善。该研究的一个局限性在于，尽管可能性不大，但慢性BP可能会自行康复，这可能对患者的病情进展有一定作用。虽然OMT、PT和家庭锻炼对患者的康复有帮助，但还需要进一步研究来证实OMT、PT和家庭锻炼治疗BP的有效性。
