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Objective: This study aimed to determine which prodromal symptoms frequently occur in patients with Bell’s palsy and evaluate the association between these symptoms and clinical severity of paresis or the severity of facial nerve injury. Materials and Methods: The study included 86 patients with Bell’s palsy between August 2018 and April 2020. Severity levels of Bell’s palsy and facial nerve damage were evaluated using the House-Brackmann (H-B) grading scale and electrodiagnostic study, respectively. Subsequently, a self-reported questionnaire on prodromal symptoms was administered. To assess the degree of recovery, the H-B grade was reported at 9 weeks and 6 months after the onset of paralysis. Results: The most common prodromal symptoms were postauricular pain, sensory decline in the tongue, headache on the affected side, myalgia, facial sensory decline on the affected side, taste impairment, and dry eye. Taste impairment was significantly correlated with severe facial paralysis reported at 9 weeks after onset ( P Conclusions: The prodromal symptoms of Bell’s palsy were not associated with the severity of facial nerve injury in an electrodiagnostic study. Taste impairment was related to clinical severity of paralysis at subacute stage, 9 weeks after onset, but it was not associated with long-term prognosis.

The longitudinal effect of B12 insufficiency on sarcopenia has not yet been investigated in older adults. We aimed to study the impact of B12 levels on alterations in muscle mass, function and strength over two years. Non-sarcopenic older adults (n = 926) aged 70–84 were included. Using the Korean Frailty and Aging Cohort Study, this two-year longitudinal study used data across South Korea. The tools used for assessing muscle criteria were based on the Asian Working Group for Sarcopenia guidelines. Participants were divided into the insufficiency (initial serum B12 concentration < 350 pg/mL) and sufficiency groups (≥350 pg/mL). Logistic regression analyses were performed to evaluate the effect of initial B12 concentration on sarcopenia parameters over a two-year period. In women, multivariate analysis showed that the B12 insufficiency group had a significantly higher incidence of low SPPB scores (odds ratio [OR] = 3.28, 95% confidence interval [CI] = 1.59–6.76) and sarcopenia (OR = 3.72, 95% CI = 1.10–12.62). However, the B12 insufficiency group did not have a greater incidence of sarcopenia or other parameters in men. Our findings suggest B12 insufficiency negatively impacts physical performance and increases the incidence of sarcopenia only in women.

Background: Neutrophil-to-lymphocyte ratio (NLR), a systemic inflammatory biomarker, has been associated with poorer outcomes in acute ischemic stroke patients. The present study was designed to expand these findings by investigating the association between NLR and short-term functional outcomes in acute ischemic stroke patients. Methods: This retrospective study evaluated patients within 7 days after the onset of acute ischemic stroke. Stroke severity on admission was measured using the National Institutes of Health Stroke Scale (NIHSS). The functional outcomes were assessed using the Berg Balance Scale (BBS), Manual Function Test (MFT), the Korean version of the modified Barthel Index (K-MBI), and the Korean Mini-Mental State Examination (K-MMSE) within 2 weeks of stroke onset. The modified Rankin Scale (mRS) was evaluated at discharge. Results: This study included 201 patients, who were grouped into three NLR tertiles (2.71) on admission. A multivariate analysis showed that the top tertile group (NLR > 2.71) had significantly higher risks of unfavorable outcomes on the K-MBI (p = 0.010) and K-MMSE (p = 0.029) than the bottom tertile group (NLR < 1.84). Based on the optimal cut-off values from a receiver operating characteristic curve analysis, a higher NLR was significantly associated with higher NIHSS scores (p = 0.011) and unfavorable outcomes on the K-MBI (p = 0.002) and K-MMSE (p = 0.001). Conclusions: A higher NLR is associated with poorer short-term functional outcomes in acute ischemic stroke patients.

Vitamin B12 (B12) is involved as a cofactor in the synthesis of myelin. A lack of B12 impairs peripheral nerve production, which can contribute to sarcopenia. In this cross-sectional study, we aimed to investigate the relationship between B12 insufficiency and sarcopenia in community-dwelling older Korean adults. A total of 2325 (1112 men; 1213 women) adults aged 70–84 years were recruited. The tools used for sarcopenia were based on the Asian Working Group for Sarcopenia (AWGS) guidelines. Individuals with low appendicular skeletal muscle mass index (ASMI) (

