Serial gadolinium-enhanced magnetic resonance imaging and assessment of facial nerve function in Bell's palsy

• Eleven patients with mild or moderate acute idiopathic peripheral facial palsy, so-called Bell's palsy, were serially examined by gadolinium-DTPA-enhanced MRI on mean days 11, 40, and 97 (third examination, n = 10) after the onset of palsy. Results of the clinical and neurophysiologic assessment of facial nerve function were compared with the gadolinium-enhanced MRI findings. Eight of the 11 patients demonstrated contrast enhancement of the facial nerve at the initial examination, but in 7 of them, the enhancement had disappeared by the time of the serial follow-up gadolinium-enhanced MRI scans. The disappearance of facial nerve enhancement was found to be related to clinical and neurophysiologic improvements in facial nerve function during recovery from Bell's palsy. The three patients whose scans were negative at the initial gadolinium-enhanced MRI examination had the same clinical severity of palsy, but initially they had milder neurophysiologic involvement than those who demonstrated enhancement; these three patients did not exhibit enhancement at serial follow-up scans. These findings indicate that the presence of enhancement at the initial MRI scan is not necessarily indicative of a poor prognosis for recovery.

Nyckelord

Acute Disease

Adult

Comparative Study

Contrast Media

Electrodiagnosis

Facial Nerve/pathology/*physiopathology

Facial Paralysis/diagnosis/*physiopathology

Female

Follow-Up Studies

Gadolinium DTPA/*diagnostic use

Human

Image Enhancement

Magnetic Resonance Imaging

Male

Middle Aged

Neurophysiology

Prognosis

Support; Non-U.S. Gov't

Taste/physiology

Xerophthalmia/physiopathology

MEDICINE

MEDICIN

Publikations- och innehållstyp

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