[Posterior auricular muscle reflex in the study of the facial muscle function]

To date the study of facial nerve function is based on just two tests: electroneurography (ENGH) and electromyography (EMG). Nevertheless neither of these tests gives reliable results until 8-10 days after onset of the paralysis. The authors have used an evoked auditory potential--more specifically the posterior auricular muscle reflex (PAMr) which is directly activated by the VII cranial nerve in the brainstem after acoustical stimulation. They first tested this method in normal subjects and later in patients with Bell's Palsy and the Ramsey Hunt Syndrome. The authors assert the predictive capacity of this test, in particular, underlining the clear-cut relationship between the time required for the paralysis to heal and the difference in side-to-side PAMr latency. While the sensitivity of the ENGH and PAMr tests are similar, PAMr makes staging of the evolution possible on the 2nd day after onset.