Introduction Although there are similar characteristics between obese individuals and fall-susceptible population, little is known about relationships between body weight and risk factors for fall, particularly in the elderly population. The aim of this study was to determine whether body mass index-based obesity is associated with decreased balance and whether instability has relationships with the main risk factors for falls. Methods A total of 317 participants were categorized based on their body mass index. Clinical balance assessments were performed using the Berg Balance Scale, Timed Up and Go test, and Short Physical Performance Battery. The knee extensor strength of each individual was measured using a dynamometer. Total sway distance was calculated on InBody posturography in four conditions. Results The results of three clinical balance assessment tools showed significant correlation with body mass index. The obese group showed decreased isokinetic knee extensor muscle strength and had a higher total sway distance than the normal weight group. Conclusions The elderly population with obesity exhibits poor balance performing ability, and it is associated with the decreased strength of the lower limbs and impaired postural stability. The logistic regression analysis of our study showed that body mass index-based obesity can be regarded as a fall risk.

The objective of this study was to assess the cross-sectional areas (CSA) of lumbar paraspinal muscles and their fatty degeneration in adults with degenerative lumbar spondylolisthesis (DLS) diagnosed with chronic radiculopathy, compare them with those of the same age- and sex-related groups with radiculopathy, and evaluate their correlations and the changes observed on magnetic resonance imaging (MRI). This retrospective study included 62 female patients aged 65–85 years, who were diagnosed with lumbar polyradiculopathy. The patients were divided into two groups: 30 patients with spondylolisthesis and 32 patients without spondylolisthesis. We calculated the CSA and fatty degeneration of the erector spinae (ES) and multifidus (MF) on axial T2-weighted magnetic resonance (MR) images from the inferior end plate of the L4 vertebral body levels. The functional CSA (FCSA): CSA ratio, skeletal muscle index (SMI), and MF CSA: ES CSA ratio were calculated and compared between the two groups using an independent t-test. We performed logistic regression analysis using spondylolisthesis as the dependent variable and SMI, FCSA, rFCSA, fat infiltration rate as independent variables. The result showed more fat infiltration of MF in patients with DLS (56.33 vs. 44.66%, p = 0.001). The mean FCSA (783.33 vs. 666.22 mm2, p = 0.028) of ES muscle was a statistically larger in the patients with DLS. The ES FCSA / total CSA was an independent predictor of lumbar spondylolisthesis (odd ratio =1.092, p = 0.016), while the MF FCSA / total CSA was an independent protective factor (odd ratio =0.898, p = 0.002)

Frailty is a common geriatric condition due to aging and defined as a decline in strength and a decrease in the physiologic ability to maintain the homeostasis. Vitamin B12 (B12), water-soluble vitamins, are a cofactor in DNA synthesis and involved in the metabolism of every cell in the human body, including the central nervous system. Demyelination neuromuscular symptoms observed in the peripheral nervous system, along with signs of significant damage to nerve fibers, often cause weakness, numbness in distal limbs, impaired balance, gait ataxia, and even physical frailty. In this cross-sectional study, we aimed to investigate the relationship between frailty and B12 level in community-dwelling Korean older adults. Using the data from the Korean Frailty and Aging Cohort Study, 2938 participants (1400 men and 1538 women) were recruited in this study. To evaluate frailty, we compared the frail group and not-frail group based on the modified Korean version of the cardiovascular health study frailty index developed by Fried. SARC-F is used to screen for sarcopenia. The short physical performance battery (SPPB) timed up and go (TUG) test and activities-specific balance confidence scale used to evaluate the physical function and fall risk of participants. B12 concentrations were classified into clinically relevant categories: insufficient (

BackgroundFrailty is a common geriatric condition due to aging, defined as a decrease in the functional reserve to maintain the homeostasis. As part of the aging process, body composition changes occur. This study investigated the relationship between body composition and frailty in a community-dwelling elderly Korean population.MethodsThis cross-sectional cohort study analyzed data of 2,385 elderly participants (aged 70–84 years, 1131 males and 1254 females) of the Korean Frailty and Aging Cohort Study from 2016 to 2017. Body composition, including total and trunk fat masses and fat-free mass, were measured with dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index (TFMI), and fat-free mass index (FFMI) represented total fat mass, trunk fat mass, and fat-free mass according to height. Based on the frailty index developed by Fried, we compared the frail and non-frail groups. Poor physical performance assessed with the short physical performance battery score of 2) participants showed a high incidence of frailty in both sexes. BMI showed an association with frailty only in males. In both sexes, FFMI was associated with a lower incidence of frailty, which was statistically significant in the fully adjusted models. In the female, fat-related indexes including body fat percentage, FMI, and TFMI showed a significant association with poor physical performance. In contrast, males with low FFMI only showed a significant association with poor physical performance.ConclusionsFrailty closely correlated with FFMI in both sexes. The poor physical performance associated with frailty correlated with fat-related body composition in females and fat-free mass in males owing to the difference in body composition between the sexes. In the assessment of frailty, body composition and sex-related differences should be analyzed.

