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KMID : 0860920070090010001
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2007 Volume.9 No. 1 p.1 ~ p.7
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Electrophysiologic Evaluation of Facial Nerve and Prognostic Factors in Facial Neuropathy
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Ro Ki-Bong
Kwon Hee-Kyu
Park Yoon-Kun
Ha Kang-Wook
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Abstract
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Objectives: To observe association between clinical and electrophysiologic findings and to investigateprognostic factor for facial neuropathy through long term follow up study.
Methods: Thirty-three patients with facial neuropathy were retrospectively analyzed. The etiology,House- Brackmann grade and electrophysiologic findings were evaluated at the time of diagnosis and thefollow up (initial vs final). The initial evaluation was performed between 5 days and 1 month after onset.The compound muscle action potentials (CMAPs) were recorded in orbicularis oris, nasalis, orbicularis oculi muscles. The amplitude ratio of lesion side to normal side were obtained in each muscle recordingsand the average of the amplitude ratio were used as an amplitude ratio of the lesion side. The relation ofHouse-Brackmann grade and the CMAP ratio was investigated. The prognosis according to the etiologyand amplitude ratio (initial) were analyzed.
Results: House-Brackmann grade and the amplitude ratio were well correlated. The CMAP ratios lessthan 10% showed poor outcome whereas those more than 10% had a good outcome. The patients withCMAPs ratio above 30% recovered completely. Bell’s palsy and Ramsay-Hunt syndrome revealed favor-able outcome.
Conclusion: House-Brackmann grade tends to show correlation with electrophysiologic findings. The CMAP ratios obtained between 5 days and 1 month after onset would be useful in predicting outcome of facial palsy.
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KEYWORD
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Facial nerve paralysis, House-Brackmann grade, Compound muscle action potentials
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