title: Effects of electroacupuncture therapy for Bell's palsy from acute stage: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Although many patients with facial paralysis have obtained benefits or completely recovered after acupuncture or electroacupuncture therapy, it is still difficult to list intuitive evidence besides evaluation using neurological function scales and a few electrophysiologic data. Hence, the aim of this study is to use more intuitive and reliable detection techniques such as facial nerve magnetic resonance imaging (MRI), nerve electromyography, and F waves to observe changes in the anatomic morphology of facial nerves and nerve conduction before and after applying acupuncture or electroacupuncture, and to verify their effectiveness by combining neurological function scales.
  
  
  METHODS
  A total of 132 patients with Bell's palsy (grades III and IV in the House-Brackmann [HB] Facial Nerve Grading System) will be randomly divided into electroacupuncture, manual acupuncture, non-acupuncture, and medicine control groups. All the patients will be given electroacupuncture treatment after the acute period, except for patients in the medicine control group. The acupuncture or electroacupuncture treatments will be performed every 2 days until the patients recover or withdraw from the study. The primary outcome is analysis based on facial nerve functional scales (HB scale and Sunnybrook facial grading system), and the secondary outcome is analysis based on MRI, nerve electromyography and F-wave detection. All the patients will undergo MRI within 3 days after Bell's palsy onset for observation of the signal intensity and facial nerve swelling of the unaffected and affected sides. They will also undergo facial nerve electromyography and F-wave detection within 1 week after onset of Bell's palsy. Nerve function will be evaluated using the HB scale and Sunnybrook facial grading system at each hospital visit for treatment until the end of the study. The MRI, nerve electromyography, and F-wave detection will be performed again at 1 month after the onset of Bell's palsy.
  
  
  BACKGROUND
  Chinese Clinical Trials Register identifier: ChiCTR-IPR-14005730. Registered on 23 December 2014.
authors: Department of Acupuncture, Baoshan Hospital of Integrated TCM and Western Medicine, Shanghai, 201999, China. liu54643@163.com.|Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China. liu54643@163.com.
authors: Zhi-dan
authors: ZD
authors: Liu
authors: Department of Medical Imaging, Baoshan Hospital of Integrated TCM and Western Medicine, Shanghai, China. hjbxw@163.com.
authors: Jiang-bo
authors: JB
authors: He
authors: Department of Neurology, Baoshan Hospital of Integrated TCM and Western Medicine, Shanghai, 201999, China. grace_yellow@hotmail.com.
authors: Si-si
authors: SS
authors: Guo
authors: Department of Gerontology, Baoshan Hospital of Integrated TCM and Western Medicine, Shanghai, 201999, China. yangzhixin931018@163.com.
authors: Zhi-xin
authors: ZX
authors: Yang
authors: Department of Neurology, Third People's Hospital, Shanghai Jiaotong University, Shanghai, 201999, China. shenjun0309@sina.com.
authors: Jun
authors: J
authors: Shen
authors: Department of Acupuncture, Baoshan Hospital of Integrated TCM and Western Medicine, Shanghai, 201999, China. lxy_0220@163.com.
authors: Xiao-yan
authors: XY
authors: Li
authors: Department of Acupuncture, Baoshan Hospital of Integrated TCM and Western Medicine, Shanghai, 201999, China. bslw5660@163.com.
authors: Wei
authors: W
authors: Liang
authors: Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China. shenweidong1018@163.com.
authors: Wei-dong
authors: WD
authors: Shen
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D020330:Bell Palsy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002681:China; D002985:Clinical Protocols; D015671:Electroacupuncture / Q000009:adverse effects; D004576:Electromyography; D005154:Facial Nerve / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009460:Neurologic Examination; D020127:Recovery of Function; D012107:Research Design; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult