Electroneurography cannot predict when facial synkinesis develops in patients with facial palsy

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Electrophysiology

Background:

• Facial palsy, including Bell's palsy and Ramsay Hunt syndrome, can lead to facial synkinesis.
• Early intervention in facial palsy rehabilitation is crucial to prevent long-term complications like synkinesis.
• Electroneurography (ENoG) is a diagnostic tool used to assess nerve function in facial palsy.

Purpose of the Study:

• To determine if Electroneurography (ENoG) values measured early after facial palsy onset can predict the timing of facial synkinesis development.
• To establish optimal timing for initiating rehabilitation to prevent facial synkinesis in patients with lower ENoG values.

Main Methods:

• A cohort of 16 facial palsy patients (11 Bell's palsy, 5 Ramsay Hunt syndrome) was studied.
• ENoG values were recorded 10-14 days post-facial palsy onset.
• The onset of oral-ocular synkinesis was tracked, and its correlation with ENoG values was analyzed.

Main Results:

• No significant correlation was found between ENoG values and the onset day of oral-ocular synkinesis (ρ = .09, p = .73).
• Oral-ocular synkinesis developed approximately 4.0 ± 0.7 months after facial palsy onset, irrespective of initial ENoG values.
• ENoG values were not predictive of synkinesis development timing.

Conclusions:

• ENoG values are unreliable predictors for the onset of facial synkinesis in facial palsy patients.
• Biofeedback rehabilitation with mirror therapy is recommended for high-risk patients starting three months post-facial palsy onset to mitigate synkinesis.
• This proactive rehabilitation approach aims to improve functional outcomes and prevent the development of facial synkinesis.