Vitamin B12 (B12), also known as cobalamin, is a water-soluble vitamin. It is a cofactor in DNA synthesis and is involved in the metabolism of every cell of the human body, including the central nervous system. Those with a deficiency of B12 can present with peripheral neuropathy, pernicious anemia, or a cognitive disorder. Previous studies have revealed that a deficiency of B12 is associated with cognitive decline or Alzheimer disease. The data of 2991 people were evaluated from 2 years of the Korean Frailty and Aging Cohort Study, a nationwide multicenter survey. To assess cognitive function, a short form of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was used. Of the CERAD-K tests, we included the Mini-Mental State Examination in the Korean version of the CERAD assessment packet (MMSE-KC), the word list: memory/recall/recognition, digit span (forward, backward), trail making test-A, and the frontal assessment battery. B12 concentrations were classified into clinically relevant categories, insufficient (

Background: Prediction of the severity and outcomes of Ramsay Hunt syndrome (RHS) is difficult. Objectives: The aim of this study was to evaluate the predictive power of the neutrophil-to-lymphocyte ratio (NLR) for the severity and outcomes of RHS. Material and Methods: From 2007 to 2017, a retrospective study of 102 hospitalized patients with RHS was conducted. The degree of paralysis was assessed by determining the House-Brackmann (H-B) grade. Obesity, hypertension, and diabetes mellitus were assessed, and the blood NLR and platelet-to-lymphocyte ratio were determined. The patients received steroids and antivirals, and were followed in the outpatient department at 1, 4, 12, and 24 weeks. Results: The H-B grade of the high-NLR group was significantly higher than that of the normal-NLR group (p = 0.039), and the probability of complete recovery was significantly lower in the high-NLR group (p = 0.048). Conclusions: Patients with RHS who have an elevated NLR have poor outcomes in terms of the H-B grade. Therefore, the NLR may be useful for evaluating the prognosis of patients with RHS.

Influenza virus-like particle (VLPs) vaccines are a promising alternative to conventional egg-based vaccines. Evaluation of vaccine efficacy induced by HA-M1 VLPs, NA-M1 VLPs or M1 VLPs against virus challenge infection would provide important insight into vaccine design strategy. In this study, we generated VLPs containing hemagglutinin (HA), neuraminidase (NA) or M1 proteins derived from the A/California/04/09. Mice were immunized intramuscularly with HA-M1, NA-M1 or M1 VLPs and protective immunity was evaluated by assessing lung virus loads against low (5LD50) or high (100LD50) lethal dose of homologous virus challenges. High levels of virus-specific serum IgG antibody responses were induced in mice after HA-M1 VLPs immunization, whereas low or no IgG antibody responses were detected from immunization with NA-M1 VLPs or M1 VLPs, independently. Mice that were immunized with HA-M1 VLPs showed below the limit of detection on lung virus loads against low dose (5LD50) of challenge and significant reduction against high dose (100LD50) of challenge infection. Mice that were immunized with NA-M1 or M1 VLPs also displayed reduced lung viral loads compared to naïve control. In vitro cultures of cells from mouse spleen and bone marrow revealed that HA-M1 VLPs and NA-M1 VLPs induced higher levels of antibody-secreting cell (ASC) responses compared to naïve control, whereas M1 VLPs showed no ASC responses. HA-M1, NA-M1 or M1 VLPs immunization demonstrated varying degree of protection with respect to body weight changes and survival rates, which are consistent with the levels of antibody responses in sera and ASC responses from spleen and bone marrow.

