The Value of Prognostic Clinical Data in Bell's Palsy

Overview

Journal Braz J Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2006 Feb 1

PMID 16446959

Citations 4

Authors

Cristiane A Kasse

Oswaldo Laercio M Cruz

Fernando D Leonhardt

Jose Ricardo G Testa

Ricardo G Ferri

Erika Y Viertler

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Electroneurography (ENoG) and clinical staging are currently the methods of choice to indicate prognosis in Bell's palsy, although ENoG is an electrophysiological test not universally available.

Aim: Identify other options of prognostic evaluation based upon clinical aspects and minimal electrical stimulation test allowing prognostic measurement in almost any circumstances.

Study Design: Historic cohort.

Material And Method: Chart review of 1,521 cases of IPFP, analyzing the following clinical aspects: gender, age, paralyzed side, installation mode, previous symptoms, associated symptoms and minimal electrical stimulation test (Hilger test) and its statistical correlation to facial palsy evolution after 6 months.

Results: Data indicated that patients above 60 years old had worse prognosis in comparison with patients under 30 years old. A progressive mode of paralysis installation, absence of previous symptoms, concomitant vertigo and response superior to 3.5 mA at minimum electrical stimulation test were also related to worse prognosis. On the other hand, the absence of concomitant symptoms, diminished tearing and sudden onset were related to better prognosis.

Conclusion: Clinical factors and Hilger's test can accurately indicate the prognosis in cases of Bell's palsy when ENoG is not available.

Citing Articles

Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy.

Song K, Chang S, Lee J, Shin S, Lee H J Audiol Otol. 2018; 22(3):148-153.

PMID: 29656635 PMC: 6103497. DOI: 10.7874/jao.2017.00374.

Facial Nerve Laceration and its Repair.

Shafaiee Y, Shahbazzadegan B Trauma Mon. 2016; 21(2):e22066.

PMID: 27626005 PMC: 5003502. DOI: 10.5812/traumamon.22066.

Modern management of facial palsy: a review of current literature.

Stew B, Williams H Br J Gen Pract. 2013; 63(607):109-10.

PMID: 23561689 PMC: 3553607. DOI: 10.3399/bjgp13X663262.

Management of peripheral facial nerve palsy.

Finsterer J Eur Arch Otorhinolaryngol. 2008; 265(7):743-52.

PMID: 18368417 PMC: 2440925. DOI: 10.1007/s00405-008-0646-4.

References

Yanagihara N, Mori H, Kozawa T, Nakamura K, Kita M . Bell's palsy. Nonrecurrent v recurrent and unilateral v bilateral. Arch Otolaryngol. 1984; 110(6):374-7. DOI: 10.1001/archotol.1984.00800320028006. View

Furuta Y, Fukuda S, Chida E, Takasu T, OHTANI F, INUYAMA Y . Reactivation of herpes simplex virus type 1 in patients with Bell's palsy. J Med Virol. 1998; 54(3):162-6. DOI: 10.1002/(sici)1096-9071(199803)54:3<162::aid-jmv3>3.0.co;2-3. View

LEIBOWITZ U . Bell's palsy--two disease entities?. Neurology. 1966; 16(11):1105-9. DOI: 10.1212/wnl.16.11.1105. View

Devriese P, Schumacher T, Scheide A, de Jongh R, Houtkooper J . Incidence, prognosis and recovery of Bell's palsy. A survey of about 1000 patients (1974-1983). Clin Otolaryngol Allied Sci. 1990; 15(1):15-27. DOI: 10.1111/j.1365-2273.1990.tb00427.x. View

Smith I, Heath J, Murray J, Cull R . Idiopathic facial (Bell's) palsy: a clinical survey of prognostic factors. Clin Otolaryngol Allied Sci. 1988; 13(1):17-23. DOI: 10.1111/j.1365-2273.1988.tb00276.x. View

Campbell E, HICKEY R, NIXON K, Richardson A . Value of nerve-excitability measurements in prognosis of facial palsy. Br Med J. 1962; 2(5296):7-10. PMC: 1925552. DOI: 10.1136/bmj.2.5296.7. View

Hauser W, KARNES W, Annis J, Kurland L . Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. Mayo Clin Proc. 1971; 46(4):258-64. View

Adour K, Byl F, Hilsinger Jr R, Kahn Z, Sheldon M . The true nature of Bell's palsy: analysis of 1,000 consecutive patients. Laryngoscope. 1978; 88(5):787-801. DOI: 10.1002/lary.1978.88.5.787. View

LAUMANS E, Jongkees L . ON THE PROGNOSIS OF PERIPHERAL FACIAL PARALYSIS OF ENDOTEMPORAL ORIGIN. Ann Otol Rhinol Laryngol. 1963; 72:621-36. DOI: 10.1177/000348946307200303. View

10.

Katusic S, Beard C, Wiederholt W, Bergstralh E, Kurland L . Incidence, clinical features, and prognosis in Bell's palsy, Rochester, Minnesota, 1968-1982. Ann Neurol. 1986; 20(5):622-7. DOI: 10.1002/ana.410200511. View

11.

LEWIS B, Adour K, Kahn J, Lewis A . Hilger facial nerve stimulator: a 25-year update. Laryngoscope. 1991; 101(1 Pt 1):71-4. DOI: 10.1288/00005537-199101000-00013. View

12.

House J, Brackmann D . Facial nerve grading system. Otolaryngol Head Neck Surg. 1985; 93(2):146-7. DOI: 10.1177/019459988509300202. View

13.

GREGG G . Some observations on Bell's palsy in Belfast during the period 1949 to 1958. Arch Phys Med Rehabil. 1961; 42:602-8. View

14.

Danielidis V, Skevas A, Van Cauwenberge P, Vinck B . A comparative study of age and degree of facial nerve recovery in patients with Bell's palsy. Eur Arch Otorhinolaryngol. 2000; 256(10):520-2. DOI: 10.1007/s004050050203. View

15.

HILGER J . FACIAL NERVE STIMULATOR. Trans Am Acad Ophthalmol Otolaryngol. 1964; 68:74-6. View