Mouth movement disturbance as a sequela of bilateral Bell's palsy.
OBJECTIVE
Bell's palsy rarely recurs or arises bilaterally. We describe unique oral motor sequelae that manifest with bilateral facial palsy.


METHODS
Two rare patients with alternating bilateral Bell's palsy experienced compromised mouth movement, affecting eating, speaking, and air exchange, and reduced quality of life.


METHODS
Rehabilitation programs.


METHODS
Electromyography and electroneuronography.


RESULTS
On electromyography study, little activity of the orbicularis oris muscle was seen in any mouth or eye movement in Case 1. In Case 2, the electromyography activity of the depressor anguli oris and depressor labii inferioris muscles was stronger than that of the orbicularis oris muscle. The 2 cases demonstrated different patterns of recovery after the same subsequent treatment.


CONCLUSIONS
Different patterns of reinnervation occur in bilateral Bell's palsy. Mouth movement disturbances after bilateral Bell's palsy are most disabling when incomplete reinnervation (as suggested by electroneuronography) of the orbicularis oris muscle occurs. Misdirection of regenerating nerve fibers produces lesser levels of oral motor impairment.
Komori
Masahiro
M
Department of Otolaryngology, Takanoko Hospital, Matsuyama, Ehime, Japan. komori@m.ehime-u.ac.jp
Yanagihara
Naoaki
N
Kashiba
Keiko
K
D020330:Bell Palsy / Q000503:physiopathology*; D004568:Electrodiagnosis; D004576:Electromyography; D005133:Eye Movements / Q000502:physiology; D005152:Facial Muscles / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009055:Mouth / Q000503:physiopathology*; D009068:Movement / Q000502:physiology; D009801:Oculomotor Muscles / Q000503:physiopathology; D011788:Quality of Life