The influence of age in peripheral facial palsy on brainstem reflex excitability.

ABSTRACT

BACKGROUND: Neuronal plasticity is expected to be different at different ages and adaptive changes developing after peripheral facial palsy (PFP) may provide a clue in this respect. AIMS: To investigate the difference in the reorganization developing after facial nerve damage between patients who developed PFP at childhood-youth and middle-old age. PATIENTS AND METHODS: Twenty-two patients were divided into two groups according to the age-at-onset of PFP; young (PFP 1), and elderly (PFP 2). Two age-matched control groups (C 1 and C 2) comprised of 32 healthy subjects were included in the study. The latency, R(2) area, and recovery of the R(2) area of the blink reflex were investigated. STATISTICAL ANALYSIS: ANOVA and Bonferroni tests were used. RESULTS: The R(2) areas were significantly greater on the intact side of the PFP 1 group as compared to that in the control group ( P =0.012). The recovery of R2 component was significantly enhanced on the symptomatic (P = 0.027), and intact (P = 0.041) sides in PFP 1 as compared to that in the C 2 group at the stimulus interval of 600 ms. Significant enhanced recovery was noted at 200 ms stimulus interval on the symptomatic side of the two PFP groups (PFP 1, P = 0.05 and PFP 2, P = 0.025) and on the intact side of the PFP 1 group (P =0.035) as compared to that in the control groups. CONCLUSION: Young age-at-onset of PFP is associated with more prominent excitability changes developing at the neuronal and interneuronal level.