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Electroneurographic facial muscle pattern in Bell's palsy
M Engström1, L Jonsson, M Grindlund
1Departments of Oto-Rhino-Laryngology and Head & Neck Surgery, Uppsala University, Akademiska sjukhuset, Sweden.
Summary
Electroneurography in Bell's palsy patients shows that examining multiple facial muscles early on can predict recovery. Initial recordings in the nasalis and mentalis muscles are key indicators of a favorable outcome.
Area of Science:
- Neurology
- Electrophysiology
Background:
- Bell's palsy is a common cause of unilateral facial nerve paralysis.
- Accurate prognostication is crucial for managing patient expectations and treatment strategies.
Purpose of the Study:
- To analyze the temporal changes in electroneurographic facial muscle patterns in Bell's palsy.
- To determine if electroneurography in multiple facial regions provides additional prognostic value.
Main Methods:
- Electroneurographic recordings were performed in the frontalis, orbicularis oculi, nasalis, and mentalis muscles of 30 Bell's palsy patients.
- Recordings were taken early (mean day 11) and at 1 and 3 months post-onset.
- Correlation analysis was used to assess the relationship between recordings over time and across different muscle regions.
Main Results:
- The recovery pattern was consistent across all four facial muscle regions studied.
- Initial correlations between facial muscle recordings were weak (r=0.20-0.27), strengthening over time (r=0.33-0.65).
- Initial nasalis and/or mentalis recordings predicted favorable outcomes in 96% of patients.
- Calculating average electroneurography values from multiple muscles (1, 2, or 4) increased the gap between favorable and unfavorable outcomes (4%, 8%, 15%).
Conclusions:
- Electroneurography of multiple facial muscle regions in Bell's palsy offers significant prognostic information.
- The degree of nerve degeneration varies initially across different facial nerve branches.