Electrodiagnosis and recovery of facial paralysis at King Chulalongkorn Memorial Hospital.
OBJECTIVE
To study electrodiagnostic findings and recovery patterns of patients with facial nerve paralysis.


METHODS
Seventy-six medical records of patients who had a facial paralysis and had their electrodiagnosis performed in a 2-year period were reviewed. Patients were invited for re-evaluation. The patients would be evaluated according to House-Brackmann Facial Nerve Grading Scale (HBFNGS), residual impairment, disability, emotional and social consequences.


RESULTS
Complete data were obtained from 50 patients whose mean age was 47.0 +/- 17.9 years. Seventy-two percent were diagnosed as Bell's palsy. There was significant correlation between %CMAP amplitude and HBFNGS (grade I-VI) at r = 0.5; p < 0.01. All cases of Bell's palsy with CMAP amplitude > or = 70% of normal side regained full recovery. Patients with CMAP amplitude > or = 30% had good recovery. Bell's palsy with CMAP amplitude < 10% and with other causes had poor outcome. Nine patients had synkinesis. Most of them were of traumatic cause and had severe nerve degeneration. No evidence showed that electrical stimulation was a factor inducing synkinesis.


CONCLUSIONS
Percent CMAP amplitude could moderately predict the outcome of Bell's palsy better than other causes of facial palsy. The paralysis from traumatic cause with low %CMAP amplitude had more chance to develop synkinesis.
Department of Rehabilitation Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand. Wkitisom@mail.med.cmu.ac.th
Wasuwat
W
Kitisomprayoonkul
Puangpet
P
Sirileartthananon
Dootchai
D
Chaiwanichsiri
D000200:Action Potentials; D003430:Cross-Sectional Studies; D004568:Electrodiagnosis; D005155:Facial Nerve Diseases; D005158:Facial Paralysis / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012008:Recurrence; D012307:Risk Factors; D046608:Synkinesis; D013785:Thailand; D017211:Treatment Failure; D016896:Treatment Outcome