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EVALUATION OF THE EFFECTIVENESS OF TRANSCRANIAL MAGNETIC
STIMULATION IN DIFFERENT FREQUENCY MODES IN THE REGENERATION
OF FACIAL NERVE FUNCTIONS IN PATIENTS WITH NEUROPATHY
Kuliyev Khusniddin Shamsievich
Of the Department of Neurology Bukhara State Medical Institute
Khodzhieva Dilbar Tajievna
Head of the Department of Neurology, MD, Professor of the
Department of Neurology
Bukhara State Medical Institute
https://doi.org/10.5281/zenodo.15112799
Annotation.
Facial nerve neuropathy is a common neurological condition characterized
by unilateral weakening or complete lack of function of facial muscles due to damage to the VII
cranial nerve. The incidence is approximately 20-30 cases per 100,000 population annually,
and pathology can affect people of any age, significantly limiting their social activity and
negatively affecting their psycho-emotional state. The idiopathic form (Bell's palsy) dominates
the morbidity structure, accounting for approximately 70% of all diagnosed cases, while the
remaining 30% are caused by traumatic injuries, infectious processes, neoplasms and
metabolic disorders.
Key words:
Transcranial magnetic stimulation, facial nerve neuropathy, Bell's palsy,
neurorehabilitation, low-frequency stimulation, high-frequency stimulation, neuroplasticity,
restoration of facial muscles, electroneuromyography, modulation of cortical excitability.
Introduction.
Although the majority of patients experience spontaneous restoration of
function within 3-6 months, a significant proportion (15-30%) suffer from long-term
consequences in the form of persistent paresis of facial muscles, pathological synkinesias,
contractures and hemifacial spasm. These residual phenomena not only disrupt the functional
activity of a person, but also create serious psychosocial problems, including decreased self-
esteem, anxiety-depressive disorders, and social isolation.
Modern therapeutic strategies for facial neuropathy include the use of
glucocorticosteroids, antiviral drugs, vasoactive drugs, various physiotherapy techniques and
exercises for facial muscles. In some cases, the possibility of surgical decompression of the
nerve is being considered. Nevertheless, the effectiveness of these approaches remains
controversial, which stimulates the search for innovative therapeutic techniques that can
optimize and accelerate the regeneration of nervous tissue.
An analysis of potential predictors of the effectiveness of TMS showed that the best results
with the use of high-frequency stimulation were observed in patients younger than 60 years
old, with a disease duration of up to 14 days, in the absence of a complete block of facial nerve
conduction according to initial electroneuromyography. Individual characteristics of the
threshold of motor evoked potential also influenced the effectiveness of stimulation, which
emphasizes the importance of a personalized approach to determining the parameters of TMS.
The safety of the studied TMS protocols is confirmed by the absence of serious adverse
events. Transient side effects in the form of headache, discomfort in the stimulation area and
dizziness were observed in 15% of patients, mainly with high-frequency stimulation, but did
not require discontinuation of therapy.
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Thus, the results of the study demonstrate the therapeutic potential of transcranial
magnetic stimulation in accelerating and optimizing recovery processes in facial neuropathy.
The differentiated use of protocols of different frequencies, taking into account the clinical
characteristics of the disease and the individual characteristics of patients, makes it possible to
maximize the effectiveness of neurorehabilitation. High-frequency TMS (10 Hz) may be
recommended as an additional treatment for acute facial neuropathy, especially in patients
with incomplete conduction block according to electroneuromyography.
Conclusions:
Thus, a promising area of further research is the study of combined TMS
protocols with the consistent use of stimulation of various frequencies, as well as the
assessment of the long-term effects of neuromodulation on the development of long-term
complications of facial neuropathy, such as pathological synkinesia and contractures.
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