高频重复经颅磁刺激对缺血性脑卒中后中枢性面瘫的效果

doi:10.3969/j.issn.1006-9771.2022.02.010

Abstract

Abstract:

Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on central facial paralysis after ischemic stroke. Methods From June, 2020 to June, 2021, 54 patients with central facial palsy after ischemic stroke who were hospitalized in the Rehabilitation Department of Xuzhou Central Hospital were randomly divided into control group (n = 27) and experimental group (n = 27). Both groups were given conventional rehabilitation treatment, including medication and facial muscle rehabilitation training. The experimental group was treated with 5 Hz rTMS on the affected primary motor cortex, and the control group was treated with the same parameters of sham stimulation at the same site. Before treatment and four weeks after treatment, the House-Brackmann Grading System 2.0 (HBGS-2), the Sunnybrook Facial Grading System, the horizontal distance difference between the bilateral mouth corners to the lower center of the philtrum at rest, the horizontal distance difference between the bilateral mouth corners to the intersection of the mandibular central incisor when showing the teeth at the best effort and the angle of the tongue midline deviating from the facial midline when the tongue was stretched out were used to evaluate the facial nerve function of the patient. Results One case dropped down in each group. Before treatment, there was no significant difference in the scores of HBGS-2 and Sunnybrook Facial Grading System, the horizontal distance difference between the bilateral mouth corners to the lower center of the philtrum at rest, the horizontal distance difference between the bilateral mouth corners to the intersection of the mandibular central incisor when showing the teeth at the best effort, and the angle of the tongue midline deviating from the facial midline when the tongue was stretched out between two groups (P > 0.05). After treatment, all the indexes significantly improved in both groups (|t| > 8.987, P < 0.001), and were better in the experimental group than in the control group (t > 2.939, P < 0.01). Conclusion 5 Hz rTMS on the affected primary motor cortex is effective on the facial nerve function of patients with central facial palsy after ischemic stroke.

Key words: ischemic stroke, central facial palsy, repetitive transcranial magnetic stimulation

CLC Number:

R743.3

ZHU Hui,XIA Youbing,GONG Zunke,WANG Shiyan,MA Ke,YAN Jinqiu. Effects of high-frequency repetitive transcranial magnetic stimulation on central facial paralysis after ischemic stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 199-203.

Figures/Tables 4

References 30

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组别	n	性别/n		年龄/岁	病程/d	患侧/n		危险因素/n
组别	n	男	女	年龄/岁	病程/d	左	右	高血压	糖尿病	高血脂
对照组	27	19	8	63.19±10.17	21.44±7.04	15	12	21	15	16
试验组	27	21	6	62.37±9.43	21.63±7.98	17	10	22	16	11
χ²/t值		0.386		-0.305	0.090	0.315		0.134	0.080	1.926
P值		0.535		0.761	0.928	0.575		0.714	0.777	0.165

组别	治疗前(n = 27)	治疗后(n = 26)	t值	P值
对照组	13.00±1.72	11.00±1.74	11.402	< 0.001
试验组	13.12±1.71	8.96±2.07	20.237	< 0.001
t值	0.243	-3.842
P值	0.809	< 0.001

组别	治疗前(n = 27)	治疗后(n = 26)	t值	P值
对照组	49.88±8.28	59.00±7.82	-8.987	< 0.001
试验组	49.65±7.79	76.65±4.53	-26.876	< 0.001
t值	-0.104	9.956
P值	0.918	< 0.001

组别	静息状态下双侧嘴角至人中下中心点的水平距离差/mm		最大努力示齿时双侧嘴角至下颌中切牙交点的水平距离差/mm		伸舌时舌中线偏离面部正中线的角度/°
组别	治疗前(n = 27)	治疗后(n = 26)	治疗前(n = 27)	治疗后(n = 26)	治疗前(n = 27)	治疗后(n = 26)
对照组	7.77±1.68	6.04±1.31^a	9.12±1.40	6.92±1.26^b	24.23±5.32	15.54±5.25^c
试验组	7.96±1.54	4.35±1.35^d	9.31±1.16	5.08±1.13^e	23.00±4.57	12.04±3.47^f
t值	0.431	-4.577	0.541	-5.559	0.984	2.939
P值	0.669	< 0.001	0.591	< 0.001	0.375	0.007

Effects of high-frequency repetitive transcranial magnetic stimulation on central facial paralysis after ischemic stroke

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