scholarly journals Facial Palsy: A Retrospective Study of 416 Cases Based on Electrodiagnostic Consultation

2020 ◽  
Vol 14 (1) ◽  
pp. 15-24
Author(s):  
Vanessa F.M. Ferreira ◽  
Carla R. Graça ◽  
João A. Kouyoumdjian
Keyword(s):  
Facial Nerve ◽  
Action Potentials ◽  
Blink Reflex ◽  
Good Prognosis ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Compound Muscle Action Potentials ◽  
Axon Loss ◽  
The Mean ◽  
Prognosis Indicator

Background: Facial nerve palsy (FP) is a frequent neurological condition caused mostly by Bell´s Palsy (BP). Objectives: The main objective of this study is to describe electrophysiological parameters in a retrospective 28-year review of 416 cases of FP based on electrodiagnostic consultation. Methods: In total, 520 exams from 416 patients over a 28-year period were reviewed. Sex, age, etiology, comorbidities, and variables from electroneurography and needle electromyography were analyzed. Cases were grouped as BP (70.7%), injury (16.4%), iatrogenic (10.3%) and Ramsay Hunt syndrome (RHS) (2.6%). Results: The mean age was 41 years (3-82), 53.4% female. Diabetes was the most frequent comorbidity. Estimated Axon Loss (EAL), >90%, was found in 50% of the cases, mainly in the iatrogenic group. The amplitude drop of the Compound Muscle Action Potentials (CMAPs) was proportional in the Orbicularis Oculi, Orbicularis Oris and Nasalis muscles. The absence of CMAPs was more frequent in the iatrogenic group and less frequent in the BP one. Bell´s palsy associated with diabetes was more severe. The R1 latency (blink reflex) was significantly longer in the BP group (P>0.001). Synkinesis due to the misdirection of regenerating axons was much more frequent in the BP and RHS groups. Conclusion: Bell´s palsy was the most common cause. The EAL was equal in all facial branches. Facial nerve inexcitability was more frequent in the iatrogenic/injury groups. The R1 latency was found to be prolonged in the BP group and the only good prognosis indicator in a few cases. Misdirection reinnervation was more frequent in BP and RHS groups. There was no sex or side predominance.

scholarly journals Conduction velocity of the rabbit facial nerve: a noninvasive functional evaluation

2003 ◽  
Vol 17 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Belmiro Cavalcanti do Egito Vasconcelos ◽  
Cosme Gay Escoda ◽  
Ricardo José de Holanda Vasconcellos ◽  
Riedel Frota Sá Nogueira Neves
Keyword(s):  
Facial Nerve ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Action Potentials ◽  
Functional Evaluation ◽  
Surface Electrodes ◽  
Nerve Grafts ◽  
Synthetic Materials ◽  
Facial Nerves ◽  
The Mean

The aim of this study was to evaluate standardized conduction velocity data for uninjured facial nerve and facial nerve repaired with autologous graft nerves and synthetic materials. An evaluation was made measuring the preoperative differences in the facial nerve conduction velocities on either side, and ascertaining the existence of a positive correlation between facial nerve conduction velocity and the number of axons regenerated postoperatively. In 17 rabbits, bilateral facial nerve motor action potentials were recorded pre- and postoperatively. The stimulation surface electrodes were placed on the auricular pavilion (facial nerve trunk) and the recording surface electrodes were placed on the quadratus labii inferior muscle. The facial nerves were isolated, transected and separated 10 mm apart. The gap between the two nerve ends was repaired with autologous nerve grafts and PTFE-e (polytetrafluoroethylene) or collagen tubes. The mean of maximal conduction velocity of the facial nerve was 41.10 m/s. After 15 days no nerve conduction was evoked in the evaluated group. For the period of 2 and 4 months the mean conduction velocity was approximately 50% of the normal value in the subgroups assessed. A significant correlation was observed between the conduction velocity and the number of regenerated axons. Noninvasive functional evaluation with surface electrodes can be useful for stimulating and recording muscle action potentials and for assessing the functional state of the facial nerve.

scholarly journals Facial nerve electroneurography: variability in normal subjects

1996 ◽  
Vol 54 (3) ◽  
pp. 393-396 ◽  
Author(s):  
Jovany Luis Alves de Medeiros ◽  
João Antonio Maciel Nobrega ◽  
Luiz Augusto Franco de Andrade ◽  
Yara Juliano
Keyword(s):  
Facial Nerve ◽  
Action Potentials ◽  
Normal Values ◽  
Normal Subjects ◽  
Nasolabial Fold ◽  
Confidence Limits ◽  
Muscle Action ◽  
Surface Electrodes ◽  
Normal Individuals ◽  
Compound Muscle Action Potentials

Twenty normal individuals were submitted to facial nerve electroneurography using different techniques in order to determine the most accurate to obtain the latencies and amplitudes of the compound muscle action potentials (CMAP) of the facial muscles. First of all it was determined in which muscle or muscle group highest amplitude CMAP could be recorded with the lowest variability between sides and in test-retest. Different techniques were studied in order to determine which could give the best results. This was shown to be an arrangement of bipolar surface electrodes fixed to a plastic bar. The records with higher amplitude where obtained from the nasolabial fold muscles. Therefore 65 normal volunteers were examined using this technique and recording the potentials obtained over the nasolabial fold muscles. Normal values were determined (latency lower than 4.5 ms and amplitude larger than 2 mV - 95% confidence limits).

