Facial motor and non-motor disabilities in patients with central facial paresis: a prospective cohort study
| Autor: | Gerd Fabian Volk, Annegret Lorenz, Oliver Mothes, Carsten M. Klingner, Joachim Denzler, Farsin Hamzei, Luise Modersohn, Anika Steinerstauch, Orlando Guntinas-Lichius |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Facial Paralysis Facial Muscles Motor Activity Severity of Illness Index Pattern Recognition Automated Disability Evaluation 03 medical and health sciences 0302 clinical medicine Quality of life Humans Medicine Longitudinal Studies Prospective Studies 030212 general & internal medicine Prospective cohort study Stroke Aged Paresis Aged 80 and over Zygomaticus major muscle Rehabilitation business.industry Stroke Rehabilitation Orbicularis oris muscle Middle Aged Levator labii superioris medicine.disease Facial Expression Neurology Quality of Life Physical therapy Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurology. 266:46-56 |
| ISSN: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-018-9099-x |
| Popis: | Although central facial paresis (CFP) is a major symptom of stroke, there is a lack of studies on the motor and non-motor disabilities in stroke patients. A prospective cohort study was performed at admission for inpatient rehabilitation and discharge of post-stroke phase of 112 patients (44% female, median age: 64 years, median Barthel index: 70) with CFP. Motor function was evaluated using House-Brackmann grading, Sunnybrook grading and Stennert Index. Automated action unit (AU) analysis was performed to analyze mimic function in detail. Non-motor function was assessed using the Facial Disability Index (FDI) and the Facial Clinimetric Evaluation (FaCE). Median interval from stroke to rehabilitation was 21 days. Rehabilitation lasted 20 days. House-Brackmann grading was ≥ grade III for 79% at admission. AU activation in the lower face was significantly lower in patients with right hemispheric infarction compared to left hemispheric infarction (all p < 0.05). Median total FDI and FaCE score were 46.5 and 69, respectively. Facial grading and FDI/FaCE scores improved during inpatient rehabilitation (all p < 0.05). There was a significant increase of the activation of AU12 (Zygomaticus major muscle), AU13 (Levator anguli oris muscle), and AU24 (Orbicularis oris muscle) during inpatient rehabilitation (all p < 0.05). Multivariate analysis revealed that activation of AU10 (Levator labii superioris), AU12, AU17 (Depressor labii), and AU 38 (Nasalis) were independent predictors for better quality of life. These results demonstrate that CFP has a significant impact on patient's quality of life. Therapy of CFP with focus on specific AUs should be part of post-stroke rehabilitation. |
| Databáze: | OpenAIRE |
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