Department of Otolaryngology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Otol Neurotol. 2011 Dec;32(9):1554-8. doi: 10.1097/MAO.0b013e31823556ae.
To investigate the correlation between electroneurography (ENoG) findings and the prognosis of Bell's palsy in children compared with adults.
Twenty-two children and 92 adults with Bell's palsy who underwent ENoG between 8 days and 4 weeks from the onset of symptoms were retrospectively enrolled. The time to maximal recovery and rate of favorable recovery (House-Brackmann grade I or II) was assessed. Children (C) and adults (A) were further subdivided into low (<10%) or high (≧10%) subgroups according to their ENoG values (affected versus unaffected side) at initial evaluation. The numbers in each subgroup were as follows: C-low (n = 8), A-low (n = 21), C-high (n = 14), and A-high (n = 71).
Of the 22 children assessed, 2 of the 4 patients who showed a total loss of evoked potentials on the affected side (0% ENoG value) exhibited an unfavorable recovery. The remaining 20 patients achieved a favorable recovery eventually. Patients in group C-low reached a maximal recovery of facial movement significantly later than those in group C-high (p < 0.001). Time to maximal recovery of facial movement in group A-low was later than that in group C-low, although the difference was not statistically significant (p = 0.15). The patients in group A-high reached a maximal recovery significantly later than those in group C-high (p < 0.05).
Bell's palsy seems to recover earlier in children than adults when matched for severity. The presence of an identifiable response in ENoG, irrespective of its amplitude, may indicate a favorable recovery of facial movement in children.
与成人相比，研究儿童贝尔氏麻痹的神经电图（ENoG）结果与预后的相关性。
回顾性纳入 22 例儿童和 92 例成人贝尔氏麻痹患者，这些患者在症状发作后 8 天至 4 周内行 ENoG 检查。评估最大恢复时间和良好恢复率（House-Brackmann 分级 I 或 II）。根据初始评估时 ENoG 值（患侧与健侧），将儿童（C）和成人（A）进一步分为低（<10%）或高（≧10%）亚组。每个亚组的人数如下：C-低（n = 8），A-低（n = 21），C-高（n = 14）和 A-高（n = 71）。
在评估的 22 例儿童中，4 例患侧出现诱发电位完全丧失（ENoG 值为 0%）的患者中，有 2 例预后不良。其余 20 例患者最终恢复良好。C-低组患者的面部运动最大恢复时间明显晚于 C-高组（p < 0.001）。A-低组患者的面部运动最大恢复时间晚于 C-低组，尽管差异无统计学意义（p = 0.15）。A-高组患者的面部运动最大恢复时间明显晚于 C-高组（p < 0.05）。
在严重程度相匹配的情况下，儿童贝尔氏麻痹的恢复似乎比成人更早。无论振幅如何，在 ENoG 中存在可识别的反应可能表明儿童面部运动的恢复良好。
