발병초기 벨마비 환자의 진단에서 순목 반사(blink reflex)의 유용성
The Usefulness of Blink Reflex in the Evaluation of Early Stage of Bell’s Palsy
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Background: Bell’s palsy is the most common disease of cranial nerve. While most electrodiagnostic tests can detect the abnormality of facial nerve several days later in Bell’s palsy, blink reflex usually reveals the abnormality earlier than other tests. Therefore, we investigated the diagnostic usefulness of blink reflex in the early stage of Bell’s palsy. Methods: We performed a prospective investigation in patients with facial palsy. We enrolled patients with Bell’s palsy who were evaluated within 7 days of symptom onset and excluded patients with secondary causes of facial palsy. We analyzed the findings of blink reflex according to age, sex, evaluation time, and severity of facial palsy. Results: Of 320 consecutive patients with facial palsy, a total of 204 patients were enrolled. Blink reflex was normal for 10 patients and abnormal for 194 patients. The time interval between the symptom onset and the evaluation time was not associated with the result of blink reflex,but House-Brackmann grade was significantly related to the result of blink reflex (P<0.001). Patients with mild Bell’s palsy often showed normal blink reflex. Conclusions: Our study shows that blink reflex is useful diagnostic test regardless of evaluation timing in the early stage of Bell’s palsy, although it could be normal in patients with mild Bell’s palsy.
Abstract
Background: Bell’s palsy is the most common disease of cranial nerve. While most electrodiagnostic tests can detect the abnormality of facial nerve several days later in Bell’s palsy, blink reflex usually reveals the abnormality earlier than other tests. Therefore, we investigated the diagnostic usefulness of blink reflex in the early stage of Bell’s palsy. Methods: We performed a prospective investigation in patients with facial palsy. We enrolled patients with Bell’s palsy who were evaluated within 7 days of symptom onset and excluded patients with secondary causes of facial palsy. We analyzed the findings of blink reflex according to age, sex, evaluation time, and severity of facial palsy. Results: Of 320 consecutive patients with facial palsy, a total of 204 patients were enrolled. Blink reflex was normal for 10 patients and abnormal for 194 patients. The time interval between the symptom onset and the evaluation time was not associated with the result of blink reflex,but House-Brackmann grade was significantly related to the result of blink reflex (P<0.001). Patients with mild Bell’s palsy often showed normal blink reflex. Conclusions: Our study shows that blink reflex is useful diagnostic test regardless of evaluation timing in the early stage of Bell’s palsy, although it could be normal in patients with mild Bell’s palsy.
참고문헌 (13)
- Roob G, "Peripheral facial palsy: etiology, diagnosis and treatment", Eur Neurol, 41, pp.3~9 (1999)
- Kanzaki J, "Electrodiagnostic findings in the early stages of Bell’s palsy and Ramsay-Hunt’s syndrome", Acta Otolaryngol Suppl, 446, pp.42~46 (1998)
- Ghonim MR, "Blink reflex: prognostic value in acute peripheral facial palsy", ORL J Otorhinolaryngol Relat Spec, 52, pp.75~79 (1990)
- Mizukoshi K, "Prognostic value of blink test in patients with facial paralysis", Acta Otolaryngol Suppl, 446, pp.70~75 (1988)
- House JW, "Facial grading system", Otolaryngol Head Neck Surg, 93, pp.146~147 (1985)
- Kimura J, "Electrophysiologic study of Bell palsy: electrically elicited blink reflex in assessment of prognosis", Arch Otolaryngol, 102, pp.140~143 (1976)
- Oh SJ, "Clinical Electromyography. Nerve conduction studies", pp.389~ (1993), Wiliams & Wilkins
- Cattaneo L, "Central facial palsy revisted: a clinical-radiological study", Ann Neurol, 68, pp.404~408 (2010)
- Sartoretti-Schefer S, "Intensity of MR contrast enhancement does not correspond to clinical and electroneurographic findings in acute inflammatory facial nerve palsy", AJNR Am J Neuroradiol, 17, pp.1229~1236 (1996)
- Kohsyu H, "Facial nerve enhancement in Gd-MRI in patients with Bell's palsy", Acta Otolaryngol Suppl, 511, pp.165~169 (1994)
- 이규철, "한 대학병원에서 시행한 벨마비 환자의 임상양상 분석", 대한신경과학회지, 29(4), pp.285~290 (2011), 대한신경과학회
- Boongird P, "Electrophysiologic findings and prognosis in Bell's palsy", Muscle Nerve, 1, pp.461~466 (1978)
- Seok JI, "The usefulness of clinical findings in localizing lesions in Bell's palsy: comparison with MRI", J Neurol Neurosurg Psychiatry, 79, pp.418~420 (2008)
