Role of Electroneurography as a Prognostic Indicator for Bell’s Palsy Patients

Document Type : Original Article

Authors

1 Rheumatology & Rehabilitation department, Al Salhia Elgededa Hospital, Sharkia, Egypt

2 Professor of Rheumatology & Rehabilitation, Faculty of Medicine,Zagazig University

3 Assistant professor of Rheumatology & Rehabilitation, Faculty of Medicine,Zagazig University

4 Lecturere of Rheumatology & Rehabilitation, Faculty of Medicine,Zagazig University

Abstract

The aim of this study was to evaluate the role of electroneurography test in the prediction of outcome of patients with Bell's palsy(BP).
Methods: This Cohort study was carried out in the electrophysiological unit of Rheumatology and Rehabilitation department, at Zagazig University Hospitals on 30 adult patients with Bell's palsy. All 30 subjects were assessed clinically by sunnybrook facial nerve grading score (SBS) and electrophysiologicaly by electroneurography (ENoG) test first evaluation was done within 7th-10th day from onset, the second evaluation at 20 days and the follow up visit was at 30th to assess the clinical grading system (SBS).
Results: There was statistically highly significant increase in SBS with increase follow up time. There was statistically highly significant decrease in CMAP amplitude more than 50% difference from healthy side in both frontalis and mentalis when comparing 1st with 2nd evaluation. At one month, 20 patients (66.7%) had good recovery, while 10 patients (33.3%) had poor recovery according to the Sunnybrook scale. Multiple logistic regression analysis showed that the most significant predictive indicator of BP recovery was ENoG degeneration index. The receiver operating characteristics (ROC) curves showed ENoG degeneration index of 74.6% as a critical cutoff value of non-recovery, with the sensitivity 95% and specificity 90%.
Conclusion: This study showed that ENoG degeneration index has an important role as a significant prognostic indicator for predicting of recovery of Bell’s palsy. Sunnybrook score can be used as an additional tool in predicting non-recovery in the clinical evaluation

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