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Publication of the Medical Rehabilitation is under the auspices of the Committee on Rehabilitation, Physical Education and Social Integration of the Polish Academy of Science
Article
Medical Rehabilitation - quarterly journal
Volume 12 year 2008, Issue number 4
The Efficacy of electrotherapeutic procedutres in cases of nerve conduction abnormalities demonstrated in motor fibres of the facial nerve by neurophysiological studies
Authors: Aleksandra Zagłoba, Juliusz Huber, Alicja Witkowska, Przemysław Lisiński, Dorota Warzecha
Medical Rehabilitation 2008; 12(3): 10-22
The Efficacy of electrotherapeutic procedutres in cases of nerve conduction abnormalities demonstrated in motor fibres of the facial nerve by neurophysiological studies
Skuteczność ukierunkowanych zabiegów elektroterapii w przypadkach zmian w przewodnictwie włókien ruchowych nerwu twarzowego oceniana na podstawie badań neurofizjologicznychAleksandra Zagłoba 1, Juliusz Huber 1, Alicja Witkowska 1, Przemysław Lisiński 2, Dorota Warzecha 3
1 Department of Pathophysiology of Locomotor Organs, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
2 Department of and Clinic of Physiotherapy, Reumathology and Rehabilitation, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
3 Department of and Clinic of Rehabilitation, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
Key words
electromyography (EMG), electroneurography (ENG), facial muscles, motor fibres of the facial nerve, peripheral facial nerve palsy, electrostimulation
Abstract
Aim: The aim of the study was to show the results of complex electromyography (global EMG) and electroneurographic (ENG, M wave) studies of motor fibres of the facial nerves in 25 patients with symptoms of peripheral facial nerve palsy as well as to evaluate a therapeutic algorithm involving therapy with physical agents (electrotherapy of motor fibres in the facial nerve) supplemented with focused kinesitherapy. In such cases, early and objective diagnosis and immediate introduction of treatment allow one to obtain better results in the motor function of the face muscles.
Method: Neurophysiological tests included bilateral recordings of global electromyography from selected facial muscles (EMG; the frontal muscle, the levator alae nasi muscle, the orbicularis oris muscle) and electroneurographic motor conduction studies (ENG, M wave). Based on the diagnosis established in the treated patients (n=25) by the attending physician, the patients were divided into three groups, depending on the cause of palsy: inflammation (n=8), surgical reconstruction (n=7), idiopathic Bell’s palsy (n=10). Twenty-five healthy volunteers were studied using similar methods for comparison. Results from these studies in persons without any disturbances of the muscle-skeletal system served as a pattern of normal parameters in EMG and ENG studies. Repeated clinical neurophysiologic tests were fundamental for ascertaining the parameters of electrostimulation patterns determined individually for each patient and they were monitored after 10 and 20 physiotherapeutic procedures.
Results and conclusions: Neurophysiological examinations following two phases of treatment showed an improvement in the motor units activity of the facial muscles and in motor nerve transmission. The obtained results from EMG and ENG examinations, in particular the analysis of frequency parameters in recruitment of the muscle motor units and applied current intensity to evoke the M wave allowed us to determine optimal parameters for facial nerve stimulation. Complex neurophysiological studies enable an estimation of the progress of conservative treatment and allow one to direct therapy with physical agents towards better improvement in the activity of
rehabilitated facial muscles.PDF Full Text