Age-related degenerative changes lead to a gradual decrease in bone mineral density (BMD) and muscle mass. We aimed to assess the effects of decreased BMD and lumbar denervation on lumbar spinal muscle morphometry and the relationship between BMD and lumbar spinal muscular morphometry, respectively. Eighty-one patients, aged 50–85 years, diagnosed with unilateral lumbosacral radiculopathy based on electrodiagnostic studies between January 2016 and April 2021 were enrolled. BMD T scores in the lumbar spine and hip were measured using dual-energy X-ray absorptiometry. The cross-sectional area (CSA) of the psoas, multifidus, and erector spinae located in the middle of the lumbar spine, between the L3 and L4 and between the L4 and L5 levels, respectively, was measured using axial MRI. Functional CSA (FCSA) was defined as the CSA of lean muscle mass. Pearson correlation analyses were performed to evaluate the association between BMD T scores and the CSA, FCSA, and the ratio of the FCSA to the CSA (functional ratio) for each side. The CSA of lumbar spinal muscles showed no significant correlation with lumbar BMD. The FCSA and functional ratio of lumbar spinal muscles were significantly correlated with lumbar BMD. There was no correlation between femur BMD and lumbar spinal muscle morphometry.

Objective To evaluate the association between balance function and asymmetry of knee extension strength in an elderly Korean population. Methods The strength of the knee extensors in each leg was measured in 306 community-dwelling elderly subjects (age, 76.70±4.85 years) and 25 young healthy subjects (age, 34.23±8.93 years). Based on the difference in strength of both legs, the elderly subjects were divided into symmetric (n=128) and asymmetric (n=178) strength groups using an asymmetry cutoff 20%. We determined the postural control ability of the subjects using InBody posturography, Berg Balance Scale (BBS), Timed Up and Go test (TUG) and Short Physical Performance Battery (SPPB). The sway index (SI) of the subjects in four positions was assessed using posturography. Results The group with asymmetric strength presented a significantly higher SI than the group with symmetric strength, in the normal position with eyes open and eyes open on pillows. In the normal position with the eyes closed and in postures with the eyes closed on pillows, the statistical analysis revealed no significant differences between the two groups. The three tests for physical performance (BBS, TUG, and SPPB) show no statistically significant difference between the two groups. Conclusion The asymmetric strength group showed a significantly lower balance than the group with symmetric strength based on several posturographic parameters. Ambulatory elderly individuals with asymmetry in knee extension strength, showed deficits in balance control even in normal clinical tests.

The prevalence of obesity as well as cognitive impairment increases with age. Previous studies showed that obesity is associated with an increased risk of cognitive impairment and dementia. Body composition changes occur as part of the aging process; therefore, the assessment of obesity in elderly populations should include body composition as well as body weight. This study investigated the relationship between body mass index (BMI), body composition, and cognitive function in a community-dwelling elderly Korean population.This cohort-based cross-sectional analysis included 2386 elderly participants aged between 70 and 84 years from the Korean Frailty and Aging Cohort Study for 2016 to 2017. To investigate the relationship between body composition and cognitive function in community-dwelling individuals, BMI and body composition, including total and trunk fat mass and fat-free mass, were measured by dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index (TFMI), and fat-free mass index (FFMI) were used to represent the body composition. A short form of the Korean version of the Consortium to Establish a Registry for Alzheimer disease was used to assess cognitive function. To evaluate the relationship between variables, simple and fully adjusted multivariable analyses were performed using generalized linear regression models.The mean ages were 76.8 years for males and 76.1 years for females. The BMI of male participants was significantly lower than that of females (23.9 ± 2.89 vs 24.7 ± 3.02 kg/m2, P

A 54-year-old woman presented with a 1-month history of pain and numbness in both feet. She had taken metronidazole for over 4 years previously to treat vaginitis. On nerve conduction studies (NCS), neither the sural nor right superficial peroneal nerve (SPN) was evoked, nor did the left SPN have small amplitude, suggesting axonal peripheral polyneuropathy with sensory fiber involvement. When she restarted metronidazole, she immediately complained of recurrent paresthesia of the feet. We performed three electromyography (EMG) studies and followed the patient for 6 months.

