Clinical experience with electroneurography in the pediatric patient

Electroneurography (ENoG) has demonstrated utility in adults with facial nerve paralysis. We wished to evaluate the possible usefulness of this test in children. Twenty-six patients, aged 3 months through 16 years, were studied. Initial measurements were obtainable in all but two patients; they were successfully tested on a second attempt. All subsequent patient testing efforts were completed, for an overall successful test rate of 95%. Waveform amplitude and morphology were consistent with adult values, except in infants. The most clinically helpful use of this test was to objectively assess facial nerve function, once spontaneous motion was lost in acquired paralysis or if it had never been seen in congenital paralysis. Surprisingly, analysis of the "normal" side of the face proved most informative for three patients. Use of the test as an absolute predictor for return of function is not possible; however, the ENoG results add data that can be incorporated into the clinical information to make such predictions more rational. We conclude that ENoG can be performed on children, and that the measurements, within bounds of interpretation, can offer objective data not usually available in this age population.