Electrodiagnosis in Facial Palsy

Taverner, D.

doi:10.1001/archotol.1965.00750050483006

Cited by 69 publications

(19 citation statements)

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“…The CMAP latency upper limit detected in our sample (4.5 ms) is similar to the results reported by many authors 3,22,24,25 . Latency values between 6 and 8 ms as reported by Joachims et al 15 ,Gavilan et al 12 and Gavilan and Gavilan" in normal subjects were not observed in our sample.…”

Section: Discussionsupporting

confidence: 93%

Facial nerve electroneurography: variability in normal subjects

Medeiros

Nóbrega

Andrade

et al. 1996

Arq. Neuro-Psiquiatr.

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SUMMARY -Twenty normal individuals were submitted to facial nerve electroneurography using different techniques in order to determine the most accurate to obtain the latencies and amplitudes of the compound muscle action potentials (CMAP) of the facial muscles. First of all it was determined in which muscle or muscle group highest amplitude CMAP could be recorded with the lowest variability between sides and in test-retest. Different techniques were studied in order to determine which could give the best results. This was shown to be an arrangement of bipolar surface electrodes fixed to a plastic bar. The records with higher amplitude where obtained from the nasolabial fold muscles. Therefore 65 normal volunteers were examined using this technique and recording the potentials obtained over the nasolabial fold muscles. Normal values were determined (latency lower than 4.5 ms and amplitude larger than 2 mV -95% confidence limits).KEY WORDS: facial nerve, eletroneurography. Eletroneurografia do nervo facial: variabilidade em indivíduos normaisRESUMO -Vinte voluntários normais foram submetidos a eletroneurografia do nervo facial utilizando-se diferentes técnicas para a determinação da mais acurada para a obtenção das latências e amplitudes do potencial de ação muscular composto (CMAP) dos músculos faciais. Inicialmente determinou-se em qual músculo ou grupo muscular registra-se CMAP com maior amplitude e menor variabilidade entre lados e entre testes, assim como determinou-se qual técnica proporcionou melhores resultados. A que mostrou melhores resultados foi realizada com eletrodos de superfície bipolares de discos fixos em barra de plástico e os melhores registros foram obtidos nos músculos do sulco nasolabial. A seguir 65 voluntários normais foram estudados com esta técnica registrando-se os potenciais nos músculos do sulco nasolabial e foram determinados os valores normais para a latência (menor que 4,5 ms) e amplitude (acima de 2 mV). PALAVRAS-CHAVE: nervo facial, eletroneurografia.Since Desmedt's 4 description of compound muscle action potential (CMAP) in facial muscles, many electrophysiological techniques have been described aiming to establish an early prognosis for facial nerve palsy. Most of these techniques are based on comparative analysis between the CMAP obtained by the stimulation of the normal and damaged facial nerves. Another method is to compare the amplitude of the CMAP obtained by the stimulation of the damaged facial nerve with values obtained from a normal group of subjects, which is particulary helpful in patients with bilateral facial palsy. Fisch* and Esslen 7 considered that the percentage of reduction of the CMAP obtained on the paralyzed side is proportional to the number of affected nerve fibers. Many techniques have been described analyzing CMAPs of different facial muscles obtained with different stimuli and recording conditions 10,12 " 1416 "' 20 . To validate these techniques it must be assumed that normal subjects have small variability in CMAP amplitude between sides and in succ...

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Section: Discussionsupporting

confidence: 93%

Facial nerve electroneurography: variability in normal subjects

Medeiros

Nóbrega

Andrade

et al. 1996

Arq. Neuro-Psiquiatr.

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“…As shown in Table 3, the latency time of the affected side in group A patients (n = 162) fluctuated between 2.5 and 4 ms. This value was attributed to neuropraxia and a quick complete recovery of the nerve was expected [10,[16][17][18]. One-hundred and fortyeight out of the 162 patients had a complete and quick recovery of the facial nerve within 2 months from the onset, Table 4 summarizes the relationship between the results of ENOG and FNLT performed 14 days after the onset of paralysis.…”

Section: Resultsmentioning

confidence: 99%

“…The most prevalent qualitative tests now available are the nerve excitability test (NET) [3,4,12,13] and the maximum stimulation test (MST) [3,13]. The most common quantitative tests now available are ENOG or EEMG [5,6], FNLT [8,10,11,15,16,18] and electromyography [2].…”

Section: Discussionmentioning

confidence: 99%

A comparison of electroneuronography with facial nerve latency testing for prognostic accuracy in patients with Bell's palsy