Importance Identification of the factors associated with improved facial nerve function after treatment of Bell palsy is important to provide patients with early and effective treatment. Objective To identify factors that are associated with improved treatment outcomes in patients with Bell palsy. Design, Setting, and Participants This retrospective cohort study included 1364 patients with Bell palsy treated at the outpatient clinic of the Department of Otolaryngology at the Kyung Hee University Hospital, Seoul, Republic of Korea, between January 1, 2005, and December 31, 2017. The medical records of patients admitted to this hospital for management of acute facial palsy were reviewed by 3 otolaryngologists with more than 20 years’ experience in treating facial palsy. Main Outcomes and Measures Facial function at the initial and final visits were measured using the House-Brackmann (H-B) grading system, which is one of several analysis tools developed to quantify facial function and provide reproducible information. It is a widely accepted system for grading facial function in 6 steps, from normal (H-B grade I) to total paralysis (H-B grade VI). Results In total, 1364 patients with primary Bell palsy (718 [52.6%] women) and a mean (SD) age of 47.7 (16.7) years were enrolled. The overall rate of favorable outcome, which was defined as an H-B grade of I or II at the 6-month follow-up visit, was 80.6% (1099 of 1364 patients). Of 1099 patients who had a favorable outcome at 6 months, 343 (31.2%) were younger than 40 years. Of 1364 patients, 1053 (77.2%) had moderate facial dysfunction (H-B grade III or IV). No pathological spontaneous fibrillation activity (ie, good electromyography [EMG] results) was detected on EMG in 937 of 1364 patients (68.7%), 492 (36.1%) had controlled hypertension, and 673 (49.3%) were treated with oral corticosteroids alone. Multivariable analysis revealed that the following factors were associated with favorable outcome: age younger than 40 years (odds ratio [OR], 1.56; 95% CI, 1.09-2.22), an initial H-B grade of III or IV (OR, 2.62; 95% CI, 1.93-3.57), good EMG results after 2 weeks of treatment (OR, 3.38; 95% CI, 2.48-4.61), absence of diabetes (OR, 1.43; 95% CI, 1.04-2.36), and control of hypertension (OR, 1.64; 95% CI, 1.16-2.33). Conclusions and Relevance Multiple logistic regression analysis in this study suggests that multiple clinical factors are associated with favorable outcomes in patients with Bell palsy.

It is well known that vitamin D (VitD) plays an important role in bone and calcium metabolism in the human body. VitD has additional roles in the body including modulation of cell growth, neurogenesis, neuroprotection, detoxification, immune function, and reduction of inflammation. Recent studies reveal insufficiency of VitD as a risk factor for cognitive decline or dementia. VitD has a role in normal brain function; insufficiency of VitD may lead to decreased memory and cognitive function. Using 2 years of baseline data from Korean frailty and aging cohort study, 2990 subjects (1415 men and 1575 women) were recruited. A short form of Korean version of the consortium to establish a registry for Alzheimer disease (CERAD-K), an assessment of cognitive status in patients with dementia was used. Among CERAD-K tests, we included word list memory/recall/recognition, digit span (forward, backward), trail making test (TMT) A, and mini-mental state examination in the Korean version of the CERAD assessment packet (MMSE-KC). Serum samples were collected and 25-hydroxyvitamin D (25(OH)D) was measured. Serum 25(OH)D concentrations were classified into clinically relevant categories as: deficient (

This study aimed to investigate whether trunk fat mass measured using dual-energy X-ray absorptiometry (DEXA) correlates with balance and physical performance.This study utilized 2-year baseline data pertaining to 3014 participants from the database of the Korean frailty and aging cohort study. The trunk lean mass and fat mass were measured by DEXA. Trunk fat mass index (tFMI) was established using the following standard equation: Trunk fat mass (Kg)/height (m). The clinical balance tests were performed using the timed up and go test (TUG), total balance score in short physical performance battery (SPPB). We performed SPPB and evaluated independence of daily living using activities of daily living, instrumental activities of daily living (IADL), sarcopenia screening tool (SARC-F) and both hand grip power. In our study, we tried to check the correlation of tFMI with balance and physical performance and to determine the factors associated with tFMI.The tFMI was positively correlated with mean values of 4 m gait speed, repeat chair stand time in SPPB, TUG, and SARC-F and negatively correlated with hand grip, IADL, total balance test score in SPPB, total SPPB score, and age. The results of the multiple generalized linear model analysis that assessed the factors associated with balance and physical performance indicated that tFMI had a significant correlation with repeat chair stand time in SPPB (seconds) (Beta estimate [B]: 0.252), TUG (seconds) (B: 0.25), 4 m gait speed (seconds) (B: 0.055), and total balance score in SPPB (B: -0.035).Higher tFMI using DEXA was correlated with low physical performance and balance, indicating that trunk fat mass was associated with balance and physical performance in community-dwelling older people.

