FACIAL NERVE PARALYSIS. 구안와사 치료법

[문형철]

말초신경의 재생, healing process에 대해 탐구중이다.

목디스크, 허리디스크, 각종 entrapment 그리고 삼차신경통, 구안와사 

이 모든 것은 말초신경의 regeneration process와 연관이 있다. 

panic bird....

탐구의 세가지 핵심. 

1. 말초신경의 재생을 위한 약물요법, 한약

2. 말초신경 재생 촉진을 위한 치료법

3. 말초신경이 지배하고 있는 근육, 관절의 기능 회복을 위한 exercise therapy - 카밧 운동법

Bell's palsy, 구안와사 치료에 대한 아주 재미있고 유익한 논문

Kabat 안면근육운동법에 광경근 activation은 반드시 시행해야

FACIAL NERVE PARALYSIS 치료법.pdf

구안와사 치료의 Goals

1) To educate / reassure the patient about the condition.

2) To relief pain.

3) To establish the bases for re-education of muscle and nerve conduction.

4) To re-educate sensation if involved (sensory integration: touch, 2 point discrimination, temperature)

5) To facilitate / improve muscle contraction.

6) To facilitate / improve facial symmetry.

7) To prevent complications.

구안와사 환자의 Education and Reassurance

1) Explain the condition to the patient; its causes, incidence, prognosis and treatment.

2) Re-assure the patient, but be realistic (don’t give high expectations).

3) Advice the patient to take the prescribed medication from the physician, and to avoid therapy given by non professionals. Explain to the patient that taking medication and following the physical therapy program are enough.

4) If eyes are involved, the patient should do the following:

a) Use eye drops ( as the physician prescribed)

b) Don’t expose yourself to direct sunlight, being too close to TV light, or strong room lighting

c) Wear sun glasses to protect eyes

d) Don’t exhaust eyes by reading for long time

e) Avoid direct contact with air conditioners

5) Explain to the patient how the psychological state can affect the treatment, so avoid any emotional conflict and seek family or friend support to increase self awareness and self esteem.

6) Be aware of postural imbalance (especially for Ramsey-Hunt syndrome).

7) Follow the given home program.

구안와사 치료의 전략

Treatment options: The options available for physical therapy management to achieve the mentioned goals are as follows.

A. Electrotherapy

B. Neuromuscular retraining

C. Manual massage

D. Kabat rehabilitation.

Kabat Rehabilitation

• Kabat rehabilitation is type of motor control rehabilitation technique based on proprioceptive neuromuscular facilitation

(PNF).

• During Kabat, therapist facilitate the voluntary contraction of the impaired muscle by applying a global stretching then

resistance to the entire muscular section and motivate action by verbal input and manual contact. (table 1)

• When performing Kabat, 3 regional are considered: the upper (forehead and eyes), intermediate (nose), and lower (mouth).

• Prior to Kabat, ice stimulation has to perform to a specific muscular group, in order to increase its contractile power.

참고) 중풍으로 안면마비가 발생할 때, 눈감기는 정상이고 입만 마비되는 이유

[문형철]

슈반cell을 가진 신경이 재생이 잘됨. 유수신경섬유은 재생이 잘됨. 뷩거띠, axon sprouting, 신경재생동안 functional exercise를 한다고 해서 신경재생이 빨라지지를 않음. 말초신경은 0.01mm자람. 구안와사의 운동은 신경이 재생되는 동안 근육의 기능을 잃지 마라는 의미.

[inner wisdom]

잘보았습니다.^^

[조기현]

정보감사합니다^*^