An electrophysiological prognostic diagnosis for facial palsy

Two electrophysiological tests for facial palsy—electroneurography (ENoG) and nerve excitability test (NET)—were reviewed. ENoG has advantages over NET in that it reflects the percentage of degenerated facial nerve fibers and can provide an accurate prognosis. However, as disadvantages, ENoG requires large, expensive equipment, and such supramaximal electrical stimulation can be quite painful for patients. NET is less painful due to weak stimulation with just enough current to meet the threshold, and the required equipment is compact and inexpensive to procure. However, it is impossible to calculate the percentage of degenerated nerve fibers, and NET is inferior to ENoG in terms of accurate prognostic prediction for facial palsy. The appropriate timing for both ENoG and NET is 7 to 10 days after the onset. While ENoG has proven more popular than NET because of its accuracy for prognostic prediction, we should not predict the prognosis of facial palsy based solely on the results of electrophyisiolgical examinations; a comprehensive evaluation including the facial muscle grading system is essential.