Annals of Rehabilitation Medicine

"Electroneurography"

Original Articles

Electrodiagnosis

Prognostic Value of Electroneuronography in Severe Cases of Facial Palsy: Minwoo Woo, Doyoung Yuk, Seo Won Choi, Jongmin Lee, Hyun Haeng Lee; Ann Rehabil Med 2023;47(6):511-518. Published online November 22, 2023; DOI: https://doi.org/10.5535/arm.23082

Objective
To examine the prognostic value of electroneuronography (ENoG) in predicting functional recovery in severe cases of acute facial palsy.
Methods
Patients with severe degrees of facial palsy (initial House–Brackmann [HB] grades IV to VI) with available electrodiagnostic studies conducted 2–4 weeks after symptom onset were reviewed retrospectively. The patients were categorized into “good recovery” and “poor recovery” groups, with the former showing mild to no dysfunction (HB I to III) and the latter exhibiting moderate to severe dysfunction (HB IV to VI) on follow-up evaluation, 2 months after onset. ENoG amplitudes in four facial muscles (frontalis, nasalis, orbicularis oculi, and orbicularis oris), as well as age, sex, affected side, disease etiology, comorbidities, and laboratory findings, were compared between the two groups.
Results
Thirty-seven patients were included. Twenty-nine of the patients showed “good recovery,” and eight showed “poor recovery” at 2 months after symptom onset. Univariate analysis yielded no significant difference in age, sex, affected side, disease etiology, comorbidities, and laboratory findings between the two groups. Preserved ENoG amplitudes (individual, average, and trimmed means) were significantly higher in the good recovery group than in the poor recovery group (p<0.005). Sex (p=0.038) and the ENoG of the nasalis muscle, acquired 2–4 weeks from symptom onset (p=0.004), showed significant differences in multivariate regression analysis.
Conclusion
This study suggests that the female sex and lower ENoG of the nasalis muscle, acquired 2–4 weeks from symptom onset, have negative prognostic value for the 2-month functional outcome of severe facial palsy cases.

Citations

Citations to this article as recorded by

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Current Opinion in Otolaryngology & Head & Neck Surgery.2024; 32(4): 234. CrossRef
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Longdong Xu, Tingting Guo, Xihua Sheng, Huaping Du, Ying Tang
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Study protocol for a randomized trial comparing two electroacupuncture waveforms for different severity groups of Bell palsy
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Frontiers in Neurology.2024;[Epub] CrossRef

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Diagnostic Value of Facial Nerve Antidromic Evoked Potential in Patients With Bell's Palsy: A Preliminary Study: Ji Hoon Lee, Sun Mi Kim, Hea Eun Yang, Jang Woo Lee, Yoon Ghil Park; Ann Rehabil Med 2014;38(3):381-387. Published online June 26, 2014; DOI: https://doi.org/10.5535/arm.2014.38.3.381

Abstract
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Objective

To assess the practical diagnostic value of facial nerve antidromic evoked potential (FNAEP), we compared it with the diagnostic value of the electroneurography (ENoG) test in Bell's palsy.

Methods

In total, 20 patients with unilateral Bell's palsy were recruited. Between the 1st and 17th days after the onset of facial palsy, FNAEP and ENoG tests were conducted. The degeneration ratio and FNAEP latency difference between the affected and unaffected sides were calculated in all subjects.

Results

In all patients, FNAEP showed prolonged latencies on the affected side versus the unaffected side. The difference was statistically significant. In contrast, there was no significant difference between sides in the normal control group. In 8 of 20 patients, ENoG revealed a degeneration ratio less than 50%, but FNAEP show a difference of more than 0.295±0.599 ms, the average value of normal control group. This shows FNAEP could be a more sensitive test for Bell's palsy diagnosis than ENoG. In particular, in 10 patients tested within 7 days after onset, an abnormal ENoG finding was noted in only four of them, but FNAEP showed a significant latency difference in all patients at this early stage. Thus, FANEP was more sensitive in detecting facial nerve injury than the ENoG test (p=0.031).

Conclusion

FNAEP has some clinical value in the diagnosis of facial nerve degeneration. It is important that FNAEP be considered in patients with facial palsy at an early stage and integrated with other relevant tests.

Citations

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Stem Cells and Development.2023; 32(1-2): 1. CrossRef
Complexity-based analysis of the coupling between facial muscle and brain activities
Mirra Soundirarajan, Erfan Aghasian, Ondrej Krejcar, Hamidreza Namazi
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Yoona Cho, Hoseong Yi, Yoon Ghil Park
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