Electrical stimulation and Bells’ Palsy
Date First Published:
March 1, 2000
Last Updated:
September 16, 2002
Report by:
Susan J Buttress, Research Physiotherapist (Manchester Royal Infirmary)
Search checked by:
Katrina Herren, Manchester Royal Infirmary
Three-Part Question:
In [facial nerve palsy] are [facial exercises better than electrical stimulation] at improving [time to function/facial symmetry]?
Clinical Scenario:
A 50-year-old presents with Bells' Palsy. You have heard that physiotherapy is an effective treatment but wonder whether facial exercises produce a better outcome than treatment with electrical stimulation.
Search Strategy:
Medline and CINAHL 1966-06/02, AMED 1985-04/02 using the OVID interface.
Search Details:
Medline and CINAHL: [{facial nerve palsy.mp OR exp facial paralysis OR exp bells palsy}] AND ["trophic stimulation".mp OR exp physical therapy techniques OR "physiotherapy".mp OR exp electric stimulation OR exp electric stimulation therapy OR "electrical stimulation".mp OR electrotherapy.mp}] LIMIT to human AND English. AMED: {exp peripheral nerve disease} AND {exp electrotherapy}.
Outcome:
Medline and CINAHL: 253 papers were identified, AMED: 17 papers found 11 of which were relevant, but 10 papers were excluded since these described electromyographic feedback (EMG feedback training) which is not a form of electrical stimulation. The remaining paper is shown in the table.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Eutrophic stimulation for Bells' Palsy. Farragher D, Kidd GL, Tallis R. 1987, | 40 patients with a 74 months mean interval between onset and starting treatment. Stimulation v no stimulation |
Clinical Trial | FPRP (Facial Paralysis Recovery Profile) | p<0.0001 | Not randomised |
| FPRI (Facial Paralysis Recovery Index) | p<0.0001 | ||||
| FPRI (Facial Paralysis Recovery Index) | p<0.0001 | ||||
| FPRP (Facial Paralysis Recovery Profile) | p<0.0001 |
Author Commentary:
No papers were found which involved physiotherapy treatment of Bells' Palsy in the acute setting. The above paper describes significant differences in the outcomes used for patients with long-term facial nerve palsy using electrical stimulation, however this was not a rigorous study.
Bottom Line:
There is no evidence to suggest that either exercises or electrical stimulation is beneficial to patients with acute Bells' Palsy. Evidence does exist to justify the use of electrical stimulation in patients with long-term Bells' Palsy, although the study could have been more rigorous.
References:
- Farragher D, Kidd GL, Tallis R.. Eutrophic stimulation for Bells' Palsy.