A clinical study on facial palsy after stroke_West China Medical Journal

Authors：

 WANG Xiangming , ZHANG Yuehui

Department of Neurology, Panzhihua Central Hospital, Panzhihua, Sichuan 617023, P. R. China;

Corresponding?author：

WANG Xiangming, Email: xiangminwanzhong@163.com

Keywords：

Stroke; Facial palsy; Prognosis; Dysphagia; Depression

DOI：

10.7507/1002-0179.201603190

Video：

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Objective To investigate the clinical characteristics of facial palsy after stroke (FPS) in order to enhance the understanding of FPS. Methods Patients with stroke and admitted to hospital from March to June 2015 were selected in this study. They were evaluated by Modified House-Braekmann (MHBN), Barthel Index (BI), National Institute of Health Stroke Scale (NIHSS), Standardized Swallowing Assessment and Patient Health Questionnaire-9 (PHQ-9) within 48 hours after admitting. According to the MHBN scores, the patients were divided into FPS group and non-FPS group, and the incidences of dysphagia and depression, and the scores of BI, NIHSS, and PHQ-9 were compared between the two group. Six months later, the patients’ prognosis of stroke was assessed by the Modified Rankin Scale. Results A total of 129 patients were enrolled in this study, including 81 (62.8%) with FPS, and 48 (37.2%) without FPS. The incidences of dysphagia and depression in the FPS group (64.2%, 59.3%) were higher than those in the non-FPS group (22.9%, 18.8%), and the differences were statistically significant (P<0.05). The BI, NIHSS, PHQ-9 scores in the FPS group were 41.79±14.19, 11.23±4.62, 11.54±3.43, respectively, while the scores in the non-FPS group were 66.39±19.96, 7.54±3.69, 7.67±2.89, respectively; the differences in the scores between the two groups were statistically significant (P<0.05). Six months later, the patients’ prognosis in the non-FPS group was better than that in the FPS group (67.4%vs. 32.9%, P<0.001). Conclusions There is a high incidence of FPS, and there are high incidences of dysphagia and depression in the FPS patients with stroke. FPS influences the patients’ prognosis, so the understanding and treatment of FPS should be enhanced.

Citation： WANG Xiangming, ZHANG Yuehui. A clinical study on facial palsy after stroke. West China Medical Journal, 2017, 32(12): 1846-1848. doi: 10.7507/1002-0179.201603190 Copy

1.	Konecny P, Elfmark M, Horak S, et al. Central facial paresis and its impact on mimicry, psyche and quality of life in patients after stroke. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2014, 158(1): 133-137.
2.	王相明, 侯瑩, 李文. 低頻電刺激治療卒中后面癱 36 例療效分析. 蘇州大學學報: 醫學版, 2008, 28(3): 476-477.
3.	Svensson BH, Christiansen LS, Jepsen E, et al. Treatment of central facial nerve paralysis with electromyography biofeedback and taping of cheek. A controlled clinical trial. Ugeskr Laeger, 1992, 154(50): 3593-3596.
4.	中華醫學會第四次腦血管病學術會議組. 各類腦血管疾病診斷要點. 全國第四屆腦血管病學術會議.中華神經科雜志, 1996, 29(6): 379-380.
5.	徐華平, 曾麗萍, 馮珍. 電針治療腦卒中后面癱的療效觀察. 南昌大學學報: 醫學版, 2011, 51(3): 105-106.
6.	Salles AG, Toledo PN, Ferreira MC. Botulinum toxin injection in long-standing facial paralysis patients: improvement of facial symmetry observed up to 6 months. Aesthetic Plast Surg, 2009, 33(4): 582-590.
7.	王相明, 侯瑩, 李文. 低頻電刺激治療卒中后面癱的療效觀察. 中國康復醫學雜志, 2009, 24(3): 233-235.
8.	Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet, 2013, 381(9882): 1987-2015.
9.	Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation, 2015, 131(4): e29-322.
10.	何靜杰. 腦卒中患者康復預后預測的研究. 中國康復理論與實踐, 1998, 4(2): 61-63.
11.	Crary MA, Humphrey JL, Carnaby-Mann G, et al. Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care. Dysphagia, 2013, 28(1): 69-76.
12.	Martino R, Pron G, Diamant N. Screening for oropharyngeal dysphagia in stroke: insufficient evidence for guidelines. Dysphagia, 2000, 15(1): 19-30.
13.	江云, 胡貝貝, 葉曄, 等. 神經肌肉電刺激聯合康復訓練治療缺血性卒中患者咽期吞咽障礙的療效觀察. 中華物理醫學與康復雜志, 2016, 38(7): 501-503.
14.	Smith T, Gildeh N, Holmes C. The Montreal cognitive assessment: validity and utility in a memory clinic setting. Can J Psychiatry, 2007, 52(5): 329-332.
15.	彭勇軍, 王相明. 腦卒中后吞咽障礙與抑郁的相關性分析. 四川精神衛生, 2016, 29(2): 140-142.
16.	李冬輝, 宋祥勝, 黃華云, 等. 中老年女性缺血性卒中患者抑郁分布特點及相關因素. 浙江醫學, 2015, 37(9): 750-752.
17.	Konecny P, Elfmark M, Urbanek K. Facial paresis after stroke and its impact on patients’ facial movement and mental status. J Rehabil Med, 2011, 43(1): 73-75.

