Blink reflex: prognostic value in acute peripheral facial palsy.

The blink reflex (BR) has been studied during the first 2 weeks in 122 patients with Bell's palsy and Ramsay Hunt's syndrome. According to early BR (R1), the patients were divided into 3 groups: R1 less than or equal to 13 ms (16 cases); R1 greater than 13 ms (54 cases), and absent BR (52 cases). There was a remarkable tendency towards a satisfactory recovery from paralysis if BR occurred during the first 2 weeks from onset (p less than 0.001). In patients with normal BR, 93.7% had a satisfactory recovery, and in patients with delayed R1, the prognosis was still good: 86.8% had a satisfactory recovery. When the reflex was absent a bad prognosis was given in 55.8% of the patients. The BR and the severity of the lesions according to electroneurograms was tested in 111 patients and found to be significantly correlated (p less than 0.001). BR seems to be a useful index for predicting the prognosis in an early stage of the paralysis, however, more than one test should be performed at the same time to accurately establish the prognosis.