| 벨마비에서 전기생리학적 검사들의 예후 예측인자로서의 가치 |
| 문덕홍, 사은희, 윤영진, 이동조, 홍성욱 |
| 부산 춘해병원 신경과 |
| Prognostic Value Elactrophysiologic Tests in Bell's Palsy |
| Duk Hong Moon, M.D., Eun Hi Sa, M.D., Young Jin Yun, M.D.,
Dong Jo Lee, M.D., Seong Uk Hong, M.D. |
| Department of neurology, Pusan Choon Hae Hospital |
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| Abstract |
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Bell's palsy is a relatively common, unilateral facial paralysis of unknown etiology. The purpose of this study was to evaluate the prognostic value of several electrophysiologic tests in Bell's palsy.
Blink reflex (BR) , side-to-side compound muscle action potential (CMAP) amplitude comparison, and side-to-side nerve excitability test (NET) threshold differ once have been studied during the first 2 weeks in 66 patients with Bell's palsy.
According to the early response of BR(Rl) , the patients were divided into 3 groups: Rl≤13ms(17cases) ; Rl>13ms(22cases), and absent BR(27cases). There was a remarkable tendency towards a satisfactory recovery from paralysis if BR occurred during the first 2 weeks from onset(p( 0.001). In patients with normal BR, 88.2% had a satisfactory recovery, when the reflex was absent a bad prognosis was given in 59.3% of the patients.
According to side-to-side CMAP amplitude comparison, the patients were divided into 2 groups; CMAP amplitude comparison≥25% (35cases), and CMAP amplitude comparison <25% (31cases) . There was a tendency towards a satisfactory recovery from paralysis if side-to-side CMAP amplitude comparison was more than 25% (p < 0,003). In patients with more than 25% of CMAP amplitude comparison, 82.9% of the patients had a satisfactory recovery, but in patients with less than 25% of CMAP amplitude comparison, 51.6% of the patients had a bad prognosis.
According to side-to-side NET threshold difference, the patients were divided into 2 groups, NET threshold difference≤3.5mA(43cases) , and NET threshold difference >3.5mA (23cases) . When the threshold of electrical excitability on both sides differs 3.5mA or more an unsatisfactory recovery has strongly to expected(p < 0.001). In patients with less than 3.5mA of NET threshold, 81.4% had a satisfactory recovery, but in patients with more than 3.5mA of NET threshold, 60.9% had a bad prognosis.
BR, side-to-side CMAP amplitude comparison, and side-to-side NET threshold difference seem to be useful independent indices for predicting the prognosis an early stage of the paralysis.
Key Words : Electrophysiologic Tests, Prognosis of Bell's palsy |
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