The strong relation between Yanagihara's scores and electroneurography in the acute stage of bell's palsy.

Abstract

To the Editor: In their article, “Prognostic Value of Electromyography in Acute Peripheral Facial Nerve Palsy,” Drs. Sittel and Stennert (Otol Neurotol 2001;22:100–4) showed that the presence of spontaneous fibrillation in needle electromyography is a reliable sign of an unfavorable outcome. We analyzed the relationship between Yanagihara's Score (1) and electroneurography (ENoG) in a prospective case-series review for its possible utilization in predicting the progress of recovery from acute Bell's Palsy. Twenty-five patients with sudden facial paralysis of unknown cause (Bell's Palsy) participated in this study in the department of Acupuncture & Moxibustion at Kyungsan Medical Center. Treatment consisted uniformly of acupuncture (LI4, ST2, ST4, ST6, ST36, BL2, TE17, TE23, GB14, GB20, and GV26) and herb medication (Boyangwhanho-tang). Prediction of progress in recovery was based on ENoG performed not earlier than 10 days after the onset of palsy. The findings were classified into low value ENoG and high value ENoG groups. Facial nerve function was assessed using Yanagihara's scoring system at various points of time after the onset of Bell's Palsy. From the results, the ENoG value appears to be a reliable sign of favorable outcome during the acute stage of Bell's Palsy. Throughout the investigation, the Yanagihara's scores observed the predictions based on the ENoG. A strong relationship between Yanagihara's Score and ENoG during the acute stage of Bell's Palsy was observed. Further long-term studies are needed to confirm this correlation. We hope that these few comments will bring more light to the doctors of Otology. Sang-Won Han, O.M.D. Joo-Ho Chung, M.D. Jung-Chul Seo, O.M.D.