The most common disease of the facial nerve is BELL'S PALSY. This disorder affects nerve peripherally. Regarding causation of BELL'S PALSY, a viral agent has long been suspected, but its definite cause has not been found yet. Familial occurrence of BELL'S PALSY is occasionally seen, so inheritance has been suspected in its ethiology too. In this paper, 6 cases running through two generations of an Iranian family with BELL'S PALSY are described. No any other neurologic disorder has been seen among cases. This report demonstrates the role of heredity as an ethiologic factor in BELL'S PALSY, and the mode of inheritance possibly to be autosomal dominant inheritance.

Acute idiopathic peripheral facial paralysis (Bell’s PALSY) is the most common disorder of the facial nerve. Most patients recover completely, although some have permanent disfiguring facial weakness. Many studies have attempted to identify an infectious etiology for this disease. Although the cause of Bell’s PALSY remains unknown, recent studies suggest a possible association with Herpes Simplex Virus-1(HSV-1) infection. In this case-control study we investigated the presence of DNA of HSV in the saliva of 26 patients with Bells PALSY in first and second weeks of disorder compared to normal population who were matched in sex, age, as well as history of diabetes mellitus, hypertension and labial herpes. In the case group 3 and 7 patients had positive polymerase chain reaction (PCR) for HSV in first and second weeks of disease respectively compared to 4 in controls. It means that there was not any relationship between Bell’s PALSY and HSV in saliva either in first or in second week. Two and 6 of positive results from the sample of first and second weeks were from patients with severe (grade 4-6) BELL'S PALSY. Although the positive results were more in second week in patient group and more in severe palsies, but a significant relationship between BELL'S PALSY or its severity and positive PCR for HSV was not detected (P >0.05).

Sickle cell anemia (SCA) is an inherited red blood cell disorder that results from the replacement of a valine residue for glutamic acid at position 6 in the beta-subunit of haemoglobin. This can lead to tissue ischemia, microcirculation obstructions, infarction, and acute stroke while Bell’ s PALSY is a neuropathy caused by traumatic, inflammatory, infective, or compressive conditions on the facial nerve. In patients with SCA, however, stroke may occur as an acute clinical syndrome presenting with hemiplegia with the unilateral facial nerve. Until now, no case has been reported in the literature with unilateral facial nerve PALSY in SCA patients. Here, a rare case of idiopathic unilateral Bell’ s PALSY is presented in an SCA patient.

Background and Objective: BELL'S PALSY is the most common type of seventh nerve PALSY. Acyclovir has been recommended for treatment of the patients, since some evidences show that herpes virus has a role in this disease. Thus, this study was performed to determine the effect of acyclovir on BELL'S PALSY and to compare it with typical treatment i.e, prednisolone. We also investigated whether combination therapy with these two agents can cause faster improvement and alleviate the complications of the disease.Materials and Methods: This study was a clinical trial and three groups of 26 patients suffering from BELL'S PALSY were included. The patients were randomely assigned to receive prednisolone, acyclovir, prednisolone – acyclovir and the data were analyzed by Kruskal- Wallis test, at the end point.Results: This study showed that improvement ratio in patients who received prednisolone, acyclovir, and prednisolone - acyclovir was 69.23%, 65.38% and 80.76%, respectively. Statistical analysis showed that in the patients received combined prednisolone - acyclovir, the course of treatment was shorter and the response to treatment was faster than the other groups.Conclusion: This study showed that combined prednisolone - acyclovir therapy is more effective and can cause a faster improvement in BELL'S PALSY patients. Also in certain disease such as diabetes which prescription of prednisolone has limitations it is possible to use acyclovir as a substitution.

BELL'S PALSY is the most prevalent idiopathic facial paralysis. A study was carried out on 44 patients with peripheral nerve PALSY to determine the predictive value of two electrodiagnostic methods, electromyography (EMG) and evoked electromyography (EEMG). EMG and EEMG were recorded on the fifth day and the third week of the onset of the disease. The cause of bell"s PALSY in eight patients (18.2%) was identified as neuropathy, trauma, diabetes and infection. Thirty patients (68.8%) suffered from taste sense disturbances and in 26 of them the problem resolved in one week but it continued in 4 patients. 14 patients showed a decrease in potential amplitude of more than 50%. After three weeks the EMG results comprised of normal in thirty cases (77%) and fibrillation and positive sharp waves f PSW) in 9 patients (33%). A higher decrease in amplitude in the first five days resulted in a higher probability of fibrillation and PSW. There was a significant relationship between restoration of taste sense and electromyography at three weeks (P<0.05). The study also showed that age of the patients is important in prognosis of BELL'S PALSY. According to this survey the electrodiagnostic tests are valuable in prediction of BELL'S PALSY and there is a close association between the restoration of taste sense and the complication of the disease.

BACKGROUND AND OBJECTIVE: BELL'S PALSY is the most common disorder of the facial nerve, developing some acute changes in the face. Considering its probable viral etiology, antiviral therapy is recently added to the classic regimen. This study has been conducted to compare the effectiveness of two regimens of prednisolone versus prednisolone plus acyclovir in the treatment of Bell’s PALSY. METHODS: This clinical trial study was performed on 496 patients with Bell’s PALSY who divided into two groups; the first group was treated with oral prednisolone and the second group with oral prednisolone and acyclovir. The patients were evaluated at the end of the second week, first, third and sixth months after treatment. The outcome of therapy in two treated groups were compared. FINDINGS: Two hundred and forty eight patients (108 males and 140 females) with average age of 20-39 and 248 patients (135 males and 113 females) with the same mean age were treated with prednisolone and prednisolone plus acyclovir, respectively. At the end of the study, the recovery rate in the combined regimen group was 95.06% (237 patients) and in the prednisolone regimen group was 91.2% (226 patients) (p= 0.035). CONCLUSION: The result of this study shows that combination of prednisolone plus acyclovir is the preferred regimen of therapy in Bell’s PALSY.

BACKGROUND: Evaluating the function of facial nerve is essential in order to determine the influences of various treatment methods. The aim of this study was to evaluate and assess the agreement of Photoshop scaling system versus the facial grading system (FGS).METHODS: In this semi-experimental study, thirty subjects with facial nerve paralysis were recruited. The evaluation of all patients before and after the treatment was performed by FGS and Photoshop measurements.RESULTS: The mean values of FGS before and after the treatment were 35±25 and 67±24, respectively (p<0.001). In Photoshop assessment, mean changes of face expressions in the impaired side relative to the normal side in rest position and three main movements of the face were 3.4±0.55 and 4.04±0.49 millimeter before and after the treatment, respectively (p<0.001). Spearman's correlation coefficient between different values in the two methods was 0.66 (p<0.001).CONCLUSIONS: Evaluating the facial nerve PALSY using Photoshop was more objective than using FGS. Therefore, it may be recommended to use this method instead.

Acquired brachial plexus injury historically has been linked with excessive lateral traction applied to the fetal head, usually in association with shoulder dystocia. Recent reports in the obstetric literature, however, have suggested that in utero forces may underlie a significant portion of these injuries. Brachial plexus palsies may therefore precede the delivery itself and may occur independent of the actions of the accoucheur. Thus we propose that the long-held notions of a traction-mediated pathophysiologic mechanism for all brachial plexus injuries warrant critical reappraisal.