The Facial Paralysis Prognostic Index

Abstract

The treatment of facial paralysis requires a reliable estimate of prognosis as well as an accurate diagnosis. Although the majority of patients recover, the degree of subsequent facial function varies. An estimation of the risk of nerve degeneration and subsequent disability is needed to guide therapy and to advise patients. Currently, prognosis is obtained by clinical evaluation of initial signs and symptoms, specific nerve excitability and function testing, and response to medical therapy. This study attempts to identify and quantitate factors that predict the outcome of facial paralysis. In 1214 patients with Bell's palsy, we identified factors associated with a severe course or poor outcome. We analyzed the predictive value of each item in an extensive research protocol, estimating the relative contribution to the total risk of unfavorable outcome by means of multiple regression models. With the use of these data, we have developed the facial paralysis prognostic index (FPPI). The FPPI can assist otologists to more accurately estimate outcome based on physical examination and electrical testing.

Comparison of Facial Nerve Paralysis in Adults and Children

“…These conditions may cause Bell's palsy, with recovery from facial nerve paralysis shown to decrease with increasing age of patients 11. Other studies6-8 found that age is a prognostic factor in patients with facial nerve paralysis. However we found that recovery rate in patients with Bell's palsy was not related to age, with no statistically significant difference between children and adults ( p = 0.983).…”

“…Numerous studies conducted on factors influencing the prognosis of facial nerve palsy showed younger age,6-8 initial paralysis lower than HB grade III,6-9 and normal responses on nerve excitability tests6,9 and in stapedial reflex,9,10 were associated with good prognosis.…”

Eutrophic electrical stimulation for Bell's Palsy

“…Both FPRP and FPRI have been previously described and validated. [14][15][16] Assessments of all patients were carried out at presentation and the start of treatment and at approximately six-weekly intervals thereafter. Independent assessment of the first 30 patients by three therapists was carried out initially and for the first six months of treatment.…”

Comparisons of steroid, acyclovir, lipoprostoglandin E1 and steroid+acyclovir treatments in facial paralysis: A rat study

“…The disease is progressive for 7-10 days and we are unable to predict which patients will develop the more severe form [2,27]. Therefore, in selecting patients for treatment, relying on deterioration as shown by progression from incomplete to complete paralysis or on results of electrical tests is inappropriate.…”