Exploration électrophysiologique du réflexe de clignement dans la paralysie faciale a frigore

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Abstract
Bell’s palsy is a common and well-known disease. Nevertheless, diagnosis may be difficult in some cases with very slight paresis, and prognosis is always a hazard. Many techniques, mostly electrophysiological, are used in order to refine diagnosis or prognosis. When evoked by electrical stimulation of the frontal region, blink reflex shows at electromyographic recording 2 components: normal blink reflex implies integrity of facial nerve in its whole course. Increase of the latencies is seen in Bell’s palsy. Measurement of the first component latency is now used as a diagnostic test in this disease. The aim of the present study was to compare this new technique with conduction time test and with electrogustometry. Blink reflex is disturbed early in facial paralysis; it is more sensitive than the 2 other measurements, for in several patients only blink reflex is affected. All patients were treated with ACTH. Evolution was generally good and best demonstrated with blink reflex; conversely, increase of conduction time test may persist for many weeks despite a good clinical recovery. Electrogustometry also shows correlation with the clinical state, but it frequently remains normal in the presence of severe lesions of facial nerve. The authors consider that 2 successive improvements of blink reflex give a clear sign of good prognosis. Blink reflex is a technique of daily usage; advantages are sensitivity and fair correlation with the clinical state.

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