J Korean Neurol Assoc.
1999 Sep;17(5):668-674.
Relationship between Prognosis and Serial Electrophysiologic Study in Bell's Palsy
- Affiliations
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- 1Department of Neurology, School of medicine, Kyungpook National University.
Abstract
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BACKGROUND: This study aimed to evaluate the abilities of transcranial magnetic stimulations(TMS) and electrical stimulations(ES) in predicting clinical recovery in patients with Bell's palsy and to contribute to the understanding of the relations observed between the clinical and electrophysiological time courses of the disease.
METHOD: We serially studied 22 patients(9 males, mean age 42) with Bell's palsy. Facial nerve function was graded according to the House-Brackmann grading system.
RESULTS
A side-to-side comparison(amplitude ratio) of the amplitude of evoked responses between the initial and follow up studies showed a significant change except for the TMS on the stylomastoid foramen. With the TMS over the parieto-occipital area, the absence of a compound muscle action potential(CMAP) was observed in 19 patients during the early course of the disease. The reappearance(n=14) of evoked muscle potentials after an initial absence was observed in 14 patients with satisfactory recoveries at the last follow-up study. The amplitude ratio of ES and TMS during the early course of the disease correlated with the clinical outcome.
CONCLUSIONS
Our findings indicate that TMS and ES can provide an early prediction for the outcome of the palsy. The presence of CMAP at the acute phase or the reappearance of CMAP after an initial absence with TMS suggests a rather good prognosis. Both TMS and ES were found to be useful methods for the assessment of facial palsy and as early predictors for the outcome in patients with Bell's palsy. Serial neurophysiologic studies were also important for evaluation of the prognosis of facial palsy.
