ABSTRACT
Introduction: Bell’s palsy is an idiopathic peripheral disease of the seventh cranial nerve. More than 70% of patients attaincomplete clinical recovery, with no noticeable residua. Electrophysiological tests may offer valuable information in defining theseverity of nerve injury and a possible subsequent dysfunction.Aim: This study aims to assess the prognostic value of electrophysiological tests in the management of Bell’s palsy.Materials and Methods: All the patients with Bell’s palsy and without clinical evidence of other cranial nerve damage or centralnervous system diseases were included in the study. Nerve conduction study was performed on the 14th day or on the firstvisit of the patient to the hospital.Results: In 101 patients, majority of patients come under Grade IV (43.6%) and next comes Grade V (31.7%). Eighty-twopatients (81.2%) had normal latency, among these, 73 cases recovered within 6 months. Of 17 who had prolonged latency,seven patients recovered fully.Conclusions: Electrophysiological studies can predict the duration of the clinical recovery and the outcome of the illness. Theamplitude ratio of compound muscle action potential is the most reliable parameter in assessing the prognosis.
ABSTRACT
Introduction: The history of Guillain–Barre syndrome (GBS) runs parallel with the discovery of the peripheral nervous system. Upto the second half of the 19th century, injury to the peripheral nervous system had not yet emerged as a possible cause of palsy.Aim: This study aims to study the treatment and outcome in patients with various subtypes of GBS.Materials and Methods: Patients who had been admitted with the diagnosis of GBS based on Asbury’s criteria which includedascending areflexic quadriparesis, with or without cranial nerve dysfunction, and evolving within a period of 4 weeks. We alsoincluded patients who presented with features of GBS subtypes without prominent weakness. A detailed history and physicalexamination as per a structured pro forma were taken and necessary laboratory investigations were done.Results: Twenty-five patients were admitted with disability grade of >3 in GBS disability scale (>5 in Medical Research Councildisability scale) and 18 were admitted below the score. Sixteen patients needed ventilator support and 10 patients expired.Among the 22 patients who were treated with intravenous immunoglobulin (IvIg), 14 patients (24.6%) had a good outcome and8 patients (14.0%) had a poor outcome. Among the nine patients who were treated with plasma exchange, six patients had agood outcome and three had a poor outcome. Among the 19 patients, who were treated with injection methylprednisolone, eightpatients had a good outcome and 11 patients had a poor outcome. The values obtained are not statistically significant (P = 0.076).Conclusion: The mean improvement in GBS disability scale from admission to the end of the 8th week is more for IvIg-treatedpatients when compared to methylprednisolone-treated group.