Facial paralysis affects one in 60 individuals over the course of their life. One-third of affected patients experience inadequate recovery, which results in physical and social impairments. In addition to the idiopathic type of paralysis, facial palsy can be caused by viral or bacterial infections, benign or malignant tumors of the head or neck and by traumatic facial palsy, including facial nerve injuries and trauma caused by external force, resulting in intracranial bleeding, temporal bone fractures or soft tissue injuries.
Symptoms of peripheral and central types of facial paralysis are almost identical and include the loss of facial expression and hemifacial weakness.
Low-Level Laser Therapy (LLLT) has shown favourable outcomes in preclinical and clinical studies in the regeneration of peripheral nerves. Laser Acupuncture Therapy (LAT) is defined as the stimulation of traditional acupoints with low-intensity, non-thermal laser irradiation.A patient described in this case report suffered from a longterm, severe type of facial paralysis that had failed to improve with other interventions.
Case presentation: A 52-year-old man was presented to the Acupuncture Department of China Medical University Hospital with a severe left-sided facial paralysis caused by a traumatic brain contusion 12 years ago. He was unable to close his left eye, he had saliva drooling and speech difficulties. The man had been hospitalised in the emergency department of Taichung Armed Forces General Hospital after a traffic accident.
During the first two years after the surgery, he received acupuncture treatments, mainly for pain relief, an unsteady gait and left-sided facial paralysis. He was treated by several Traditional Chinese Medicine (TCM) doctors, none of which resulted in any improvement in his left-sided facial paralysis. After living with his condition for 12 years, the patient visited the Chief Doctor of the Acupuncture Department at China Medical University Hospital, who suggested that he try LAT. The patient described his speech difficulties, saliva drooling and his inability to eat solid food.
His level of facial muscle stiffness was relatively low. He was given a total of 30 LAT sessions over 17 weeks, delivered as two-three treatments per week in the first 12 weeks, then once-weekly for the remaining five weeks. The patient attended the clinic for a follow-up appointment after the first four weeks. He and the investigator both wore protective goggles to prevent any disturbance of visual perception during laser irradiation. Notwithstanding, LLLT is considered to be a very safe treatment.
The most significant improvement during the LAT sessions was the patient’s progressive ability to close his left eye. After the 10th treatment, there was a noticeable movement of the left eyelid. After the 22nd treatment, the patient could fully close his left eye and this improvement persisted at follow-up. From the 10th treatment, the patient reported that his left eye was shedding fewer tears and he no longer used an eye cover before falling asleep. Moreover, he reported an improvement of his facial muscles, giving him the ability to eat solid food. He was able to bite into an apple without the problems he experienced before LAT. He also reported that his mouth drooling had ceased and his family members were noticing more clarity in his speech.
Conclusion: We found that LAT improved long-term sequelae of facial palsy. This case report provides strong support for the use of LAT for subacute and chronic cases of paralysis that fail to respond to other treatment modalities. LAT is a fast, noninvasive, pain-free method that is easy for the physician to apply and easy for the patient to undergo. These characteristics, combined with the safety features of LAT, make it a promising complementary therapy for chronic facial paralysis.This study was done by Gil Tona, Li-Wen Leeb, Yi-Hung Chena, Cheng-HaoTua , Yu-Chen Leea, Graduate Institute of Acupuncture Science, China Medical University, Taiwan. The author is Head of the Department of Acupuncture, Sir Ganga Ram Hospital, Delhi