CORRELATION OF MRI, CLINICAL, AND ELECTRONEURONOGRAPHIC FINDINGS IN ACUTE FACIAL-NERVE PALSY

Intratemporal enhancement of (Gd-DTPA) was investigated by an interlea ved-overlapping magnetic resonance imaging (MRI) technique in 35 cases of acute facial palsy. In a reference group (normal facial function), enhancement was localized from the ganglion geniculi to the stylomast oid foramen. In cases of acute palsy, the facial nerve enhanced in the meatal fundus independent of etiology (idiopathic, herpetic, or traum atic). In 70% of those with Ramsay-Hunt syndrome, the vestibular and c ochlear nerves, the labyrinth, and the sheets of the internal and exte rnal auditory canal additionally enhanced. No correlation was found be tween intensity, extension, and duration of the enhancement and the cl inical, intraoperative, or electroneuronographic degree of the facial palsy. The pathogenesis of the Gd-DTPA enhancement of the facial nerve appears to be closely connected with the vascular supply of the fallo pian canal and the permeability of the neural sheets.