Magnetic Facial Nerve Stimulation in Bell's Palsy

Abstract

The transcranial magnetic stimulation (TMS) technique makes it possible to stimulate the intracranial part of the facial nerve. In a total of 51 patients with acute Bell's palsy, TMS was performed, and the responses were compared with those elicited by conventional extracranial electric stimulation (EES). Clinical recovery was evaluated at 258–539, mean 410, days from the beginning of the palsy. With both techniques the motor evoked potentials (MEPs) could always be elicited on the healthy side, the mean latency being 4.7 ms with TMS and 3.7 ms with EES. In the acute phase, TMS elicited MEPs on the paralyzed side in 47% of the patients, and EES in 98%. The patients with TMS elicitable MEPs during the first 4 days of the palsy had significantly belter recovery than those without response (p<0.05). The difference in recovery between patients with or without elicitable TMS responses on days 5–8 and 9–14 was not significant. In EES. the amplitude difference between the two sides within the first 4 days was not significantly (p>0.05) different. On days 9–14 the patients with a < 80% difference between the two sides recovered significantly (p<0.05) better than those with a difference of ⩾80%, So, TMS may be of help in the early prognosis of Bell's palsy.

Key words:

• prognostic factors
• neurophysiological testing
• VII nerve