Which electrophysiological measure is appropriate in predicting prognosis of facial paralysis?

Abstract

Objective: The prognostic value of electrophysiology and its significance in the prediction facial function outcome in facial palsy patients remains unclear because of the different methodologies used in previous studies. We aimed to establish the prognostic value of electrophysiological testing in a group of patients with facial palsy.

Methods: We prospectively analyzed facial nerve electrophysiology results and compared them with the House-Brackmann scale in 65 patients. The treatment consisted of a standard corticosteroid plus antiviral regimen. Clinical evaluation comprised the House-Brackmann grading system and electrophysiological tests (nerve excitability, nerve conduction study (NCS), needle electromyography (EMG), and blink reflex) conducted on the 5th, 20th, and 90th days after paralysis onset.

Results: In predicting the prognosis, the nerve excitability test in the acute phase, NCS in the subacute phase, blink reflex in the acute and subacute phases and needle EMG in the subacute phase provided statistically significant results.

Conclusion: Prognosis can be determined, and excessive tests can be eliminated with proper timing and electrophysiological testing.

Significance: In determining the prognosis of facial paralysis, the nerve excitability test should be used in the acute phase, and NCS and needle EMG should be used in the subacute phase. Blink reflex studies are helpful in both the acute and subacute phases.