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

Medeiros, Jovany Luis Alves de; Nóbrega, J.A.M.; Andrade, Luiz Augusto Franco de; Novo, Neil Ferreira

doi:10.1590/s0004-282x1996000300006

Cited by 7 publications

(6 citation statements)

References 11 publications

(12 reference statements)

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“…Isto foi demonstrado em 8 de 11 pacientes examinados por Engstrom e col. 29 . O estudo neurofisiológico completo pode estabelecer um prognósti-co; após o quinto dia, degeneração axonal está relacionado à recuperação incompleta 30 .…”

Section: Discussionunclassified

Paralisia facial periférica idiopática de Bell: a propósito de 180 pacientes

Valênça

Andrade-Valença

Lima

2001

Arq. Neuro-Psiquiatr.

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RESUMO -O objetivo deste estudo foi analisar aspectos clínicos, epidemiológicos e evolutivos da paralisia facial periférica idiopática em 180 pacientes. Houve ligeiro predomínio do sexo feminino (66,7%). Quanto à faixa etária mais acometida, foram observados dois picos de incidência um nas terceira e quarta décadas, e o outro na sexta década de vida. Nos 180 pacientes houve 198 episódios de paralisia facial periférica, sendo 17 recorrências e em um paciente a paralisia foi de instalação inicial bilateral. Em 15 pacientes (8,3%) houve recidiva da paralisia facial, em dois casos a paralisia se repetindo por mais duas vezes. Em 12 casos (70,6%) a recidiva ocorreu no mesmo lado da paralisia anterior. O lado esquerdo da face estava envolvido em 55,6% dos casos. Em oito pacientes a paralisia aconteceu na gestação (n=5) ou no pós-parto (n=3). Quatro das pacientes grávidas apresentaram paralisia de Bell no terceiro trimestre. Uma paciente com 18 anos de idade desenvolveu paralisia facial do lado direito no sétimo mês da gravidez, havendo recidiva da paralisia no mesmo lado aos 23 anos de idade, no 15º dia pós-parto. Como condicões associadas encontramos hipertensão arterial sistêmica (11,7%), diabete mélito (11,1%), gravidez ou pós-parto imediato (4,4%; 6,7% nas mulheres) e neurocisticercose (1,1%). Em 72,8% dos casos não encontramos associação com outras afecções. Em 22,8% dos pacientes observou-se uma das seguintes sequelas: espasmo hemifacial (12,8%), recuperação parcial do déficit motor (10,6%), síndrome das lágrimas do crocodilo (3,3%), contrações sincinéticas (2,8%), lacrimejamento (1,1%) e fenômeno de Marcus Gunn invertido (1,1%). Concluíndo, no estudo foi demonstrado que a paralisia facial periférica idiopática pode provocar sequelas importantes, cosméticas ou funcionais, em mais de 20% dos pacientes.PALAVRAS-CHAVE: paralisia facial periférica, hipertensão arterial, diabete mélito, gravidez, sequela. Idiopathic facial paralysis (Bell´s palsy): a study of 180 patientsAbstract -The objective of this study was to analyze some clinical and epidemiologic aspects, as well as the follow up of 180 patients with Bell´s palsy. In the study population there was a predominance of female (66.7%). Two peaks of incidence in the age distribution were identified: third-fourth and sixth decades of life. In the group of 180 patients there were 198 events of facial paralysis, 17 recurrences and in one patient the paralysis was bilateral at the onset. In 15 patients (8.3%) there were recurrences of the facial paralysis, in 12 cases (70.6%) the recurrences were ipsilateral. The left side of the face was involved in 55.6% of the cases. In eight patients the paralysis ocurred during pregnancy (n=5) or puerperium (n=3). As associated conditions we found: arterial hypertension (11.7%), diabetes mellitus (11.1%), pregnancy or puerperium (4.4%; 6.7% in the women), and neurocysticercosis (1.1%). In 72.8% of the cases no association with such conditions was found. In 22.8% of the patients some kind of sequelae were identified: hemifacial spa...

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Section: Discussionunclassified

Paralisia facial periférica idiopática de Bell: a propósito de 180 pacientes

Valênça

Andrade-Valença

Lima

2001

Arq. Neuro-Psiquiatr.

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“…Therefore, nerve conduction study has value in determining the prognosis rather than the diagnosis in Bell palsy. [6] Compared to the nerve conduction study, the blink reflex is abnormal even at a relatively early stage and more sensitive in revealing facial nerve abnormality. [7] When treating patients with acute facial nerve palsy, imaging tests are not performed on all patients due to the low frequency of severe neurological disorders.…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced MRI findings of patients with acute Bell palsy within 7 days of symptom onset: A retrospective study

Seok,

Park,

Park

et al. 2023

Medicine

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The brain magnetic resonance imaging (MRI) findings seen in patients with Bell palsy are abnormal contrast enhancement of affected facial nerves. Previous studies were conducted on a few patients, mainly those who had experienced palsy for several weeks. This study investigated the diagnostic usefulness of MRI by examining MRI findings of acute Bell palsy (within 7 days of symptom onset) in a large cohort. Among the patients with Bell palsy (idiopathic unilateral facial palsy) who visited the hospital, 123 patients who underwent contrast-enhanced MRI of the internal auditory canal within 7 days of symptom onset were reviewed retrospectively. MRI examination results were investigated along with the patient’s clinical symptoms and electrodiagnostic test results. Based on the MRI results, the frequency of abnormal contrast enhancement and contrast-enhanced areas were investigated. Of the 123 patients, 13 (11%) had normal brain MRI results, and 110 (89%) had abnormal findings. The frequency of abnormal contrast enhancement was not significantly associated with test timing (P = .56). Of the 110 patients with abnormal findings, 65 (59%) showed contrast enhancement in the labyrinthine segment and 36 (33%) in both the labyrinthine segment and geniculate ganglion. Most patients with Bell palsy who are in the acute phase showed abnormal contrast enhancement in their facial nerves, and similar findings were even observed in the examination conducted on the day of symptom onset. Brain MRI helps in the diagnosis of acute Bell palsy.

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“…Compound motor action potential (CMAP) is a quantitative measure of innervation and is derived from the summation of local muscle fiber's action potentials . CMAP is routinely used in the workup of many neuropathies, including facial nerve injuries, brachial plexus lesions, and spinal cord injuries . Laryngeal CMAP amplitude has been shown in animal models to quantitatively measure vocal fold innervation in both the physiologic and injured states .…”

Section: Introductionmentioning

confidence: 99%