title: Outcomes of Neonatal Bulbar Weakness.
abstract: OBJECTIVE
  Neonatal bulbar weakness (BW) has various etiologies and a broad prognostic range. We aimed to report outcomes in a large series of children with neonatal BW and explore the association of orofacial electrodiagnostic data with outcome.
  
  
  METHODS
  We retrospectively reviewed the files of children who presented with facial, lingual, laryngeal, or pharyngeal weakness at birth and who underwent electrodiagnostic studies combining conventional needle electromyography (EMG) of orofacial muscles, blink responses, and EMG during bottle-feeding. Outcome measures included the need for prolonged respiratory assistance and enteral feeding, as well as sensorimotor and cognitive impairments.
  
  
  RESULTS
  Of 175 patients, 73% had developmental disorders, 25% suffered from acquired brain damage, and 2% had no apparent underlying disorders. Motor or mental impairment was observed in 71%; death occurred in 16%. Outcomes were not significantly different when comparing developmental disorders versus acquired brain damage or neurogenic versus normal detection EMG. Abnormal blink responses were associated with higher frequencies of respiratory assistance (P = .03), gastrostomy (P = .025), and death (P = .009); moderate or severe oropharyngeal incoordinations were associated with higher frequencies of respiratory assistance (P = .006), prolonged enteral feeding (P < .0001), and gastrostomy (P = .0002).
  
  
  CONCLUSIONS
  Orofacial electrodiagnostic studies provide supplementary information to help the pediatrician anticipate the management and prognosis of young infants with BW.
authors.affiliation: Faculté de Médecine Pierre et Marie Curie, Université Paris 6, Paris, France;
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Baudon
authors.affiliation: Clinical Neurophysiology Unit, Hôpital Armand-Trousseau, Assistance Publique - Hôpitaux de Paris, Paris, France; docteur.frenault@wanadoo.fr.
authors.forename: Francis
authors.initials: F
authors.lastname: Renault
authors.affiliation: Clinical Neurophysiology Unit, Hôpital Armand-Trousseau, Assistance Publique - Hôpitaux de Paris, Paris, France; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru;
authors.forename: Roberto
authors.initials: R
authors.lastname: Flores-Guevara
authors.affiliation: Faculté de Médecine René Descartes, Université Paris 5, Paris, France; and Department of Maxillofacial Surgery, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Vazquez
mesh_terms: D010244:Bulbar Palsy, Progressive / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome