Abstract Background: Bell’s palsy is the most common acute mononeuropathy. Although most patients recover, a subset experiences persistent facial weakness. Early identification of reliable prognostic indicators is essential for guiding management and counseling. Objective: To evaluate the prognostic value of electroneurography (ENoG) and blink reflex (BR) testing in predicting outcomes among patients with Bell’s palsy. Materials and Methods: A prospective observational study was conducted at Kasturba Medical College, Manipal, from August 2021 to January 2023. Seventy-three patients presenting within 14 days of symptom onset were enrolled. Baseline facial nerve conduction studies, ENoG (calculated as CMAP amplitude of affected/unaffected side × 100), and BR testing were performed. House–Brackmann (HB) grading was assessed at baseline and at 6–8 weeks’ follow-up. Multivariate logistic regression and receiver operating characteristic analyses were performed to identify the predictors of incomplete recovery (HB grade III–VI). Results: Of the 73 patients, 9 (12.3%) showed unfavorable ENoG values (<10%). At follow-up, 60 patients (82.2%) achieved good recovery (HB grade I–II). An ENoG value <10% was an independent predictor of poor outcome (odds ratio = 0.20, 95% confidence interval: 0.04–0.86, P = 0.037). BR abnormalities were seen in 95.9% but showed no significant association with recovery ( P = 0.52). Conclusion: ENoG performed within the first 14 days of Bell’s palsy onset is a reliable early prognostic marker for incomplete recovery, whereas BR abnormalities, although common, lack predictive value. Early electrophysiological testing may facilitate timely risk stratification and individualized management.
Chouhan et al. (Wed,) studied this question.