Predicting value for incomplete recovery in Bell's palsy of facial nerve ultrasound versus nerve conduction study
•Our study compares the clinical usefulness of nerve ultrasound and nerve conduction study in patients with Bell’s palsy.•Nerve Ultrasound may show abnormally increased facial nerve diameter in the acute phase of Bell’s palsy.•The predictive value of facial nerve ultrasound for incomplete recovery i...
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| Veröffentlicht in: | Clinical neurophysiology 2024-02, Vol.158, p.35-42 |
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| creator | Di Pietro, G. Falco, P. D'Elia, C. Cavalcanti, L. De Stefano, G. Di Stefano, G. Fabiano, E. Galosi, E. Leone, C. Vicenzini, E. Truini, A. Mancini, P. |
| description | •Our study compares the clinical usefulness of nerve ultrasound and nerve conduction study in patients with Bell’s palsy.•Nerve Ultrasound may show abnormally increased facial nerve diameter in the acute phase of Bell’s palsy.•The predictive value of facial nerve ultrasound for incomplete recovery is lower than that of the nerve conduction study.
This longitudinal study aims at assessing the predictive value of facial nerve high-resolution ultrasound (HRUS) for incomplete clinical recovery in patients with Bell’s palsy, the most common facial nerve disease.
We prospectively enrolled 34 consecutive patients with Bell’s palsy. All patients underwent neurophysiological testing (including facial nerve conduction study) and HRUS evaluations 10–15 days (T1), one month (T2), and three months (T3) after the onset of Bell’s palsy. Patients who did not experience complete recovery within three months were also evaluated after six months (T4). We have then compared the accuracy of HRUS with that of the facial nerve conduction study in predicting incomplete clinical recovery at three and six months.
At T1, the facial nerve diameter, as assessed with HRUS, was larger on the affected side than on the normal side, particularly in patients with incomplete recovery at T2, T3 and T4. ROC curve analysis, however, showed that the facial nerve diameter at T1 had a lower predictive value than the facial nerve conduction study for an incomplete clinical recovery at three (T3) and six (T4) months. Still, the facial nerve diameter asymmetry, as assessed with HRUS, had a relatively high negative predictive value (thus indicating a strong association between normal HRUS examination and a good prognosis).
Although HRUS shows abnormally increased facial nerve diameter in patients in the acute phase of Bell’s palsy, the predictive value of this technique for incomplete clinical recovery at three and six months is lower than that of the nerve conduction study.
Nerve ultrasound has a low predictive value for incomplete clinical recovery in patients with Bell’s Palsy. |
| doi_str_mv | 10.1016/j.clinph.2023.11.020 |
| format | Article |
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This longitudinal study aims at assessing the predictive value of facial nerve high-resolution ultrasound (HRUS) for incomplete clinical recovery in patients with Bell’s palsy, the most common facial nerve disease.
We prospectively enrolled 34 consecutive patients with Bell’s palsy. All patients underwent neurophysiological testing (including facial nerve conduction study) and HRUS evaluations 10–15 days (T1), one month (T2), and three months (T3) after the onset of Bell’s palsy. Patients who did not experience complete recovery within three months were also evaluated after six months (T4). We have then compared the accuracy of HRUS with that of the facial nerve conduction study in predicting incomplete clinical recovery at three and six months.
At T1, the facial nerve diameter, as assessed with HRUS, was larger on the affected side than on the normal side, particularly in patients with incomplete recovery at T2, T3 and T4. ROC curve analysis, however, showed that the facial nerve diameter at T1 had a lower predictive value than the facial nerve conduction study for an incomplete clinical recovery at three (T3) and six (T4) months. Still, the facial nerve diameter asymmetry, as assessed with HRUS, had a relatively high negative predictive value (thus indicating a strong association between normal HRUS examination and a good prognosis).
Although HRUS shows abnormally increased facial nerve diameter in patients in the acute phase of Bell’s palsy, the predictive value of this technique for incomplete clinical recovery at three and six months is lower than that of the nerve conduction study.
