Electroneurography value as an indicator of high risk for the development of moderate-to-severe synkinesis after Bell’s palsy and Ramsay Hunt syndrome

Abstract

Background: The degree of distress caused by the sequelae of peripheral facial nerve palsy usually depends on the severity of synkinesis.

Objective: To clarify whether electroneurography (ENoG) can predict the severity of synkinesis after peripheral facial nerve palsy.

Materials and methods: One-hundred and fourteen patients treated for facial nerve palsy at our hospital from April 2014–September 2016 were retrospectively reviewed. ENoG was performed 10–16 days after symptom onset. Patients were classified into Groups A (ENoG value 10%–20%, n = 9) and B (ENoG value <10%, n = 21). Eight months after symptom onset, electrophysiological and symptomatic outcomes were evaluated as the aberrant regeneration ratio of the blink reflex and the total synkinesis score of the Sunnybrook facial grading system, respectively. The outcomes of the groups were compared.

Results: Group B had a significantly higher median aberrant regeneration ratio (0% versus 87%, p=.015), median total synkinesis score (1 versus 3, p < .001), and incidence of moderate-to-severe synkinesis (0% versus 57.2%, p=.003) than did Group A.

Conclusions and significance: Patients with an ENoG value of <10% have higher risks of aberrant regeneration and moderate-to-severe synkinesis than those with an ENoG value of 10%–20%. Patients with ENoG values of <10% may require rehabilitation to prevent synkinesis.

背景：周围性面神经麻痹后遗症引起的痛苦程度通常取决于联动的严重程度。

目的：阐明神经电图（ENoG）是否可以预测周围性面神经麻痹后联动的严重程度。

材料与方法：回顾性分析2014年4月至2016年9月在我院收治的114例面神经麻痹患者。症状出现后10-16天进行ENoG。患者被分为A组（ENoG值10％-20％, n = 9）和B组（ENoG值<10％, n = 21）。症状出现8个月后, 电生理和症状结果分别作为眨眼反射的异常再生率和Sunnybrook面部分级系统的总联动评分进行评估。比较了这些组的结果。

结果：B组具有显著较高的中位异常再生率（0％对87％, p = .015）、中位总联动评分（1对3, p <.001）, 中度至重度综合征发生率（与A组相比, 0％对57.2％, p = .003）

结论和意义：ENoG值<10％的患者比ENoG值为10％-20％的患者具有更高的异常再生和中至重度联动的风险。 ENoG值<10％的患者可能需要康复来预防联动。

Keywords:

• Facial nerve palsy
• Bell’s palsy
• Ramsay Hunt syndrome
• electroneurography
• synkinesis
• blink reflex

Disclosure statement

The authors declare no conflicts of interest in association with the present study.