电生理检测对贝耳麻痹病人的预后估计

Electrophysiological study in the prognosis of Bell's palsy

关键词:  贝耳麻痹  瞬目反射  肌电图

Key words:  Bell's palsy  blink reflex  electromyography

摘要:

目的:用电生理的方法来判断贝耳麻痹病人的预后.方法:对发病1周以内的42例贝耳麻痹病人进行了连续4周的瞬目反射(Blink Reflex,BR)检测,在病情发展高峰期进行了面神经末端潜伏期及波幅测定,部分病人进行了面肌肌电图检查.结果:在病后3周内BR测出与患侧相关的R波之一者,恢复率为97%(30/31),R波出现得越早,病情恢复得越快.结论:BR是贝耳麻痹早期预后良好的可靠指标.BR、面神经ML、AMP和面肌肌电图相结合可作为晚期预后不良的指标.

Abstract:

To estimate the prognosis of Bell's palsy. Methods: Blink Reflex (BR), electromyography (EMG), Latency and Amplitude of facial never were performed in 42 patients with Bell's Palsy .All patients were examined by BR test in the first, second, third and fourth week after the occurrence of the disease, and we followed the patients about half a year. Results:(1) When 1 of the 3R waves (R1, R2 and R2') related with the ill side existed or appeared in three weeks after onset, 97%(30/31) patients could recover completely, the recovery time was related to the time of the occurrence of R wave. (2) When 1 of the 3 waves appeared in the fourth week, 60%(3/5) patients could recover completely. When none of the 3 waves appeared after the fourth week, 100%(6/6) patients could not recover completely. EMG showed spontaneous activity in 3 of the 6 patients in the fourth week. (3) We examined latency and Amplitude of facial never when the illness stopped developing, all patients had normal latencies, 5 patients' Amplitude reduced more than 90%, 3 of the 5 patients did not appear the related R waves after the fourth week. Conclusions: BR might provide the early sign of good prognosis of Bell's palsy, and BR together with EMG and latency and amplitude of facial never might provide the later sign of bad prognosis.