Blink Reflex: Prognostic Value in Acute Peripheral Facial Palsy

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Abstract
The blink reflex (BR) has been studied during the first 2 weeks in 122 patients with Bell’s palsy and Ramsay Hunt’s syndrome. According to early BR (R1), the patients were divided into 3 groups: R1 ≤ 13 ms (16 cases); R1 > 13 ms (54 cases), and absent BR (52 cases). There was a remarkable tendency towards a satisfactory recovery from paralysis if BR occurred during the first 2 weeks from onset (p < 0.001). In patients with normal BR, 93.7% had a satisfactory recovery, and in patients with delayed R1, the prognosis was still good: 86.8% had a satisfactory recovery. When the reflex was absent a bad prognosis was given in 55.8% of the patients. The BR and the severity of the lesions according to electroneurograms was tested in 111 patients and found to be significantly correlated (p < 0.001). BR seems to be a useful index for predicting the prognosis in an early stage of the paralysis, however, more than one test should be performed at the same time to accurately establish the prognosis.

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