Background The annual incidence of Bell’s palsy (BP) is 15 to 20 per 100,000 with 40,000 new cases each year, and the lifetime risk is 1 in 60. For decades, clinicians have searched the prognostic tests of sufficient accuracy for acute facial paralysis. Objective The present study was designed to verify in BP which clinical or electrophysiological parameters could be considered as predictive of the degree of recovery of normal facial muscle function. Methods Sixty-three patients with BP were initially assessed according to the House and Brackmann facial function scoring system “HB system”. All patients were followed for 3 months, the functional recovery then reassessed according to HB system. Nerve conduction studies were measured on the affected side via a bipolar surface stimulator placed over the stylomastoid foramen. Results We could not find statistically significant differences between BP with good and poor prognosis as regard age, sex, onset, diabetes, hypertension, dyslipidemia, or the initial HB Score. Compound motor action potential amplitude (CMAP) detected during the initial electroneurography (ENoG) was statistically significant between BP with good and poor prognosis. Conclusions The initial ENoG is more predictive of recovery of Bell’s palsy than the initial clinical grading using the HB system. Age, sex, hypertension, diabetes, and dyslipidemia do not seem to correlate with the degree of recovery in Bell’s palsy.

中文翻译：

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贝尔麻痹：恢复的临床和神经生理学预测因素

背景贝尔麻痹 (BP) 的年发病率为每 100,000 人中 15 至 20 人，每年新增病例 40,000 人，终生风险为六分之一。几十年来，临床医生一直在寻找足够准确的急性面瘫预后测试。目的本研究旨在验证在 BP 中哪些临床或电生理参数可被视为预测正常面部肌肉功能恢复的程度。方法对63例BP患者采用House和Brackmann面部功能评分系统“HB系统”进行初步评估。所有患者均随访3个月，然后根据HB系统重新评估功能恢复情况。通过放置在茎乳孔上的双极表面刺激器在患侧测量神经传导研究。结果 我们无法发现 BP 在年龄、性别、发病、糖尿病、高血压、血脂异常或初始 HB 评分方面具有良好和不良预后的 BP 之间存在统计学显着差异。在初始神经电图 (ENoG) 期间检测到的复合运动动作电位幅度 (CMAP) 在具有良好和不良预后的 BP 之间具有统计学意义。结论 初始 ENoG 比使用 HB 系统的初始临床分级更能预测贝尔麻痹的恢复。年龄、性别、高血压、糖尿病和血脂异常似乎与贝尔麻痹的恢复程度无关。在初始神经电图 (ENoG) 期间检测到的复合运动动作电位幅度 (CMAP) 在具有良好和不良预后的 BP 之间具有统计学意义。结论 初始 ENoG 比使用 HB 系统的初始临床分级更能预测贝尔麻痹的恢复。年龄、性别、高血压、糖尿病和血脂异常似乎与贝尔麻痹的恢复程度无关。在初始神经电图 (ENoG) 期间检测到的复合运动动作电位幅度 (CMAP) 在具有良好和不良预后的 BP 之间具有统计学意义。结论 初始 ENoG 比使用 HB 系统的初始临床分级更能预测贝尔麻痹的恢复。年龄、性别、高血压、糖尿病和血脂异常似乎与贝尔麻痹的恢复程度无关。