周围性面瘫电生理检查与预后相关分析

Prognostic value of electrophysiology in peripheral facial paralysis

目的 评价面神经电图（ENoG）、F波和瞬目反射（BR）等电生理检查在早期周围性面瘫预后判断中的价值及相关性.方法 对发病3周内行ENoG、F波和BR检测的31例周围性面瘫患者的恢复情况进行随访,时间6个月～2年,分别以F波、BR异常与否以及ENoG是否≥90％作为诊断界值,比较3种诊断方法判断预后的准确度以及三者间的相关性.结果 3种方法均能准确判断周围性面瘫的预后,ENoG≥ 90％、F波和BR异常均预示预后差.Pearson相关性分析显示,F波和BR结果之间（r=0.674,P＜0.01）、ENoG与BR间（r =0.445,P＜ 0.05）具有一定的相关性,ENoG与F波的无相关性（r=0.251,P＞0.05）.结论 结合多项适当的电生理检查全面综合分析,对周围性面瘫早期预后判断起重要作用.

Objective To assess the prognostic value and the correlations among facial nerve electrogram （ENoG）,F waves and Blink Relfex （BR） in early stage of peripheral facial paralysis.Methods Thirty-one patients with peripheral facial paralysis within three weeks from initial attack of this disease tested by using ENoG,F wave and BF were followed up from six months to two years.Abnormality of F wave,or BR,or EnoG ≥90％ was used as diagnostic threshold,respectively.The accuracy of the three methods and the correlations among the three methods for predicting the prognosis of peripheral facial paralysis were evaluated,respectively.Results Three methods may all correctly reflect the prognosis of peripheral facial paralysis.Abnormality of F wave,or BR,or ENoG≥90％ all suggested the poor prognosis of peripheral facial paralysis.Pearson analysis showed that there were correlations between the results of F wave and BR （r=0.674,P＜0.01）,between the results of ENoG and BR （r =0.445,P ＜0.05）,but there was no correlation between the results of ENoG and F wave （r =0.251,P ＞ 0.05）.Conclusions Comprehensive analysis of different electrophysiological examinations may correctly judge the prognosis of peripheral facial paralysis at early stage.