Value of Nerve-excitability Measurements in Prognosis of Facial Palsy

Campbell, E. D. R.; Hickey, R. P.; Nixon, Kezia; Richardson, A. T.

doi:10.1136/bmj.2.5296.7

Cited by 94 publications

(20 citation statements)

References 3 publications

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“…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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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 patients with biphasic waves throughout the 7 days after onset of paralysis had good outcomes, but those with monophasic or flat waves within 1 week had poor outcomes. According to previous studies [21][22][23][24] , abnormal findings in conventional tests, such as the nerve excitability test and electroneurography, appear more than 7 days after the onset of paralysis. Therefore, we considered that the AFNR was more useful for the early evaluation of nerve degeneration in patients with Bell's palsy than the conventional tests.…”

Section: Discussionmentioning

confidence: 99%

Early Assessment of Nerve Degeneration Using the Antidromic Facial Nerve Response

Nakatani

Iwai

Hamada

et al. 2009

ORL

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Conclusion: The antidromic facial nerve response (AFNR) is recommended as a monitoring method to detect cases resulting in facial nerve degeneration within 1 week after onset in patients with Bell’s palsy and Hunt syndrome. Objectives: The purpose of this study was to establish criteria for the AFNR to predict the prognosis of Bell’s palsy and Hunt syndrome in the early stages, not exceeding 1 week after onset. Materials and Methods: 54 patients, including 40 with Bell’s palsy and 14 with Hunt syndrome, were examined in this study. All patients were tested for the AFNR within 1 week after onset of paralysis and AFNR waveforms were analyzed. Four AFNR parameters, the total (peak-to-peak) amplitude (T-amp), the amplitudes of the positive wave (P-amp) and the negative wave (N-amp), and the N-amp/T-amp (N/T) ratio, were compared with the outcomes of facial paralysis. Results:In most patients with poor outcomes, T-amp was <4 µV and N-amp was <2 µV. The mean value of the N/T ratio in patients with a poor outcome fell to <0.4 after the 3rd day from onset, while that in patients with a good outcome was stable between 0.4 and 0.6 during the first week.

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“…Facial nerve paresis including Bell's palsy and Ramsey‐Hunt syndrome appears suddenly in healthy individuals. Although remission is often focused by conservative treatment (Campbell, Hickey, Nixon, & Richardson, ), in some cases, persists paresis adversely reduced the quality of life. In these cases, the pathological mechanism involves the attenuation of central‐nervous‐system motor‐nerve signals rather than organic damage to the facial nerves or mimetic muscles.…”

Section: Introductionmentioning

confidence: 99%

Axonal supercharged interpositional jump‐graft with a hybrid artificial nerve conduit containing adipose‐derived stem cells in facial nerve paresis rat model

et al. 2018

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Purpose Interpositional jump‐graft (IPJG) technique with the hypoglossal nerve for supercharging can be applied in a facial nerve paresis case. In IPJG, an autologous nerve is required, and the donor site morbidity is unavoidable. Biodegradable nerve conduits are made from polyglycolic acid (PGA) and used recently without donor site complications after providing autologous grafts. Hybrid artificial nerve conduits with adipose‐derived stem cells (ASCs) also attract attention as a nerve‐regeneration enhancing agent. This study examined the effect of hybrid artificial nerve conduit on IPJG. Materials and methods A total of 34 Lewis rats were used and divided into 4 groups by the bridge materials: autograft (n = 8), PGA nerve conduit (n = 8), hybrid PGA nerve conduit with ASCs (n = 8), and the nontreated control groups (n = 8). ASCs were collected from 2 rats and cultured. The animals were assessed physiologically and histopathologically at 13 weeks after surgery. Results In compound muscle action potential, the amplitude of hybrid PGA group (3,222 ± 1,779 μV) was significantly higher than that of PGA group (1,961 ± 445 μV, P < .05), and no significant difference between hybrid PGA and autograft group. All treated groups showed a myelinated nerve regeneration with double innervation in hypoglossal and facial nerve nuclei for vibrissal muscle. Conclusion This study showed the effectiveness of IPJG with a hybrid PGA conduit especially in physiological examination.

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Value of Nerve-excitability Measurements in Prognosis of Facial Palsy

Cited by 94 publications

References 3 publications

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

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

Early Assessment of Nerve Degeneration Using the Antidromic Facial Nerve Response

Axonal supercharged interpositional jump‐graft with a hybrid artificial nerve conduit containing adipose‐derived stem cells in facial nerve paresis rat model

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