Time course of Bell palsy
W. W. Qiu, S. S. Yin, F. J. Stucker, R. F. Aarstad and H. H. Nguyen
Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Medical Center, Shreveport, USA.
This study was designed to quantitatively characterize the time course of
facial palsy and the relationship between electroneurography and the facial
nerve grading percentage as a function of onset time. Bilateral
electroneurographic recordings during different stages in the course of the
disease were repeated and compared with categorized videotaped facial
movements using the House-Brackmann facial nerve grading system in 32
patients with Bell palsy. Preliminary results of this study demonstrate a
time gap between the percentage of electroneurographic response and the
category of the facial nerve grading system during the same period of
disease progress. A theoretical model of the time course and specific
patterns regarding the recovery of facial function is established. The
theoretical time course of facial palsy is divided into 3 stages;
preclinical, clinical, and postclinical. Based on the time course of
electroneurographic and facial grading functions, the period between 10 and
14 days after onset was found to be most valuable for prediction of
recovery. According to this theoretical model, a given time course pattern
based on the results of serial electroneurographic recordings provides
reliable prognostic information on recovery from Bell palsy.
