Abstract
447 patients with Bell's palsy who visited our clinic from Apr. 1962 to Mar. 1964 have been studied clinically and electromyographically.
The conclusions are as follows:
(1) The measurement of the intensity-duration curve of the stimulating electric current is highly valuable in assessing prognosis and is convenient for pursuing the clinical course.
(2) But the electrical reaction of degeneration (the so-called “Entartungsreaktion”) should not be discarded in case of Bell's palsy, as the test is very easy to carry out and yet gives useful informations.
(3) In the early stage of Bell's palsy, the electromyography cannot have a prognostic value.
(4) As to the electrotherapy for the patients without degeneration of the facial nerve, application of a low-frequency rectangular pulse wave with amplitude modulation proved not so effective, compared with sufficiently good result by voluntary exercise therapy as well as massage combined with steroid administration in the initial stage.
(5) In case of the patients with degeneration, a complete cure cannot be expected. Sequelae of the degeneration were inevitably observed. Therefore, further effort of the doctors should be given to find a preventive measure against degeneration.
(6) Though the efferent impulses are blocked in neurapraxia, many hyperexcitable fibres are mixed in the distal portion of the involved facial nerve.
(7) Not infrequently, complex NMU voltage is observed in patients without demonstrable degeneration in the early course of the disease.
(8) In the convalescence of patients with degeneraton, the strange “coupled spike” is frequently observed in the electromyogram.
