Escalante et al reported prognostic factors for a patient with Bell's palsy. The authors are from Madigan Army Medical Center, Military Medical Center San Antonio, Uniformed Services University and Facial Plastic Surgery Associates (Fort Worth).

Patient selection: Bell's palsy


Mean time to recovery: 6 weeks


Almost all patients recover to House-Brackmann III or better.


Risk factors for worse House-Brackmann grade at recovery:

(1) House-Brackmann VI (25% return to HB I; 40% HB III)

(2) House-Brackmann V (17% HB III at recovery)

(3) greater degeneration on electroneuronography


A House-Brackmann grade from I to III tended to have good recovery.


Risk factors for synkinesis:

(1) House-Brackmann V or VI at presentation


Potential candidate for facial nerve decompression: > 90% degeneration on electroneurography and no motor unit potentials on voluntary electromyography


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