Danielides

Skevas

Cauwenberge

1996

Eur Arch Otorhinolaryngol

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The purpose of this study was to evaluate the ability of electroneuronography (ENOG), also called evoked electromyography (EEMG), and facial nerve latency testing (FNLT) to assess the prognosis of facial nerve palsy, using the House-Brackmann facial nerve grading system as criterion. From 1988 to 1994 these tests were employed at the ORL Clinic of the University of Ioannina in 250 patients with idiopathic facial nerve palsy. The ENOG test results indicated that when the amplitude of the compound muscle action potentials ranged from 51% to 95% of the normal value, 97% of the patients achieved complete functional recovery (grade I) within at least 2 months. When the muscle action potential decreased to a value below 51% of normal values, prognosis for recovery was considerably worse. FNLT test results indicated that as the latency time extended, the recovery grade of the facial nerve worsened. When latency time was within the normal range (group A patients), about 92% of patients had complete functional recovery. In contrast all patients having either a very extended latency time or unable to be monitored (groups C and D) demonstrated incomplete functional recoveries that ranged from grade II to grade VI. Comparing each test with the House-Brackmann facial nerve grading system, we ascertained that the percent accuracy for ENOG was 97.6%, and that for FNLT was 94.4%.

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“…Longworth and Taverner 12 and Taverner 18 emphasized the value of the CMAP latency to predict the prognosis in Bell's palsy, but Esslen 3 " 5 and Zander Olsen 2 "' 21 demonstrated that the CMAP amplitude is the most important parameter. Our data corroborated this and is in accordance with previous reports 2 -5 " 7,1 ' 1,11 ' 13,16 -17,19 ' 21 .…”

Section: Discussionmentioning

confidence: 99%

“…The age ranged between 2 and 68 years old, average 32 and median 33 years old. The requirements for patient inclusion in the present study were: 1) Bell's palsy diagnosis according to Taverner 18 , 2) absence of previous peripheral facial palsy, 3) continuous follow-up until complete recovery or until the fourth month of palsy if recovery was not complete.…”

Section: Methodsmentioning

confidence: 99%

Facial electroneurography in Bell's palsy: variability in the early stage and comparison between interpretation methods

Medeiros

Nóbrega

Andrade

et al. 1996

Arq. Neuro-Psiquiatr.

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-To determine the variability of the abnormalities found in the electroneurography (ENG) of the facial nerve in cases of Bell's palsy during the initial two week period was one of the objectives of the authors. A second one was to investigate the value of ENG as a tool to determine an early prognosis of recovery utilizing two different methods. In the first one the amplitude of the compound muscular action potential (CMAP) obtained on the paralyzed side was compared to this potential on the opposite (normal) side. The second method compared the CMAP on the paralyzed side to normal standardized data from normal individuals. A group of 33 patients with Bell's palsy was followed until total recovery or for at least 4 months, if the recovery was not achieved earlier. It was observed that amplitude of the CMAP become stable towards the sixth day of palsy and this is a good time to establish the prognosis. Another conclusion is that both methods were equivalent to determine the prognosis in Bell's palsy.KEY WORDS: electroneurography, Bell's palsy, facial nerve.Eletroneurografia do nervo facial na paralisia de Bell: variabilidade na fase aguda e comparação entre técnicas RESUMO -O objetivo deste trabalho é determinar a variabilidade da eletroneurografia (ENG) do nervo facial na paralisia de Bell durante as primeiras duas semanas e investigar o valor da ENG na determinação de um prognóstico precoce utilizando-se dois métodos diferentes. O primeiro método compara a amplitude do potencial de ação muscular composto obtido no lado paralisado com o lado normal e o segundo método compara o potencial de ação muscular composto obtido no lado paralisado com valores normativos. Um grupo de 33 pacientes com paralisia de Bell foi seguido até a recuperação total ou pelo menos por quatro meses nos casos em que não houve recuperação. Observou-se que a amplitude do potencial de ação muscular composto estabiliza-¬ se em torno do sexto dia e que este é um bom momento para se realizar o exame e se estabelecer um prognóstico. Outra conclusão é que ambos os métodos são equivalentes para determinação prognóstica. PALAVRAS-CHAVE: eletroneurografia, paralisia de Bell, nervo facial.The pathologic process in idiopathic peripheral facial palsy stabilizes two weeks after the beginning of the illness 58 . The usual method of electroneurography (ENG) used to determine the prognosis in Bell's palsy consists of comparing the amplitude of the compound muscular action potential (CMAP) registered on the affected side with the CMAP amplitude obtained on the normal hemiface. A large difference implies a great number of nerve fibers affected and a worse prognosis.

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Electrodiagnosis in Facial Palsy

Cited by 69 publications

References 3 publications

Facial nerve electroneurography: variability in normal subjects

Facial nerve electroneurography: variability in normal subjects

A comparison of electroneuronography with facial nerve latency testing for prognostic accuracy in patients with Bell's palsy

Facial electroneurography in Bell's palsy: variability in the early stage and comparison between interpretation methods

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