Predicting the Prognosis of Bell's Palsy in Children Using Integrated Electromyography and Electroneurography

ABSTRACT Objective To predict the prognosis of pediatric Bell's palsy using integrated electromyography (EMG) and electroneurography (ENoG). Methods The present study enrolled 24 pediatric patients with Bell's palsy who underwent an integrated EMG and an ENoG (ENoG) test after Day 8 and within three weeks of paralysis onset, respectively. Previous studies reported that an integrated EMG value ≤ 25% in the orbicularis oculi and orbicularis oris at Week 2 post‐onset indicated a poor prognosis. The sensitivity, specificity, positive and negative likelihood ratio (NLR), and positive and NLR of the test were determined using a 2 × 2 contingency table according to whether the ENoG value was above or below 10% and whether the patient experienced a full or incomplete recovery using an integrated EMG value of 25% as the cut‐off. Results A patient was more likely to have an incomplete recovery if the integrated EMG value was lower than the cut‐off value. There was a strong correlation between the integrated EMG value and ENoG value. Regarding the prognostic value of combining the integrated EMG and ENoG values, 10 of 12 patients with an integrated EMG value ≤ 25% and ENoG value < 10% had an incomplete recovery (sensitivity 100%, specificity 85.7%). Conclusion The findings of the present study suggested that combining the integrated EMG and ENoG values increased specificity as well as the accuracy of predicting the prognosis of facial paralysis in children. Level of Evidence 3