Adour and Swandson developed the Facial Paralysis Recovery Profile (FPRP) and Index (FPRI), a grading system for monitoring recovery of facial nerve function in patients with Bell's palsy. The authors were from Kaiser Permanente in Oakland, California.
Component measures:
(1) facial paralysis recovery profile for 3 facial sites
(2) "minus" points for complications (early and late)
(3) points for serious complications
|
Site |
Level of Function |
Points |
|
forehead |
absent |
0 |
|
|
1 – 25% |
1 |
|
|
26 – 50% |
1 |
|
|
51 – 75% |
2 |
|
|
76 - 100% |
2 |
|
eye |
absent |
0 |
|
|
1 – 25% |
1 |
|
|
26 – 50% |
2 |
|
|
51 – 75% |
3 |
|
|
76 - 100% |
4 |
|
mouth |
absent |
0 |
|
|
1 – 25% |
1 |
|
|
26 – 50% |
2 |
|
|
51 – 75% |
3 |
|
|
76 - 100% |
4 |
where:
• In the reference tables the ranges overlap (for example 25-50%, 50-75%).
facial paralysis recovery profile =
= SUM(points for all 3 sites)
|
Stage of Disease |
Complications |
Minus Points |
|
early |
pain |
1 |
|
|
epiphora (overflow of tears) |
1 |
|
|
ageusia (impaired sense of taste) |
1 |
|
|
decreased lacrimation |
1 |
|
|
hyperacusis (exceptionally acute sense of hearing) |
1 |
|
late |
contracture |
1 |
|
|
synkinesis (involuntary muscle contracture on making an expression) |
1 |
|
|
crocodile (gustatory) tears (tearing during eating and chewing) |
1 |
|
|
facial spasm |
1 |
|
|
ptosis of eyebrow |
1 |
minus point score =
= SUM(all minus points)
where:
• The minus points are listed as "-1" in the references. However, since I am subtracting the total for the final score, I am listing them as "+1".
• I am assuming that the course of the patient is divided into early and late stages, and that only 5 complications are graded accordingly.
Serious but rare complications: assigned 4 points for each (from Table 3, page 1292, Ardour 1971):
(1) corneal ulceration
(2) facial sling
(3) tarsorrhaphy (need to suture all or part of the upper and lower eyelids together)
serious complication score =
= SUM(points for all 3 rare complications)
facial paralysis recovery index =
= (facial paralysis recovery profile) – (minus point score) – (points for serious complications)
Interpretation:
• minimum facial paralysis recovery profile: 0
• maximum facial paralysis recovery profile: 10
• minimum minus point score: 0
• maximum minus point score: 5 (or –5 if viewed as negative number)
• minimum serious complication score: 0
• maximum serious complication score: 12 (or –12 if viewed as negative number)
• minimum facial paralysis recovery index: -5 (typical); -17 (including all rare complications)
• maximum facial paralysis recovery index: 10
• A recovery index of 10 indicates complete recovery with no complications.
Specialty: Neurology, Emergency Medicine, Surgery, general, Otolaryngology
ICD-10: ,