Prognostic value of the blink reflex test in Bell’s palsy and Ramsay-Hunt syndrome

2018 ◽  
Vol 45 (5) ◽  
pp. 966-970 ◽  
Author(s):  
Young Min Hah ◽  
Sang Hoon Kim ◽  
Junyang Jung ◽  
Sung Su Kim ◽  
Jae Yong Byun ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Blink Reflex ◽  
Bell’S Palsy ◽  
Bell's Palsy ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Blink Reflex Test

scholarly journals Facial Nerve Schwannomas Mimicking as Vestibular Schwannomas

2017 ◽  
Vol 78 (04) ◽  
pp. 283-287
Author(s):  
Sean Wise ◽  
David Cohen ◽  
Jason Bell ◽  
Dennis Bojrab ◽  
Michael LaRouere ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Outcome Measures ◽  
Action Potentials ◽  
Internal Auditory Canal ◽  
Vestibular Schwannomas ◽  
Tumor Capsule ◽  
Spontaneous Action ◽  
The Mean ◽  
Spontaneous Action Potentials ◽  
Stimulation Of

Objective The objective of this study was to identify preoperative and intraoperative findings that may aid in distinguishing facial nerve schwannomas (FNS) from vestibular schwannomas (VSs), particularly in cases limited to the internal auditory canal (IAC) and cerebellopontine angle (CPA). Study Design This was a retrospective study. Setting This study was set at a Tertiary Referral Center. Patients Seventeen cases from October 2002 to July 2015 with an IAC/CPA mass presumed to be a VS who were found to have a FNS intraoperatively. Main Outcome Measures The main outcome measures included preoperative presentation, intraoperative findings, and subsequent intervention. Results Preoperative hearing loss and imbalance were seen in 70.5 and 64.7%, respectively. Suspicious intraoperative findings included: facial nerve incorporated intimately with the tumor capsule in 12 cases; spontaneous action potentials noted while drilling the bony IAC in 3 cases; and action potentials noted on stimulation of the entire tumor capsule in 10 cases. The mean long-term facial function was House–Brackmann grade II and the mean length of follow-up was 4.86 years. Conclusion FNSs are rare and may be difficult to distinguish from VS preoperatively. Surgical findings that should raise concern include spontaneous action potentials during drilling the bony IAC, absence of a plane of dissection between the facial nerve and tumor, or stimulation of the tumor capsule.

scholarly journals Bilateral facial palsy in an adult with chickenpox

2020 ◽  
Vol 6 (12) ◽  
pp. 2286
Author(s):  
Arthur Wong ◽  
Jeyanthi Kulasegarah
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Clinical Signs ◽  
The Body ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Nerve Recovery

<p class="abstract">Chickenpox is a result of primary infection with varicella zoster virus. Isolated facial nerve palsy as a complication is rare, and here we report an extraordinary case of bilateral facial nerve palsy following chickenpox in an adult. A 55-year-old male presented to the emergency department with a day’s history of facial weakness. He had recently contracted chickenpox with an onset 16 days prior. Physical examination noted crusted vesicles all over the body and a bilateral facial palsy. There were no clinical signs of meningitis or cerebrovascular accident. He was managed with a short course of oral aciclovir and prednisolone and recovered fully after a month. Presentations of facial nerve palsy in chickenpox are rare and should be differentiated from Ramsay Hunt syndrome. Prognosis is relatively good with the majority of known cases seeing complete facial nerve recovery within 6 months.  </p>

scholarly journals Data for temporal facial nerve recovery in Ramsay Hunt syndrome following intratympanic steroid therapy

Data in Brief ◽  
2020 ◽  
Vol 30 ◽  
pp. 105549
Author(s):  
Akira Inagaki ◽  
Toshiya Minakata ◽  
Sachiyo Katsumi ◽  
Shingo Murakami
Keyword(s):  
Facial Nerve ◽  
Steroid Therapy ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Nerve Recovery

A Case of Ramsay Hunt Syndrome without Facial Nerve Palsy (Haymann Type IV)

2018 ◽  
Vol 111 (1) ◽  
pp. 23-28
Author(s):  
Sayuri Yamamoto ◽  
Hideaki Kouzaki ◽  
Takeshi Shimizu
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Ramsay Hunt Syndrome ◽  
Type Iv ◽  
Hunt Syndrome
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