Electroneurography value as an indicator of high risk for the development of moderate-to-severe synkinesis after Bell’s palsy and Ramsay Hunt syndrome

Abstract

Background: The degree of distress caused by the sequelae of peripheral facial nerve palsy usually depends on the severity of synkinesis.Objective: To clarify whether electroneurography (ENoG) can predict the severity of synkinesis after peripheral facial nerve palsy.Materials and methods: One-hundred and fourteen patients treated for facial nerve palsy at our hospital from April 2014–September 2016 were retrospectively reviewed. ENoG was performed 10–16 days after symptom onset. Patients were classified into Groups A (ENoG value 10%–20%, n = 9) and B (ENoG value <10%, n = 21). Eight months after symptom onset, electrophysiological and symptomatic outcomes were evaluated as the aberrant regeneration ratio of the blink reflex and the total synkinesis score of the Sunnybrook facial grading system, respectively. The outcomes of the groups were compared.Results: Group B had a significantly higher median aberrant regeneration ratio (0% versus 87%, p=.015), median total synkinesis score (1 versus 3, p < .001), and incidence of moderate-to-severe synkinesis (0% versus 57.2%, p=.003) than did Group A.Conclusions and significance: Patients with an ENoG value of <10% have higher risks of aberrant regeneration and moderate-to-severe synkinesis than those with an ENoG value of 10%–20%. Patients with ENoG values of <10% may require rehabilitation to prevent synkinesis.