title: Choosing the best rehabilitation treatment for Bell's palsy.
abstract: BACKGROUND
  It is useful to perform neurophysiologic electromyography and electroneurography (EMG/ENG) on patients with peripheral facial palsy during the acute phase of paralysis in order to assess the severity of their nerve lesion and thus plan rehabilitation treatment and evaluate its results.
  
  
  OBJECTIVE
  To evaluate the motor recovery of patients with Bell's palsy with respect to the severity of their neurological lesion and to compare the results of two different rehabilitation treatments, with electromyographic biofeedback (EMG-BFB) and mirror visual biofeedback (mirror-BFB), in patients with Bell's palsy and neurophysiologic pattern of axonotmesis.
  
  
  METHODS
  Cohort study on retrospective clinical records.
  
  
  METHODS
  102 patients with Bell's facial palsy were clinically assessed according to the House scale both during the acute phase of paralysis and 12 months after onset.
  
  
  METHODS
  All patients underwent EMG/ENG examination 3-4 weeks after the onset of paralysis; 29 patients had an EMG pattern of neurapraxia and were not given rehabilitation treatment; 73 patients who presented with signs of denervation had an EMG pattern of axonotmesis. The group, which was homogenous in terms of lesion severity, was divided into two parts: 38 patients were treated with electromyographic biofeedback (EMG-BFB) and 35 were treated with mirror visual feedback (mirror-BFB).
  
  
  RESULTS
  All 29 patients with neurapraxia made a full spontaneous recovery; Although the 73 patients with axonotmesis received different types of rehabilitation treatment, they obtained similar results regarding quality of recovery, development of synkinesis, rehabilitation timing and resources used.
  
  
  CONCLUSIONS
  Rehabilitation treatment is not necessary for patients with neurapraxia. The two biofeedback methods used to treat patients with axonotmesis resulted in similar rehabilitation outcomes.
authors.affiliation: Rehabilitation Unit, IRCCS Policlinico, Fondazione San Matteo, University of Pavia, Pavia, Italy. elena.dallatoffola@unipv.it
authors.forename: E
authors.initials: E
authors.lastname: Dalla Toffola
authors.forename: C
authors.initials: C
authors.lastname: Tinelli
authors.forename: A
authors.initials: A
authors.lastname: Lozza
authors.forename: M
authors.initials: M
authors.lastname: Bejor
authors.forename: C
authors.initials: C
authors.lastname: Pavese
authors.forename: I
authors.initials: I
authors.lastname: Degli Agosti
authors.forename: L
authors.initials: L
authors.lastname: Petrucci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020330:Bell Palsy / Q000145:classification / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D004576:Electromyography / Q000379:methods*; D056228:Feedback, Sensory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058765:Neurofeedback / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D020127:Recovery of Function; D012720:Severity of Illness Index; D055815:Young Adult