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J Acupunct Res > Volume 30(4); 2013 > Article
Sung, Kim, Goo, Ryu, Suk, Lee, Kim, Park, Seo, Park, and Baek: Study on the Validity of Electromyography(EMG) And Early-performed Electroneurography(ENoG) as Predicting Factor for Facial Palsy - based on Collaborative Treatment between Korean and Western Medicine

Abstract

Objectives :

This study was performed to confirm the usefulness of EMG and early-performed ENoG as predicting factor for facial palsy by clinical outcome.

Methods :

We gathered patients who visited the Facial Palsy Center in Kyung Hee University Hospital at Gangdong between January 2010 and September 2012. We used inclusion/exclusion criteria and reviewed 231 patients’ medical records including gender, age, HB grade and EMG & ENoG axonal loss. We compared the relation between EMG axonal loss and improvement degree at 4 & 6 weeks after treatment, and between ENoG axonal loss at 3–5 & 6–8 days after onset and EMG axnoal loss using regression analysis.

Results :

Each analysis had statistical significance, but EMG & improvement degree at 6 weeks after treatment showed statistically higher correlation than that at 4 weeks after treatment, and ENoG at 6∼8 days after onset & EMG showed statistically higher correlation than that at 3∼5 day after onset.

Conclusions :

We could get the evidence of the validity of EMG and early-performed ENoG as predicting factor for facial palsy based on collaborative treatment between Korean and western medicine.

Fig. 1.
Flow chart
acupunct-30-4-115-12-f1.gif
Fig. 2.
Regression analysis between EMG and improvement degree
Improvement degree(4 weeks) : improvement degree at 4 weeks after treatment.
Improvement degree(6 weeks) : improvement degree at 6 weeks after treatment.
acupunct-30-4-115-12-f2.gif
Fig. 3.
Regression analysis between ENoG and EMG
ENoG(3∼5 days) : ENoG axonal loss at 3∼5 days after onset.
ENoG(6∼8 days) : ENoG axonal loss at 6∼8 days after onset.
acupunct-30-4-115-12-f3.gif
Table 1.
Gross Grading System of House-Brackmann
Grade Description Characteristics
  I Normal Normal facial function all areas
  II Milde dysfunction Gross : slight weakness noticeable on close inspection on close inspection may have very slight synkinesis
At rest : normal symmetry and tone Motion
  Forehead : motion is moderate to good function
  Eye : complete closure with minimal effort
  Mouth : slight asymmetry
  III Moderate dysfunction Gross : obvious but not disfiguring difference between both the sides, noticeable but not severe synkinesis, contracture, or hemifacial spasm
At rest : normal symmetry and tone Motion
  Forehead : slight to moderate movement
  Eye : complete closure with effort
  Mouth : slightly weak with maximum effort
  IV Moderately sever dysfunction Gross : obvious weakness and/or disfiguring asymmetry
At rest : normal symmetry and tone Motion
  Forehead : none
  Eye : incomplete closure
  Mouth : asymmetric with maximum effort
  V Sever dysfunction Gross : only barely perceptible
At rest : asymmetry Motion
  Forehead : none
  Eye : incomplete closure
  Mouth : slight movement
VI Total paralysis No movement
Table 2.
General Characteristics
Age Gender Effected side Total
Male Female Left Right
10∼9 3 4 5 2 7(3.0 %)
20∼29 6 9 5 10 15(6.5 %)
30∼39 23 18 18 23 41(17.7 %)
40∼49 25 19 22 22 44(19.0 %)
50∼59 29 34 30 33 63(27.3 %)
60∼69 19 25 24 20 44(19.0 %)
70∼79 6 11 10 7 17(7.4 %)
Total 111 (48.1 %) 120 (51.9 %) 114 (49.4 %) 117 (50.6 %) 231 (100.0 %)
Table 3.
Changes in Mean HB Grade According to Treatment Period
Mean ± SD t p-value
Before treatment 3.97 ± 0.719 - -
1 week after treatment 3.67 ± 0.761 5.630 0.000
3 weeks after treatment 2.84 ± 0.941 17.911 0.000
4 weeks after treatment 2.38 ± 1.065 21.266 0.000
6 weeks after treatment 2.02 ± 1.047 26.654 0.000
Table 4.
Regression Analysis between EMG and Improvement Degree
Model summary Coefficients
R R square F change Sig. F B Std. error t Sig.
4 weeks .764 .583 187.457 .000 (constant) 1.494 .071 21.093 .000
EMG −1.290 .094 −13.691 .000
6 weeks .827 .683 289.130 .000 (constant) 1.700 .062 27.574 .000
EMG −1.394 .082 −17.004 .000

4 weeks : improvement degree at 4 weeks after treatment.

6 weeks : improvement degree at 6 weeks after treatment.

Table 5.
Regression Analysis between ENoG and EMG
Model summary Coefficients
R R square F change Sig. F B Std. error t Sig.
3∼5 days .401 .161 34.237 .000 (constant) .586 .028 20.593 .000
ENoG .289 .049 5.851 .000
6∼8 days .759 .576 137.354 .000 (constant) .370 .034 10.747 .000
ENoG .579 .049 11.720 .000

3–5 days : ENoG axonal loss at 3–5 days after onset.

6–8 days : ENoG axonal loss at 6–8 days after onset.

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