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Prognostic value of the blink reflex test in Bell's palsy and Ramsay-Hunt syndrome
Young Min Hah1, Sang Hoon Kim1, Junyang Jung2
1Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
Objective:
This study was designed to evaluate the prognostic value of the blink reflex (BR) test in patients with Bell's palsy (BP) or Ramsay Hunt syndrome (RHS).
Methods:
The House-Brackmann (HB) grade of patients diagnosed with BP and RHS was determined at first visit and 3 months later. Final HB grade III-VI was defined as an incomplete recovery. Factors evaluated as prognostic of poor recovery included electroneurography (ENoG) degeneration rate (DR)>90%, and absence of BR. Rates of complete and incomplete recovery were calculated and the associations between prognostic factors and recovery were determined.
Results:
Of the 129 included patients, 98 (76%) had BP and 31 (24%) had RHS. Absence of BR and low mean ENoG value were significantly associated with incomplete recovery in both the BP and RHS groups (p<0.05 each). Initial HB grade V-VI was significantly associated with rate of incomplete recovery in patients with RHS (p<0.05 each). Severe residual palsy (final HB grade V-VI) in the absence of BR was significantly more frequent in patients with RHS than with BP (p<0.05).
Conclusion:
BR test results were a good prognostic indicator in patients with BP and RHS, as were ENoG value. Absence of BR was more frequently associated with severe residual palsy in RHS than in BP.