Prognostic value of the blink reflex test in Bell's palsy and Ramsay-Hunt syndrome

Objective: This study was designed to evaluate the prognostic value of the blink reflex (BR) test in patients with Bell's palsy (BP) or Ramsay Hunt syndrome (RHS). Methods: The House–Brackmann (HB) grade of patients diagnosed with BP and RHS was determined at first visit and 3 months later. Final HB grade III–VI was defined as an incomplete recovery. Factors evaluated as prognostic of poor recovery included electroneurography (ENoG) degeneration rate (DR) > 90%, and absence of BR. Rates of complete and incomplete recovery were calculated and the associations between prognostic factors and recovery were determined. Results: Of the 129 included patients, 98 (76%) had BP and 31 (24%) had RHS. Absence of BR and low mean ENoG value were significantly associated with incomplete recovery in both the BP and RHS groups (p < 0.05 each). Initial HB grade V–VI was significantly associated with rate of incomplete recovery in patients with RHS (p < 0.05 each). Severe residual palsy (final HB grade V–VI) in the absence of BR was significantly more frequent in patients with RHS than with BP (p < 0.05). Conclusion: BR test results were a good prognostic indicator in patients with BP and RHS, as were ENoG value. Absence of BR was more frequently associated with severe residual palsy in RHS than in BP.