The asymmetry in lower extremity strength is known to be related to the functional mobility in older adults living in the community. However, little is known about the association between lower extremity lean mass asymmetry and functional mobility in this patient group. Hence, this study aimed to determine whether asymmetry in lower extremity muscle mass has a significant relationship with functional mobility in older adults living in the community.This cross-sectional study analyzed the pre-existing data from the Korean Frailty and Aging Cohort Study. A total of 435 older people (aged 70-84 years) were divided into the following groups according to their Limb Asymmetry Index (LAsI): low, intermediate, and high asymmetric groups. LAsI is calculated using lower extremity lean mass, and comparisons between groups were conducted. The participants were also further divided into better and worse mobility groups based on their physical performance test results (Timed Up and Go and Short Physical Performance Battery), and comparisons between groups were conducted. Comparisons between fallers and non-fallers were also conducted. In addition, this study investigated the factors that had a significant effect on gait speed and fall experience within the past year among older adults living in the community.The LAsI was significantly associated with gait speed in older adults living in the community. Older adults in the highest tertile of the LAsI had a slower gait speed than those in the lowest tertile of the LAsI. However, no significant difference was observed in the LAsI between the better mobility group and worse mobility group. Moreover, the LAsI was not a significant predictor of falls.Asymmetry in lower extremity lean mass was significantly associated with gait speed in older adults living in the community.

Objective The aim of this study was to investigate what prodromal symptoms are occurring and associated with occurrence and clinical severity of Bell’s palsy using House-Brackmann facial nerve grading system (HBS). An additional aim was to evaluate whether the result of electrodiagnostic examination reflects HBS and what prodromal symptoms are related with poor outcome. Method The investigation included 51 patients with Bell’s palsy. To clinically assess the severity of Bell’s palsy, HBS was used. To evaluate the facial nerve damage, the CMAP amplitude were measured and the percent amplitude reduction was calculated by comparing the affected side with the healthy side. A self-reported questionnaire was conducted about prodromal sympto. Results The most common prodromal symptoms were postauricular pain (66.7%), tongue sensory decline (41.1%), blepharospasm (33.3%) in order of frequency. All of these symptoms were significantly associated with onset of Bell’s palsy and the most powerful risk factor was postauricular pain (p 0.001). A CMAP difference of more than 70% were significantly associated with postauricular pain, tongue sensory decline and blepharospasm (p Conclusion This study indicates that patients with Bell’s palsy can have a variety of prodromal symptoms including systemic, sensory, opthalmic, auricular symptoThrough this, can predict the clinical, electrodiagnostic prognosis and postauricular pain was the most powerful risk factor on occurrence of Bell’s palsy.

Objective Prognosis for Bell’s palsy is good, but the proportion of patients with poor outcomes may reach 30%. Ultrasound (US) may provide a tool to assess the anatomical aspects of the nerve, complementary to the functional aspects assessed by electrodiagnostic studies. The aim of this study was to evaluate the prognostic role of neuromuscular ultrasound in Bell’s palsy. Method A total of 45 patients with acute onset of Bell’s palsy were included in the study. We measured the bilateral diameter of the distal facial nerve using US along with calculation of side to side differences in each patient. Direct facial nerve conduction studies recording compound muscle action potentials of 4 facial muscles were determined bilaterally and the percent amplitude reduction was calculated by comparing each side. If the percent amplitude reduction of any facial muscle satisfy the condition of more than 90% was assigned to the unfavorable prognosis group, and the remainder to the favorable prognosis group. Bilateral facial nerve diameters and side to side differences were compared between the two groups. Results In affected side, the facial nerve diameter was significantly larger in the unfavorable prognosis group than favorable prognosis group (p = 0.036, 95% CI = 0.008–0.236), with a significant side-to-side difference in the unfavorable prognosis group as well (p = 0.017, 95% CI = 0.026–0.248). Conclusion The significant difference in facial nerve diameter and the side-to-side difference in diameter between the two groups denotes the ability of ultrasound to detect facial nerve enlargement which may be useful to predict prognosis in patients with Bell’s palsy.

Objective To evaluate the relationships between tongue pressure and different aspects of the oral-phase swallowing function. Methods We included 96 stroke patients with dysphagia, ranging in age from 40 to 88 years (mean, 63.7 years). Measurements of tongue pressure were obtained with the Iowa Oral Performance Instrument, a device with established normative data. Three trials of maximum performance were performed for lip closure pressure (LP), anterior hard palate-to-tongue pressure (AP), and posterior hard palate-to-tongue pressure (PP); buccal-to-tongue pressures on both sides were also recorded (buccal-to-tongue pressure, on the weak side [BW]; buccal-to-tongue pressure, on the healthy side [BH]). The average pressure in each result was compared between the groups. Clinical evaluation of the swallowing function was performed with a videofluoroscopic swallowing study. Results The average maximum AP and PP values in the intact LC group were significantly higher than those in the inadequate lip closure group (AP, p=0.003; PP, p