Nerve ultrasound has a low predictive value for incomplete clinical recovery in patients with Bell’s Palsy.</description><identifier>ISSN: 1388-2457</identifier><identifier>EISSN: 1872-8952</identifier><identifier>DOI: 10.1016/j.clinph.2023.11.020</identifier><identifier>PMID: 38150916</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Bell Palsy - diagnostic imaging ; Bell's palsy ; Facial Nerve - diagnostic imaging ; Facial nerve conduction study ; Facial Paralysis ; High-resolution nerve ultrasound ; Humans ; Longitudinal Studies ; Nerve Conduction Studies</subject><ispartof>Clinical neurophysiology, 2024-02, Vol.158, p.35-42</ispartof><rights>2023 International Federation of Clinical Neurophysiology</rights><rights>Copyright © 2023 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-cce9df57b6b6c36545dd1a2daf492633853c2ad7834e8f0f1db8f410e8d34fd03</citedby><cites>FETCH-LOGICAL-c408t-cce9df57b6b6c36545dd1a2daf492633853c2ad7834e8f0f1db8f410e8d34fd03</cites><orcidid>0000-0003-0352-7871 ; 0000-0002-4464-9982 ; 0000-0003-0982-0905 ; 0000-0002-8828-361X ; 0000-0002-2630-7647</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1388245723007964$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38150916$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Pietro, G.</creatorcontrib><creatorcontrib>Falco, P.</creatorcontrib><creatorcontrib>D'Elia, C.</creatorcontrib><creatorcontrib>Cavalcanti, L.</creatorcontrib><creatorcontrib>De Stefano, G.</creatorcontrib><creatorcontrib>Di Stefano, G.</creatorcontrib><creatorcontrib>Fabiano, E.</creatorcontrib><creatorcontrib>Galosi, E.</creatorcontrib><creatorcontrib>Leone, C.</creatorcontrib><creatorcontrib>Vicenzini, E.</creatorcontrib><creatorcontrib>Truini, A.</creatorcontrib><creatorcontrib>Mancini, P.</creatorcontrib><title>Predicting value for incomplete recovery in Bell's palsy of facial nerve ultrasound versus nerve conduction study</title><title>Clinical neurophysiology</title><addtitle>Clin Neurophysiol</addtitle><description>•Our study compares the clinical usefulness of nerve ultrasound and nerve conduction study in patients with Bell’s palsy.•Nerve Ultrasound may show abnormally increased facial nerve diameter in the acute phase of Bell’s palsy.•The predictive value of facial nerve ultrasound for incomplete recovery is lower than that of the nerve conduction study.
This longitudinal study aims at assessing the predictive value of facial nerve high-resolution ultrasound (HRUS) for incomplete clinical recovery in patients with Bell’s palsy, the most common facial nerve disease.
We prospectively enrolled 34 consecutive patients with Bell’s palsy. All patients underwent neurophysiological testing (including facial nerve conduction study) and HRUS evaluations 10–15 days (T1), one month (T2), and three months (T3) after the onset of Bell’s palsy. Patients who did not experience complete recovery within three months were also evaluated after six months (T4). We have then compared the accuracy of HRUS with that of the facial nerve conduction study in predicting incomplete clinical recovery at three and six months.
At T1, the facial nerve diameter, as assessed with HRUS, was larger on the affected side than on the normal side, particularly in patients with incomplete recovery at T2, T3 and T4. ROC curve analysis, however, showed that the facial nerve diameter at T1 had a lower predictive value than the facial nerve conduction study for an incomplete clinical recovery at three (T3) and six (T4) months. Still, the facial nerve diameter asymmetry, as assessed with HRUS, had a relatively high negative predictive value (thus indicating a strong association between normal HRUS examination and a good prognosis).
Although HRUS shows abnormally increased facial nerve diameter in patients in the acute phase of Bell’s palsy, the predictive value of this technique for incomplete clinical recovery at three and six months is lower than that of the nerve conduction study.
