Relation between House-Brackmann Grading Scale and Electrophysiologic Findings in Peripheral Facial Nerve Palsy

J Korean Assoc EMG Electrodiagn Med 2007;9(2):122-127.
Published online May 10, 2007.

Abstract

Objectives: To examine the relation between House-Brackmann (H-B) grading scale and electrophysiologic findings in peripheral facial nerve palsy and evaluate the relevance of that H-B grading scale in point of electrophysiologic finding. Methods: 74 patients with peripheral facial nerve palsy who visted the Seoul National University Hospital from January 2000 to October 2004 were enrolled. Physiatrists classified the patients by H-B grading scale. Other physiatrist who was blind to the result of H-B grading did the nerve conduction study (NCS) and needle electromyography on the frontalis, orbicularis oculi, nasalis and orbicularis oris. Results: There is a significant difference of compound muscle action potential (CMAP) amplitude in NCS findings as H-B grading scale in frontalis, orbicularis oculi, nasalis. The abnormal spontaneous activity and interference pattern of facial motor unit action potential have significant correlation for H-B grading scale. There is no significant difference in electrophysiologic findings between H-B grade III and IV. Conclusion: The difference between H-B grade III and IV is ambiguous and subjective. And it is difficult to assess the patients with differential function along the branches of the facial nerve by the H-B grading scale.

Key Words: House-Brackmann grading, Nerve conduction study, Needle electromyography, Electrophysiologic finding