Prognostic value of the blink reflex test in Bell's palsy and Ramsay-Hunt syndrome

Auris Nasus Larynx. 2018 Oct;45(5):966-970. doi: 10.1016/j.anl.2018.01.007. Epub 2018 Feb 3.


Objective: This study was designed to evaluate the prognostic value of the blink reflex (BR) test in patients with Bell's palsy (BP) or Ramsay Hunt syndrome (RHS).

Methods: The House-Brackmann (HB) grade of patients diagnosed with BP and RHS was determined at first visit and 3 months later. Final HB grade III-VI was defined as an incomplete recovery. Factors evaluated as prognostic of poor recovery included electroneurography (ENoG) degeneration rate (DR)>90%, and absence of BR. Rates of complete and incomplete recovery were calculated and the associations between prognostic factors and recovery were determined.

Results: Of the 129 included patients, 98 (76%) had BP and 31 (24%) had RHS. Absence of BR and low mean ENoG value were significantly associated with incomplete recovery in both the BP and RHS groups (p<0.05 each). Initial HB grade V-VI was significantly associated with rate of incomplete recovery in patients with RHS (p<0.05 each). Severe residual palsy (final HB grade V-VI) in the absence of BR was significantly more frequent in patients with RHS than with BP (p<0.05).

Conclusion: BR test results were a good prognostic indicator in patients with BP and RHS, as were ENoG value. Absence of BR was more frequently associated with severe residual palsy in RHS than in BP.

Keywords: Bell’s palsy; Blink reflex test; Prognosis; Ramsay Hunt syndrome.

MeSH terms

  • Adult
  • Bell Palsy / physiopathology*
  • Blinking / physiology*
  • Female
  • Herpes Zoster Oticus / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Recovery of Function
  • Severity of Illness Index
  • Young Adult