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ABSTRACT: Objective
Owing to a lack of prospective studies, our aim was to evaluate diagnostic factors, in particular, motor and non-motor function tests, for prognostication of recovery time in patients with acute facial palsy (AFP).Design
Prospective cohort study.Setting
University hospital.Participants
259 patients with AFP.Measurements
Clinical data, facial grading, electrophysiological motor function tests and other non-motor function tests were assessed for their contribution to recovery time.Results
The predominant origin of AFP was idiopathic (59%) and traumatic (21%). At baseline, the House-Brackmann scale (HB) was >III in 46% of patients. Follow-up time was 5.6±9.8 months with a complete recovery rate of 49%. The median recovery time was 3.5 months (95% CI 2.2 to 4.7 months). The following variables were associated with faster recovery: Interval between onset of AFP and treatment <6 days versus ?6 days (median recovery time in months 2.1 vs 6.5; p<0.0001); HB ?III vs >III (2.2 vs 4.6; p=0.001); no versus presence of pathological spontaneous activity in first electromyography (EMG; 2.8 vs probability of recovery <50%; p<0.0001); no versus voluntary activity in EMG (probability of recovery <50% vs 3.1; p<0.0001); normal versus pathological ipsilateral electroneurography (1.9 vs 6.5; p=0.008), normal versus pathological stapedius reflexes (1.6 vs 3.3; p=0.003).Conclusions
Start of treatment and grading, but most importantly EMG evaluated for pathological spontaneous activity and the stapedius reflex test are powerful prognosticators for estimating the recovery time from AFP. These results need confirmation in larger datasets.
SUBMITTER: Volk GF
PROVIDER: S-EPMC3669721 | biostudies-literature | 2013 Jun
REPOSITORIES: biostudies-literature
Volk Gerd Fabian GF Klingner Carsten C Finkensieper Mira M Witte Otto W OW Guntinas-Lichius Orlando O
BMJ open 20130620 6
<h4>Objective</h4>Owing to a lack of prospective studies, our aim was to evaluate diagnostic factors, in particular, motor and non-motor function tests, for prognostication of recovery time in patients with acute facial palsy (AFP).<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>University hospital.<h4>Participants</h4>259 patients with AFP.<h4>Measurements</h4>Clinical data, facial grading, electrophysiological motor function tests and other non-motor function tests were assessed for th ...[more]