title: Comparison of Transcranial Magnetic Stimulation and Electroneuronography Between Bell's Palsy and Ramsay Hunt Syndrome in Their Acute Stages.
abstract: OBJECTIVE
  To examine the neurophysiologic status in patients with idiopathic facial nerve palsy (Bell's palsy) and Ramsay Hunt syndrome (herpes zoster oticus) within 7 days from onset of symptoms, by comparing the amplitude of compound muscle action potentials (CMAP) of facial muscles in electroneuronography (ENoG) and transcranial magnetic stimulation (TMS).
  
  
  METHODS
  The facial nerve conduction study using ENoG and TMS was performed in 42 patients with Bell's palsy and 14 patients with Ramsay Hunt syndrome within 7 days from onset of symptoms. Denervation ratio was calculated as CMAP amplitude evoked by ENoG or TMS on the affected side as percentage of the amplitudes on the healthy side. The severity of the facial palsy was graded according to House-Brackmann facial grading scale (H-B FGS).
  
  
  RESULTS
  In all subjects, the denervation ratio in TMS (71.53±18.38%) was significantly greater than the denervation ratio in ENoG (41.95±21.59%). The difference of denervation ratio between ENoG and TMS was significantly smaller in patients with Ramsay Hunt syndrome than in patients with Bell's palsy. The denervation ratio of ENoG or TMS did not correlated significantly with the H-B FGS.
  
  
  CONCLUSIONS
  In the electrophysiologic study for evaluation in patients with facial palsy within 7 days from onset of symptoms, ENoG and TMS are useful in gaining additional information about the neurophysiologic status of the facial nerve and may help to evaluate prognosis and set management plan.
authors.affiliation: Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Dong Min
authors.initials: DM
authors.lastname: Hur
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Lee
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Jung Mi
authors.initials: JM
authors.lastname: Park
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Sang Yeol
authors.initials: SY
authors.lastname: Yong
authors.forename: Jong Mock
authors.initials: JM
authors.lastname: Shinn
authors.forename: Kyung Joon
authors.initials: KJ
authors.lastname: Oh
keywords: Bell palsy; Herpes zoster oticus; Prognosis; Transcranial magnetic stimulation