Prognostic factors of Bell's palsy and Ramsay Hunt syndrome

被引:21
作者
Cai, Zhengyi [1 ]
Li, Huijing [2 ]
Wang, Xun [1 ]
Niu, Xiaoting [1 ]
Ni, Peiqi [1 ]
Zhang, Wanli [1 ]
Shao, Bei [1 ]
机构
[1] Wenzhou Med Univ, Affiliated Hosp 1, Dept Neurol, Wenzhou, Zhejiang, Peoples R China
[2] Wenzhou Med Univ, Affiliated Hosp 1, Dept Pediat, Wenzhou, Zhejiang, Peoples R China
关键词
Bell's palsy; electroneurography; prognostic factors; Ramsay Hunt syndrome; FACIAL-NERVE PARALYSIS; ELECTRONEUROGRAPHY; MANAGEMENT; INDICATOR; RECOVERY;
D O I
10.1097/MD.0000000000005898
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to compare clinical characteristics, electroneurography (ENoG) results, and functional outcomes of patients with Bell's palsy (BP) and Ramsay Hunt syndrome (RHS). Around 57 patients with BP and 23 patients with RHS were enrolled in this study from January 2010 and September 2015. Both clinical characteristics and ENoG results were recorded at hospital admission. The evaluations of functional outcomes were conducted with House-Brackmann (H-B) grading system at 6-month follow-up. There were no significant differences in age, gender proportion, initial H-B grades, time before commencement of treatment and the presence of comorbid disease in 2 groups. However, the final H-B grades at 6-month follow-up were significantly better in BP patients than RHS patients. The results of ENoG showed that degeneration index (DI) was significantly higher in the RHS group than the BP group. But no significant difference was found in the value of prolonged latency time (PLT) between the 2 groups. In multivariate analysis, age and ENoG DI were independently associated with functional outcome of recovery in the BP group (OR 0.167, 95% CI 0.038-0.622, P=0.009 and OR 0.289 95% CI 0.107-0.998, P=0.050, respectively). However, in the RHS group, only ENoG DI was related to the final H-B grades (OR 0.067, 95% CI 0.005-0.882, P=0.040). Spearman's rank correlation analysis showed that higher age and ENoG DI were related to poorer prognosis in 2 groups (P<0.05). PLT was related to functional outcomes only in the BP group (rs=0.460, P<0.001). The receiver operating characteristic (ROC) of ENoG DI analysis revealed that the cutoff value was 67.0% for BP prognosis and 64.5% for RHS prognosis. What's more, patients with hypertension or diabetes mellitus had both higher final H-B grade and ENoG DI than those without the same comorbidity. Patients with RHS had poorer prognosis than those with BP. Some factors including age, ENoG DI, and the presence of disease influenced recovery from BP and RHS. The present study demonstrated that BP patients with ENoG DI<67.0% and RHS patients with ENoG DI <65.5% had a greater opportunity for recovery within half a year.
引用
收藏
页数:5
相关论文
共 24 条
[11]   Etiology, Diagnosis, and Management of Facial Palsy: 2000 Patients at a Facial Nerve Center [J].
Hohman, Marc H. ;
Hadlock, Tessa A. .
LARYNGOSCOPE, 2014, 124 (07) :E283-E293
[12]   FACIAL-NERVE GRADING SYSTEM [J].
HOUSE, JW ;
BRACKMANN, DE .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 1985, 93 (02) :146-147
[13]   Comparison of Transcranial Magnetic Stimulation and Electroneuronography Between Bell's Palsy and Ramsay Hunt Syndrome in Their Acute Stages [J].
Hur, Dong Min ;
Kim, Seong Hoon ;
Lee, Young Hee ;
Kim, Sung Hoon ;
Park, Jung Mi ;
Kim, Ji Hyun ;
Yong, Sang Yeol ;
Shinn, Jong Mock ;
Oh, Kyung Joon .
ANNALS OF REHABILITATION MEDICINE-ARM, 2013, 37 (01) :103-109
[14]   Prognostic value of electroneurography in Bell's palsy and Ramsay-Hunt's syndrome [J].
Lee, DH ;
Chae, SY ;
Park, YS ;
Yeo, SW .
CLINICAL OTOLARYNGOLOGY, 2006, 31 (02) :144-148
[16]   Predicting the Long-Term Outcome After Idiopathic Facial Nerve Paralysis [J].
Mantsopoulos, Konstantinos ;
Psillas, Georgios ;
Psychogios, Georgios ;
Brase, Cristoph ;
Iro, Heinrich ;
Constantinidis, Jannis .
OTOLOGY & NEUROTOLOGY, 2011, 32 (05) :848-851
[17]   Which electrophysiological measure is appropriate in predicting prognosis of facial paralysis? [J].
Ozgur, Arslan ;
Semai, Bek ;
Hidir, Ulas Umit ;
Fatih, Ozdag Mehmet ;
Tayfun, Kasikci ;
Zeki, Odabasi .
CLINICAL NEUROLOGY AND NEUROSURGERY, 2010, 112 (10) :844-848
[18]  
Peitersen E, 2002, ACTA OTO-LARYNGOL, V122, P4, DOI 10.1080/000164802760370736
[19]   RAMSAY HUNT FACIAL PARALYSIS - CLINICAL ANALYSES OF 185 PATIENTS [J].
ROBILLARD, RB ;
HILSINGER, RL ;
ADOUR, KK .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 1986, 95 (03) :292-297
[20]   IDIOPATHIC FACIAL (BELLS) PALSY - A CLINICAL SURVEY OF PROGNOSTIC FACTORS [J].
SMITH, IM ;
HEATH, JP ;
MURRAY, JAM ;
CULL, RE .
CLINICAL OTOLARYNGOLOGY, 1988, 13 (01) :17-23