Prognostic sensibility of clinical scales in Bell’s Palsy: a prospective
longitudinal study
Abstract
Introduction: The first aim of the study was to compare three clinical
scales at baseline: the Sunnybrook Facial Grading System (SFGS), the
eFACE and the MBLF protocol. Then we intend to specify their sensibility
to predict sequelae of Bell’s palsy at 12 months. Methods: We carried
out a longitudinal study of 23 patients with Bell’s palsy. We reported
every three months, from baseline to follow-up at 12 months, all the
results of their facial assessment. In order to precise the criterion
validity of the three clinical scales at baseline, effect of House and
Brackmann severity grades was tested on SFGS composite score, eFACE
dynamic score and MBLF total score. Then, these three scores were
compared between group A (patients without sequelae at 12 months) and
group B (patients with sequelae). Sensibility in predicting sequelae at
12 months was specified with Receiver Operating Characteristics curve
for each clinical scale. Results: Grades effect on each clinical scale
was found (p< .005). At baseline, no significant difference
was observed between group A and group B on clinical scales. At three
months, only the MBLF total score was significant to predict recovery
(χ2 = 8.37, p < .0038*, AUC = .769). From the 6th month, the
three clinical scales could predict sequelae at 12 month (p
<.005). Conclusion: Clinical tools are essential to assess
patients with Bell’s palsy at baseline and follow-up. At baseline, the
dynamic scores are not significantly different. At 3 months, only the
MBLF significantly discriminated patients with or without sequelae at 12
months. At 6 months, all three scales were able to predict sequelae at
12 months.