Abstract
Objectives
1) To determine whether a novel biomarker (hyperphosphorlyated neurofilament-heavy subunit) is able to be quantitated in patients with idiopathic facial nerve paralysis. 2) To determine whether correlation exists between biomarker quantitation and clinical parameters in patients with idiopathic facial nerve paralysis.
Methods
This is a prospective pilot study that assesses the utility of the serum biomarker hyperphosphorylated neurofilament-heavy subunit protein(NF-H) in evaluating patients with idiopathic facial nerve paralysis. From May 2006 to August 2007, 12 patients that presented to the Emergency, Neurology, and Otolaryngology departments at a county hospital with acute onset unilateral facial paralysis were enrolled into the study. Serum samples at the time of presentation were obtained, and the following additional data was recorded and analyzed: age, sex, severity of paralysis at presentation, duration between time of onset of paralysis and presentation, side of paresis, associated comorbidities, time to recovery, and ancillary testing results. Data analysis was performed using Student's T-test and analysis of variance; linear regression models and correlation coefficients were calculated using Microsoft Excel computer software.
Results
There was no significant relationship between patient age (r2=0.20), sex (p=0.19), and side of paralysis (p=0.49) and biomarker level. The biomarker level increased with increasing facial paresis severity (p=0.002, r2=0.17), and had a more pronounced correlation when patients presented within the first 24 to 48 hours of paralysis (p=0.006, r2=0.59). There was no correlation between biomarker and prognosis or ancillary testing results.
Conclusions
Hyperphosphorylated neurofilament-heavy subunit levels correlated with initial severity of facial paralysis, but were time-dependent.
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