Abstract
CLINICAL AND ELECTROPHYSIOLOGICAL EVALUATION OF BELL'S PALSY CASES IN RESPONSE TO TREATMENT
Haitham H. Basee*, Imad A. Lateef and Ammar A. Mohammed
ABSTRACT
Background: Bell’s palsy is an abrupt, isolated, unilateral, peripheral facial paralysis without detectable cause. It is the most common cause of unilateral facial weakness. Patients and methods: The study was carried out at the unit of Neurology in Al-Kadhymia Teaching Hospital, during the period from the 1st of October 2004 – 1st of October 2005 . Patients graded clinically according to the House-Brackmann Grading System into (Grades I-VI) and classified according to the electrophysiological data into: group I (demyelinating) and group II (axonal). All Patients received the same course of treatment consisting of steroids (prednisolone) and antiviral (acyclovir). Results: The follow up within the first, fourth and sixth weeks showed highly significant improvement regarding group I, while no significant improvement regarding group II .On the other hand, clinical evaluation of those patients showed no response to treatment, a group of factors probably were contributing to the delay of recovery that include: severe post-auricular pain, hyperacusis, loss of taste and delayed administration of treatment. Conclusion: Most of Bell's palsy cases are of the Demyelinating type, which has a better prognosis than the axonal type. Hyperacusis, loss of taste, and sever post auricular pain may indicate poor outcome, and early initiation of combined treatment with acyclovir and corticosteroid within three days of onset will improve outcome.
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