2015 Volume 25 Issue 5 Pages 836-843
It is important to explain prognostication to the patient who had a medical examination in the early stage of facial nerve palsy. In this retrospective study, we investigated the possibility of prognosis prediction of facial nerve palsy using both integrated electromyography (integrated EMG) and electroneurography (ENoG) for 98 patients visiting within 3 days after onset. All patients underwent both integrated EMG and ENoG within 3 days after onset and 2 weeks later.
In the results, within 3 days after the onset, there were patients in whom ENoG values were under the normal range, who were hard to recover. The integrated EMG values were divided into two groups at 55% considering the cutoff value provided from a ROC curve, and the ENoG values were also devided at 25%. 58 % of patients with both the integrated EMG values of 25% or less and ENoG values of 55% or less in the orbicularis oculi muscle did not recover, and 70% of patients in orbicularis oris muscle did not. Ninety seven % of patients with both the integrated EMG values over 25% and ENoG values over 55% in the orbicularis oculi muscle re- covered, and 86% of patients in orbicularis oris muscle recovered.
In the results of two weeks after the onset, patients with both the integrated EMG values of 25% or less and ENoG values of 25% or less in the orbicularis oculi muscle showed positive predictive values of 69% and negative predictive values of 94% (sensitivity: 0. 83, specificity: 0. 88). Patients with those in the orbicularis oris muscle showed positive predictive values of 83% and negative predictive values of 93% (sensitivity: 0. 79, specificity: 0. 95).
In conclusion, the combination of results of integrated electromyography with those of ENoG provides the accurate and useful information predicting the prognosis and recovery rate of patients visiting within 3 days after facial nerve palsy onset.
