Department of Neurology, E-DA Hospital/I-Shou University, No. 1, Yida Rd., Jiaosu Village Yanchao District, Kaohsiung City, 82445, Taiwan.
Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 833, Taiwan.
Neurol Sci. 2021 Oct;42(10):4149-4154. doi: 10.1007/s10072-021-05095-4. Epub 2021 Feb 3.
Multiple electrophysiologic studies have been conducted in the evaluation of facial neuropathy. In our study, the diagnostic and prognostic values of nerve conduction studies (NCSs) and transcranial magnetic stimulation (TMS) were compared for idiopathic unilateral facial neuropathy.
We recruited patients with newly diagnosed idiopathic unilateral facial neuropathy and performed a blink reflex test, facial NCSs, and TMS. The amplitude of facial compound muscle action potential (CMAP) and motor evoked potential (MEP) between the affected and unaffected sides of the face was compared.
A total of 30 patients were enrolled in the final analysis. TMS yielded a better detection rate, and MEP reduction rate was significantly higher than CMAP reduction rate, early in the course of the disease. Poor prognosis was positively associated with the CMAP reduction rate. The cutoff value of the CMAP reduction rate in the prediction of poor prognosis was established as 0.42.
Facial TMS could detect idiopathic unilateral facial neuropathy with a high sensitivity when used as an early diagnostic tool. Facial NCS could predict prognosis, and the CMAP reduction rate was significantly associated with poor short-term prognosis.
多项电生理研究已应用于评估面神经病变。本研究旨在比较神经传导研究（NCS）和经颅磁刺激（TMS）在特发性单侧面神经病变中的诊断和预后价值。
我们招募了新诊断为特发性单侧面神经病变的患者，并进行了眨眼反射试验、面 NCS 和 TMS。比较了患侧和健侧面部复合肌肉动作电位（CMAP）和运动诱发电位（MEP）的振幅。
共有 30 例患者最终进入分析。TMS 具有更高的检出率，且在疾病早期 MEP 降低率显著高于 CMAP 降低率。预后不良与 CMAP 降低率呈正相关。CMAP 降低率预测不良预后的截断值设定为 0.42。
面部 TMS 作为早期诊断工具，具有较高的敏感性，可检测出特发性单侧面神经病变。面 NCS 可预测预后，CMAP 降低率与短期预后不良显著相关。