1. Konecny P, Elfmark M, Horak S, et al. Central facial paresis and its impact on mimicry, psyche and quality of life in patients after stroke. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2014, 158(1): 133-137.
2. 王相明, 侯瑩, 李文. 低頻電刺激治療卒中后面癱 36 例療效分析. 蘇州大學學報: 醫學版, 2008, 28(3): 476-477.
3. Svensson BH, Christiansen LS, Jepsen E, et al. Treatment of central facial nerve paralysis with electromyography biofeedback and taping of cheek. A controlled clinical trial. Ugeskr Laeger, 1992, 154(50): 3593-3596.
4. 中華醫學會第四次腦血管病學術會議組. 各類腦血管疾病診斷要點. 全國第四屆腦血管病學術會議.中華神經科雜志, 1996, 29(6): 379-380.
5. 徐華平, 曾麗萍, 馮珍. 電針治療腦卒中后面癱的療效觀察. 南昌大學學報: 醫學版, 2011, 51(3): 105-106.
6. Salles AG, Toledo PN, Ferreira MC. Botulinum toxin injection in long-standing facial paralysis patients: improvement of facial symmetry observed up to 6 months. Aesthetic Plast Surg, 2009, 33(4): 582-590.
7. 王相明, 侯瑩, 李文. 低頻電刺激治療卒中后面癱的療效觀察. 中國康復醫學雜志, 2009, 24(3): 233-235.
8. Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet, 2013, 381(9882): 1987-2015.
9. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation, 2015, 131(4): e29-322.
10. 何靜杰. 腦卒中患者康復預后預測的研究. 中國康復理論與實踐, 1998, 4(2): 61-63.
11. Crary MA, Humphrey JL, Carnaby-Mann G, et al. Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care. Dysphagia, 2013, 28(1): 69-76.
12. Martino R, Pron G, Diamant N. Screening for oropharyngeal dysphagia in stroke: insufficient evidence for guidelines. Dysphagia, 2000, 15(1): 19-30.
13. 江云, 胡貝貝, 葉曄, 等. 神經肌肉電刺激聯合康復訓練治療缺血性卒中患者咽期吞咽障礙的療效觀察. 中華物理醫學與康復雜志, 2016, 38(7): 501-503.
14. Smith T, Gildeh N, Holmes C. The Montreal cognitive assessment: validity and utility in a memory clinic setting. Can J Psychiatry, 2007, 52(5): 329-332.
15. 彭勇軍, 王相明. 腦卒中后吞咽障礙與抑郁的相關性分析. 四川精神衛生, 2016, 29(2): 140-142.
16. 李冬輝, 宋祥勝, 黃華云, 等. 中老年女性缺血性卒中患者抑郁分布特點及相關因素. 浙江醫學, 2015, 37(9): 750-752.
17. Konecny P, Elfmark M, Urbanek K. Facial paresis after stroke and its impact on patients’ facial movement and mental status. J Rehabil Med, 2011, 43(1): 73-75.

West China Medical Journal

A clinical study on facial palsy after stroke

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