THE PROGNOSTIC VALUE OF ELECTRODIAGNOSTIC METHODS IN BELLS-PALSY

Many papers report on a poor rate of complete restitution of Bell's pa lsy if signs of degeneration can be detected in neuromyography (NMG) o r electromyography (EMG). In 119 patients who underwent infusion thera py (as developed by Stennert [19,20]) 39% showed signs of degeneration in EMG or NMG. Complete restitution was achieved in 93% of these pati ents. Degeneration was more frequent in elderly patients (< 20 years: 20%, > 60 years: 55%). This did not affect the rate of complete restit ution, which was constantly high for every age. If infusion therapy wa s started within 7 days after onset of the disease, no defects in rest itution were observed, which was frequently so if therapy was started later. After one year the rate of complete restitution was about equal in cases with signs of degeneration (98%) and non-degenerative cases (94%). But 80% of the non-degenerative cases showed complete restituti on within 3 months after onset of the palsy, whereas 80% of cases with signs of degeneration healed after this date (mean 6.1 months). After oral therapy with cortisol exclusively half of the degenerative cases did not attain complete restitution. After infusion therapy EMG and N MG do not answer the question if a Bell's palsy will heal completely o r not but enable us to predict when this will probably be the case.