TREATMENT OF PERIPHERAL FACIAL PARALYSIS AS PART OF MOTOR NEUROREHABILITATION

Abstract

The disease of the facial nerve (n.facialis) is in the first place among peripheral neuritis, both in terms of frequency and significance of functional dysfunctions and post-paralytic facial synkinesis can develop in any paralysis of the face and is associated with significant functional and psychosocial consequences for sick patients. The type and severity of nerve injury determine the degree of pathologic change, capacity for regeneration and prognosis for recovery. In the case of facial nerve neuritis, the greatest emphasis is placed on early detection, correct diagnosis of the damage and starting rehabilitation as soon as possible. In addition to drug therapy in the rehabilitation of facial nerve paralysis, the application of physiotherapeutic means, as well as acupressure, a technique from traditional Chinese medicine, has a significant place. Both basic concepts are holistic, with a comprehensive approach to the patient and the determination of treatments based on the differentiation of symptoms. The aim of the research is to analyze the impact of physiotherapeutic means combined with acupressure - a technique from traditional Chinese medicine, in patients with peripheral paralysis of the n.facialis with a moderate degree of functional disorder. Material and methods: Six patients (3 women and 3 men) diagnosed with peripheral paralysis of the facial nerve (4 left side / 2 right side) with a moderate degree of functional impairment are included in the study. For the purposes of the research, the following physiotherapeutic means were applied: thermotherapy, light therapy, electrotherapy - electrophoresis with Novocain and electrostimulation, therapeutic exercises and acupressure on the following points: Zanzhu (BL2), Yangbai (GB14), Taiyang (EX-HN5), Zygoma (SL18), Xiaguan (ST7), Yingxiang (LI20) and Yifeng (TE17). For the purposes of the research, a functional examination with a manual muscle test (MMT) for facial muscles and a test for the subjective feeling of pain is applied to all subjects at the beginning, during the therapies and at the end of the overall motor neurorehabilitation. Results: From the processed results, the influence of physiotherapeutic means in combination with acupressure in patients with peripheral paralysis of n.facialis with a moderate degree of functional disorder on muscle strength and pain intensity is observed and is most pronounced in the first month from the beginning of treatment. Discussion and conclusion: This is a complex research on physiotherapeutic possibilities combined with acupressure as part of modern motor neurorehabilitation to overcome muscle weakness, pain and asymmetry in patients with unilateral peripheral n.facialis. The presence of a positive change in the examined functional parameters is observed after the application of the combination of physiotherapy and acupressure and is most significant in the first month after the beginning of the treatments.