Bell's palsy

[emad]

Tungo and all ,

As for facial palsy and Bell,s palsy ,try to be so gently because you may share in developing complications to the patient like the most common problem Synkinesis that can develop simply because of pushing forward for improving the muscle power .I do NOT support using electrotherapy espicially using long times /periods e.g. Ultrasound therapy ,current research says it can has side effects over nerves .

After long time of dealing with facial palsy ,i think the most appropriate for those victims is Education regarding what can share in developing Synkinesis which usually occurs in severe facial nerve injuries .
Currently , i use Imagery exercises of the facial muscles to activate cortical presentations and at the same time avoid developing synkinesis .

Best Wishes
Emad

[1234nale]

To Sdkashif:

I saw your replay for few times that you are using ultrasound on face for Bells palsy. That’s always makes me mad! I don’t know why you are so insisting on doing that when last time there was many people that disagree with you. What are you try to accomplish? I thought you did some research on that topic but you apparently did not. So I posting whole article about penetration of low frequency ultrasound on human cranium in vitro. There are many researches on this or similar topics if you want you can inform your self.
And again, aria of the head, easy, ears, ovaries, testicles, brain, spinal cord are highly ultrasound-sensitive organs!!!
This is the articles:
Low-frequency Ultrasound Penetrates the Cranium and Enhances Thrombolysis In Vitro.
Technique Assessments
Neurosurgery. 43(4):828-832, October 1998.
Akiyama, Masahiko MD; Ishibashi, Toshihiro MD; Yamada, Tetsu MD; Furuhata, Hiroshi MD
Abstract:
OBJECTIVE: Refinements of treatment methods are sought to rapidly reduce the volume of intracranial clots and to decrease patient exposure to possible complications of thrombolytic therapy for intracranial hematomas. We assessed the possibility of adding ultrasonication using model systems including human blood clots and temporal bone in vitro.
METHODS: The transmittance of ultrasound through temporal bone obtained at autopsy was compared between the frequencies 211.5 KHz and 1.03 MHz, using a meter to determine the power delivered. The frequency 211.5 KHz was chosen to assess the ultrasound effect on the weight of 24-hour-old clots prepared from human blood after exposures at 37[degrees]C to 2 mg/ml urokinase with no additional treatment, ultrasound, or agitation during an interval of up to 12 hours. At these times, fibrin degradation products also were measured.
RESULTS: The transmittance of low-frequency ultrasound (211.5 KHz) through temporal bone was approximately 40%, which is four times higher than that of high-frequency ultrasound (1.03 MHz). Ultrasound but not agitation significantly increased clot lysis (140% of lysis with urokinase alone), with correspondingly increased fibrin degradation products.
CONCLUSION: We conclude that low-frequency ultrasound transmits well through human temporal bone and enhances thrombolysis in vitro. Clinically, this method may be promising for reducing dosages of thrombolytic agents and shortening the period of clot removal. Copyright (C) by the Congress of Neurological Surgeons

[emad]

Nale ,

The problem is there is a like post before you to thank that post which endorse Ultrasound therapy and all electrotherapy in facial palsy .
Physiotherapists need to learn more ,reflect more ,search more ......in case of facial palsy we are facing great challange from those people with residuals following facial palsies .Any physio. may be lucky to encounter first Bell,s palsies which could resolve with nothing ,but in case of severe facial nerve affections ,residuals if the victim ,the therapist ,the society are aware of synkinesis every thing pass! They may say to the patient there was no chance better than what we did .

Cheers
Emad

[physiobob]

Low-frequency Ultrasound Penetrates the Cranium and Enhances Thrombolysis In Vitro.
Technique Assessments
Neurosurgery. 43(4):828-832, October 1998.
Akiyama, Masahiko MD; Ishibashi, Toshihiro MD; Yamada, Tetsu MD; Furuhata, Hiroshi MD
Abstract:
OBJECTIVE: Refinements of treatment methods are sought to rapidly reduce the volume of intracranial clots and to decrease patient exposure to possible complications of thrombolytic therapy for intracranial hematomas. We assessed the possibility of adding ultrasonication using model systems including human blood clots and temporal bone in vitro.
METHODS: The transmittance of ultrasound through temporal bone obtained at autopsy was compared between the frequencies 211.5 KHz and 1.03 MHz, using a meter to determine the power delivered. The frequency 211.5 KHz was chosen to assess the ultrasound effect on the weight of 24-hour-old clots prepared from human blood after exposures at 37[degrees]C to 2 mg/ml urokinase with no additional treatment, ultrasound, or agitation during an interval of up to 12 hours. At these times, fibrin degradation products also were measured.
RESULTS: The transmittance of low-frequency ultrasound (211.5 KHz) through temporal bone was approximately 40%, which is four times higher than that of high-frequency ultrasound (1.03 MHz). Ultrasound but not agitation significantly increased clot lysis (140% of lysis with urokinase alone), with correspondingly increased fibrin degradation products.
CONCLUSION: We conclude that low-frequency ultrasound transmits well through human temporal bone and enhances thrombolysis in vitro. Clinically, this method may be promising for reducing dosages of thrombolytic agents and shortening the period of clot removal. Copyright (C) by the Congress of Neurological Surgeons

I expect this persons post is pasted from an online text book. However, after reading your post I am not sure what your point is here. Lysis by definition refers to the death of a cell by bursting, often by viral or osmotic mechanisms that compromise the integrity of the cellular membrane. Formation of blood clots lies at the basis of a number of serious diseases. By breaking down the clot, thrombolysis, the disease process can be arrested, or the complications reduced. I expect the reference in this study therefore refers to the breakdown of a blood clot (I think therefore a positive thing?).

I cannot see any reference therefore for the NON-use of Ultrasound in the treatment of facial palsy - when specifically directed at a more superficial structure. Also most physio ultrasound heads are either 1 or 3Mz and are therefore high-frequency? The study would only suggest a 10% deeper penetration at high-frequencies, or am I missing your point?

Please do correct me if I have missed an important consideration that your study is highlighting.

[emad]

I do NOT think ultrasound therapy is of benefit in case of facial nerve .Yes, i tried to find an evidence supporting the side effects of ultrasound on nerve ,i fail now to find what i have seen before ,on contrary i found researches saying ultrasound could enhance regeneration .

From my experience in dealing with facial , i refute completely ultrasound using , those patients need to learn only what could causes residuals , all those electrotherapy could cause cross-wiring in both the nerve and cortical presentations .Which means you find the patient,s face moves automaticallly interconnected ,no control of indiviudal motions and experssions .

Emad