Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline

Eur Arch Otorhinolaryngol. 2020 Jul;277(7):1855-1874. doi: 10.1007/s00405-020-05949-1. Epub 2020 Apr 8.


Purpose: Facial nerve electrodiagnostics is a well-established and important tool for decision making in patients with facial nerve diseases. Nevertheless, many otorhinolaryngologist-head and neck surgeons do not routinely use facial nerve electrodiagnostics. This may be due to a current lack of agreement on methodology, interpretation, validity, and clinical application. Electrophysiological analyses of the facial nerve and the mimic muscles can assist in diagnosis, assess the lesion severity, and aid in decision making. With acute facial palsy, it is a valuable tool for predicting recovery.

Methods: This paper presents a guideline prepared by members of the International Head and Neck Scientific Group and of the Multidisciplinary Salivary Gland Society for use in cases of peripheral facial nerve disorders based on a systematic literature search.

Results: Required equipment, practical implementation, and interpretation of the results of facial nerve electrodiagnostics are presented.

Conclusion: The aim of this guideline is to inform all involved parties (i.e. otorhinolaryngologist-head and neck surgeons and other medical specialists, therapeutic professionals and the affected persons) and to provide practical recommendations for the diagnostic use of facial nerve electrodiagnostics.

Keywords: Bell’s palsy; Diagnostics; Electromyography; Electroneurography; Electrostimulation; Facial nerve; Facial paralysis; Recommendations.

Publication types

  • Practice Guideline

MeSH terms

  • Bell Palsy*
  • Facial Nerve
  • Facial Paralysis* / diagnosis
  • Facial Paralysis* / therapy
  • Humans