Background Peripheral facial paralysis(PFP)caused by neurovascular structural anomalies frequently triggers an inflammatory cascade,leading to facial nerve edema.Standard treatments like corticosteroids usually don...Background Peripheral facial paralysis(PFP)caused by neurovascular structural anomalies frequently triggers an inflammatory cascade,leading to facial nerve edema.Standard treatments like corticosteroids usually don't work very well,while acupuncture shows special benefits in treating PFP.Objective This report discusses a case where acupuncture was used to treat hormone-insensitive PFP caused by swelling of the facial nerve due to an unusual physical structure of the right anterior inferior cerebellar artery(AICA).The goal is to improve clinicians'diagnosis and treatment accuracy for this possible cause and to highlight acupuncture's therapeutic effect.Methods We used the cranial magnetic resonance imaging(MRI)to clarify the etiology of hormone-insensitive PFP and formulated an acupuncture treatment plan.The acupuncture treatment restored the facial nerve's function after seven sessions.We performed a cranial MRI again to observe the facial nerve edema and its relationship with the surrounding vascular structures.Result Before acupuncture treatment,the patient's head MRI showed that the right AICA and the right facial nerve had a“U-shaped”abnormal physiological structure,and the local edema of the facial nerve was obvious.The left AICA had a cross interaction with the facial nerve and the auditory nerve in the inner ear canal.After 7 times of acupuncture treatment,the facial nerve function of the patient recovered,and reexamination of the head MRI showed that the local edema significantly subsided.Conclusion PFP which is caused by facial nerve edema resulting from abnormal neurovascular physiological structures is insensitive to hormonal therapy.Acupuncture can be used to promote the resolution of the edema and the restoration of facial nerve function.展开更多
Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cellular edema after early cerebr...Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cellular edema after early cerebral infarction. Cellular edema and aquaporin-4 expression can be determined by measuring cerebral infarct area and apparent diffusion coefficient using diffusion-weighted imaging（DWI）. We examined the effects of silencing aquaporin-4 on cerebral infarction. Rat models of cerebral infarction were established by occlusion of the right middle cerebral artery and si RNA-aquaporin-4 was immediately injected via the right basal ganglia. In control animals, the area of high signal intensity and relative apparent diffusion coefficient value on T2-weighted imaging（T2WI） and DWI gradually increased within 0.5–6 hours after cerebral infarction. After aquaporin-4 gene silencing, the area of high signal intensity on T2 WI and DWI reduced, relative apparent diffusion coefficient value was increased, and cellular edema was obviously alleviated. At 6 hours after cerebral infarction, the apparent diffusion coefficient value was similar between treatment and model groups, but angioedema was still obvious in the treatment group. These results indicate that aquaporin-4 gene silencing can effectively relieve cellular edema after early cerebral infarction; and when conducted accurately and on time, the diffusion coefficient value and the area of high signal intensity on T2 WI and DWI can reflect therapeutic effects of aquaporin-4 gene silencing on cellular edema.展开更多
基金supported by Zhejiang Key Reasearch Projects of Traditional Chinese Medicine(Grant No.GZY-ZJ-KJ-24016[to LHL])。
文摘Background Peripheral facial paralysis(PFP)caused by neurovascular structural anomalies frequently triggers an inflammatory cascade,leading to facial nerve edema.Standard treatments like corticosteroids usually don't work very well,while acupuncture shows special benefits in treating PFP.Objective This report discusses a case where acupuncture was used to treat hormone-insensitive PFP caused by swelling of the facial nerve due to an unusual physical structure of the right anterior inferior cerebellar artery(AICA).The goal is to improve clinicians'diagnosis and treatment accuracy for this possible cause and to highlight acupuncture's therapeutic effect.Methods We used the cranial magnetic resonance imaging(MRI)to clarify the etiology of hormone-insensitive PFP and formulated an acupuncture treatment plan.The acupuncture treatment restored the facial nerve's function after seven sessions.We performed a cranial MRI again to observe the facial nerve edema and its relationship with the surrounding vascular structures.Result Before acupuncture treatment,the patient's head MRI showed that the right AICA and the right facial nerve had a“U-shaped”abnormal physiological structure,and the local edema of the facial nerve was obvious.The left AICA had a cross interaction with the facial nerve and the auditory nerve in the inner ear canal.After 7 times of acupuncture treatment,the facial nerve function of the patient recovered,and reexamination of the head MRI showed that the local edema significantly subsided.Conclusion PFP which is caused by facial nerve edema resulting from abnormal neurovascular physiological structures is insensitive to hormonal therapy.Acupuncture can be used to promote the resolution of the edema and the restoration of facial nerve function.
基金supported by the National Natural Science Foundation of China,No.30960399a grant from Hainan Provincial International Cooperation Project of China,No.Qiongke(2012)65a grant from Hainan Provincial Health Department Project of China,No.2011-SWK-10-136/Qiongwei2011-65
文摘Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cellular edema after early cerebral infarction. Cellular edema and aquaporin-4 expression can be determined by measuring cerebral infarct area and apparent diffusion coefficient using diffusion-weighted imaging（DWI）. We examined the effects of silencing aquaporin-4 on cerebral infarction. Rat models of cerebral infarction were established by occlusion of the right middle cerebral artery and si RNA-aquaporin-4 was immediately injected via the right basal ganglia. In control animals, the area of high signal intensity and relative apparent diffusion coefficient value on T2-weighted imaging（T2WI） and DWI gradually increased within 0.5–6 hours after cerebral infarction. After aquaporin-4 gene silencing, the area of high signal intensity on T2 WI and DWI reduced, relative apparent diffusion coefficient value was increased, and cellular edema was obviously alleviated. At 6 hours after cerebral infarction, the apparent diffusion coefficient value was similar between treatment and model groups, but angioedema was still obvious in the treatment group. These results indicate that aquaporin-4 gene silencing can effectively relieve cellular edema after early cerebral infarction; and when conducted accurately and on time, the diffusion coefficient value and the area of high signal intensity on T2 WI and DWI can reflect therapeutic effects of aquaporin-4 gene silencing on cellular edema.
