[Does transcranial magnetic stimulation provide improved assessment of "idiopathic" facial paralysis? Initial...

To evaluate transcranial magnetic stimulation (TMS) in patients suffering from idiopathic facial palsy, results from 31 patients were reviewed. TMS was applied to the facial nerve by parieto-occipital, ipsilateral coil placement. At the time of the first examination (2-25 days after the onset of palsy), 11 of 31 nerves on the affected side were excitably by TMS. Patients were classified according to whether magnetic excitability of the facial nerve was possible (group I) or not possible (group II). In general, the percentage of patients with complete or nearly complete recovery of facial function was 97% following either a standard infusion therapy (corticosteroids, hydroxyethylstarch and pentoxifyllin) or orally administered corticoids (equal percentages in each group, respectively). In the first group of patients, 11 had facial nerves that were excitable with TMS and showed complete recovery of motor function within a median period of 7 weeks. In those patients with successful TMS only one experienced "crocodile tears" syndrome one year after Bell's palsy but without any further motor deficit of facial function. In patients with unresponsive nerve function following TMS 17 recovered without sequelae (median, 11 weeks), whereas 3 of 20 (15%) developed deficits of motor function. Two of these latter cases suffered from synkinesias (one that was slight after surgical decompression of the facial nerve and one severe) while one had facial contractures but without motor deficits.(ABSTRACT TRUNCATED AT 250 WORDS)