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Serial electrophysiological study on two infants with acute facial palsy
T Hatanaka1, M Takedatsu, A Yasuhara
1Department of Pediatrics, Kansai Medical University, Osaka, Japan.
Insights
Acute unilateral facial palsy in infants involves not only the facial nerve but also central brainstem pathways. Serial blink reflex and auditory brainstem response (ABR) tests help identify these complex pathogenetic processes.
Area of Science:
- Pediatric Neurology
- Neurophysiology
Background:
- Acute unilateral facial palsy in infants can have varied etiologies.
- Understanding the involvement of central pathways is crucial for prognosis.
Purpose of the Study:
- To investigate the involvement of central nervous system pathways in infant facial palsy.
- To assess the utility of electrophysiological tests in diagnosing the extent of facial nerve palsy.
Main Methods:
- Serial electrophysiological assessments including blink reflex, photo-evoked eyelid microvibration, and auditory brainstem response (ABR).
- Examination of two infants with acute unilateral facial palsy.
Main Results:
- Facial palsy in infants can involve both the facial nerve and central brainstem pathways.
- Neurapraxic changes in the facial nerve were noted in one case, with more widespread involvement in another.
- Widespread involvement correlated with a prolonged clinical recovery period.
Conclusions:
- Serial blink reflex and ABR testing are valuable tools for elucidating pathogenetic processes in infant facial palsy.
- These electrophysiological methods aid in understanding brainstem involvement during facial nerve palsy.
Abstract:
Two infants with acute unilateral facial palsy were examined serially as to the electrically and mechanically elicited blink reflex, photo-evoked eyelid microvibration and auditory brainstem response (ABR). The results indicated that in hemifacial palsy beside the affection of the facial nerve also central pathways in the brainstem were involved in the pathogenetic processes. In particular, a neurapraxic change of the facial nerve itself in one case played an important role in pathogenesis, while a wide spread involvement was observed in another case. The clinical recovery of a patient with a wide spread involvement was more prolonged. We suggest that serial determinations of blink reflexes and ABR are helpful in clarifying the underlying pathogenetic processes concerning the brainstem affection during facial nerve palsy.