Prognosis of patients with recurrent facial palsy

No studies to date have classified recurrent facial palsy according to the House-Brackmann grade, thus limiting any comparisons between patients with recurrent and primary facial palsy. The aims of the study were to analyze the degree of recovery from recurrent facial palsy and factors affecting the degree of recovery and to compare with patients recovering from primary facial palsy. Seventy-two patients with recurrent facial palsy were treated by the same treatment approach as 1,185 patients with general facial palsy. Underlying disease, palsy side, and extent of recovery were measured. Temporal bone magnetic resonance image (MRI), Electroneurography (ENoG), electromyography (EMG), and initial House-Brackmann grade were assessed and compared by statistical analyses. Recovery rate of facial palsy were compared and related risk factors were analyzed. We found that recovery to better than House-Brackmann grade II was more common in patients with primary (88.4%, 1,047/1,185) than with recurrent (72.2%, 52/72) facial palsy. Recovery was observed in 80.6% (25/31) of patients with recurrence on the ipsilateral side and in 72% (18/25) with recurrence on the contralateral side. The accuracies of ENoG and EMG were 76.4 and 84.7%, respectively. In MRI, 26.4% patients showed enhancement findings. Multivariate logistic regression analysis showed that initiation of treatment within 7 days and unfavorable EMG results were significant risk factors in patients with recurrent facial palsy. The recovery rate was lower in patients with recurrent than with primary facial palsy, but there were no significant differences in recovery rates between recurrences on the ipsilateral and contralateral sides. The prognosis of patients with recurrent facial palsy was associated with initiation of treatment within 7 days, with EMG shown to be the most reliable test.