Dextrose-based Lyftogt perineural injection therapy on facial muscle strength in a Bell’s palsy patient – a case report

Bell's palsy, a unilateral peripheral facial nerve palsy, is one of the most common acute mononeuropathies. Chronic cases persisting beyond one year present significant challenges to conventional treatment methods. Standard treatment includes steroids and antiviral medications in the acute phase, and physical therapy, various supplements such as vitamin B12 and folic acid supplementation, and injections for chronic therapy. This case report describes the effect of a unique treatment, dextrose-based Lyftogt perineural injection therapy (LPIT), in a 22-year-old Filipino male with left-sided peripheral facial nerve palsy. His condition had persisted for a duration of 13 months and was refractory to standard management. LPIT was delivered at chronic constriction points and endpoints of the facial nerve in ten different sessions. The mechanism of LPIT involves addressing glycopenia in affected nerves, reducing neurogenic inflammation, and facilitating nerve repair by enhancing the flow of nerve growth factors. Following treatment, marked improvement was observed in the functional muscle strength of the left occipitofrontalis, zygomaticus, and buccinator muscles, progressing from weak functional to functional. This case underscores LPIT's potential as an adjunct therapy for chronic Bell's palsy, adding to the limited but a growing body of evidence supporting its role in managing neuropathic conditions.