Secuelas de las parálisis faciales periféricas / Sequelae of peripheral facial palsy

Introducción y objetivos: El objeto de este trabajo es el estudio de las secuelas funcionales tras una parálisis facial periférica (PFP) analizando su incidencia y la relación con el grado de disfunción del nervio facial, desde el punto de vista neurofisiológico. Métodos: Presentamos un estudio retrospectivo que recoge un total de 150 casos de PFP. A todos los pacientes se les realizó una electroneurografía (ENG) y una electromiografía (EMG) para conocer el grado de daño axonal así como para evaluar la existencia de signos de reinervación en los músculos explorados y posibles errores de inervación. Resultados: De los enfermos sometidos a estudio, el 31,9% (46) presentaron secuelas. De estos, el 67,4% (31) eran mujeres con resultados estadísticamente significativos (p=0,031). Resultados: De todas las secuelas, las más frecuentes fueron las mioquimias que aparecieron en el 24% (36) de los casos. Los pacientes con el lado izquierdo afecto son los que presentaron mayor un número de secuelas, en el 40,3% (27), con diferencias estadísticamente significativas (p=0,05). La media de porcentaje de lesión axonal en la primera visita en los pacientes que posteriormente desarrollaron secuelas fue de 75,26%, observando que resultados más desfavorables en la ENG se relacionan de forma estadísticamente significativa con la aparición de secuelas (p=0,007). En la EMG de los enfermos con secuelas hemos observado que un mayor grado de denervación se puede considerar un factor de riesgo para la aparición de secuelas (p=0,039). Discusión/Conclusiones: En nuestro estudio hemos podido comprobar que las secuelas de las parálisis faciales son más frecuentes cuando existe una pérdida axonal importante. En este trabajo aparecen otros factores de riesgo hasta ahora no contemplados en la bibliografía como son el sexo femenino y que el lado izquierdo sea el afectado (AU)

Introduction and objectives: The purpose of this work is to study the functional sequelae after peripheral facial palsy (PFP) to analyze its impact and relationship with the degree of facial nerve dysfunction, from the neurophysiological point of view. Methods: We present a retrospective study which includes a total of 150 cases of peripheral facial palsy. All patients underwent electroneurography and electromyography to see the degree of axonal damage and to evaluate the existence of signs of reinervation in the muscles explored or possible innervation errors. Results: Of the patients studied, 31.9% (46) had sequelae; 67.4% (31) were women, a statistically significant result (P=0.031). Of all the sequelae, the most frequent was miochymia which appeared in 24% of cases (36). Patients with left side involvement presented a higher number of sequelae (40.3%, 27 cases) with a statistically significant difference (P=0.05). The average rate of axonal injury on first visit by patients who subsequently developed sequelae was 75.26%; worse results on electroneurography were statistically associated with the onset of sequelae (P=0.007). Electromyography of patients with sequelae shows that a greater degree of denervation could be considered a risk factor for the occurrence of sequelae (P=0.039). Discussion/conclusions: In our study we found that sequelae are more frequent after facial palsy when there is significant axonal loss. This work shows other risk factors so far not mentioned in the literature, such as female gender and left-side involvement (AU)

[Sequelae of peripheral facial palsy]. / Secuelas de las parálisis faciales periféricas.

INTRODUCTION AND OBJECTIVES: The purpose of this work is to study the functional sequelae after peripheral facial palsy (PFP) to analyze its impact and relationship with the degree of facial nerve dysfunction, from the neurophysiological point of view. METHODS: We present a retrospective study which includes a total of 150 cases of peripheral facial palsy. All patients underwent electroneurography and electromyography to see the degree of axonal damage and to evaluate the existence of signs of reinervation in the muscles explored or possible innervation errors. RESULTS: Of the patients studied, 31.9% (46) had sequelae; 67.4% (31) were women, a statistically significant result (P=.031). Of all the sequelae, the most frequent was miochymia which appeared in 24% of cases (36). Patients with left side involvement presented a higher number of sequelae (40.3%, 27 cases) with a statistically significant difference (P=.05). The average rate of axonal injury on first visit by patients who subsequently developed sequelae was 75.26%; worse results on electroneurography were statistically associated with the onset of sequelae (P=.007). Electromyography of patients with sequelae shows that a greater degree of denervation could be considered a risk factor for the occurrence of sequelae (P=.039). DISCUSSION/CONCLUSIONS: In our study we found that sequelae are more frequent after facial palsy when there is significant axonal loss. This work shows other risk factors so far not mentioned in the literature, such as female gender and left-side involvement.