PMID: 11314702Apr 21, 2001Paper

Prognostic value of electromyography in acute peripheral facial nerve palsy

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
C Sittel, E Stennert

Abstract

To analyze the value of electromyography in predicting recovery from acute idiopathic facial nerve paralysis. Retrospective case-series review. University-based hospital department of otorhinolaryngology/head neck surgery. Three hundred fifty-five patients with sudden facial paralysis of unknown cause (Bell's palsy). Treatment consisted uniformly of high-dose prednisolone, dextran, and pentoxifylline. Prognostication was based on electromyography performed not earlier than 10 to 14 days after the onset of palsy. The findings were classified according to Seddon into neurapraxia and axonotmesis/ neurotmesis. There is an inherent statement on prognosis in this classification because neurapraxia is presumed to recover completely within 8 to 12 weeks, whereas axonotmesis is most likely to be followed by sequelae. Facial nerve function after 6 months. Complete recovery was predicted correctly in 92.4% of cases. For the relatively rare and therefore principally more difficult predictable event defective recovery prognosis was still accurate in 80.8%. The detection of spontaneous fibrillation in needle electromyography is a reliable sign predicting unfavorable outcome. An accuracy of 80.8% for predicting unfavorable outcome may be suff...Continue Reading

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