Nerve ultrasound has a low predictive value for incomplete clinical recovery in patients with Bell’s Palsy.</description><subject>Bell Palsy - diagnostic imaging</subject><subject>Bell's palsy</subject><subject>Facial Nerve - diagnostic imaging</subject><subject>Facial nerve conduction study</subject><subject>Facial Paralysis</subject><subject>High-resolution nerve ultrasound</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Nerve Conduction Studies</subject><issn>1388-2457</issn><issn>1872-8952</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1r3DAQhkVJaD7af1CCbsnFjr5sy5dCG_IFgeTQnoVWGjVavJIjWQv776uw2x5zmmF4Zl7mQegbJS0ltL9et2byYX5tGWG8pbQljHxCp1QOrJFjx45qz6VsmOiGE3SW85oQMhDBPqMTLmlHRtqforeXBNabxYc_eKunAtjFhH0wcTNPsABOYOIW0q7O8E-YpsuMZz3lHY4OO228nnCAtAVcpiXpHEuwuPK55MPcxGBLDYgB56XY3Rd07OoB-Hqo5-j33e2vm4fm6fn-8ebHU2MEkUtjDIzWdcOqX_WG953orKWaWe3EyHrOZccN03aQXIB0xFG7kk5QAtJy4Szh5-hqf3dO8a1AXtTGZ1M_0AFiyYqNZKDjwNhQUbFHTYo5J3BqTn6j005Rot5lq7Xay1bvshWlqsquaxeHhLLagP2_9M9uBb7vAah_bj0klY2HYKrxqnVRNvqPE_4C1dmUwg</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Di Pietro, G.</creator><creator>Falco, P.</creator><creator>D'Elia, C.</creator><creator>Cavalcanti, L.</creator><creator>De Stefano, G.</creator><creator>Di Stefano, G.</creator><creator>Fabiano, E.</creator><creator>Galosi, E.</creator><creator>Leone, C.</creator><creator>Vicenzini, E.</creator><creator>Truini, A.</creator><creator>Mancini, P.</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0352-7871</orcidid><orcidid>https://orcid.org/0000-0002-4464-9982</orcidid><orcidid>https://orcid.org/0000-0003-0982-0905</orcidid><orcidid>https://orcid.org/0000-0002-8828-361X</orcidid><orcidid>https://orcid.org/0000-0002-2630-7647</orcidid></search><sort><creationdate>202402</creationdate><title>Predicting value for incomplete recovery in Bell's palsy of facial nerve ultrasound versus nerve conduction study</title><author>Di Pietro, G. ; 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This longitudinal study aims at assessing the predictive value of facial nerve high-resolution ultrasound (HRUS) for incomplete clinical recovery in patients with Bell’s palsy, the most common facial nerve disease.
We prospectively enrolled 34 consecutive patients with Bell’s palsy. All patients underwent neurophysiological testing (including facial nerve conduction study) and HRUS evaluations 10–15 days (T1), one month (T2), and three months (T3) after the onset of Bell’s palsy. Patients who did not experience complete recovery within three months were also evaluated after six months (T4). We have then compared the accuracy of HRUS with that of the facial nerve conduction study in predicting incomplete clinical recovery at three and six months.
At T1, the facial nerve diameter, as assessed with HRUS, was larger on the affected side than on the normal side, particularly in patients with incomplete recovery at T2, T3 and T4. ROC curve analysis, however, showed that the facial nerve diameter at T1 had a lower predictive value than the facial nerve conduction study for an incomplete clinical recovery at three (T3) and six (T4) months. Still, the facial nerve diameter asymmetry, as assessed with HRUS, had a relatively high negative predictive value (thus indicating a strong association between normal HRUS examination and a good prognosis).
Although HRUS shows abnormally increased facial nerve diameter in patients in the acute phase of Bell’s palsy, the predictive value of this technique for incomplete clinical recovery at three and six months is lower than that of the nerve conduction study.
Nerve ultrasound has a low predictive value for incomplete clinical recovery in patients with Bell’s Palsy.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>38150916</pmid><doi>10.1016/j.clinph.2023.11.020</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0352-7871</orcidid><orcidid>https://orcid.org/0000-0002-4464-9982</orcidid><orcidid>https://orcid.org/0000-0003-0982-0905</orcidid><orcidid>https://orcid.org/0000-0002-8828-361X</orcidid><orcidid>https://orcid.org/0000-0002-2630-7647</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bell Palsy - diagnostic imaging Bell's palsy Facial Nerve - diagnostic imaging Facial nerve conduction study Facial Paralysis High-resolution nerve ultrasound Humans Longitudinal Studies Nerve Conduction Studies |
| title | Predicting value for incomplete recovery in Bell's palsy of facial nerve ultrasound versus nerve conduction study |
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