DOI: 10.1097/PHM.0b013e3181aa7211

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Issn Print: 0894-9115

Publication Date: 2009/07/01


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Re: Cutaneous Electrical Stimulation Treatment in Unresolved Facial Nerve Paralysis

Antti Hyvärinen

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I appreciate the interest in our work on cutaneous electrical stimulation treatment for facial paralysis.1 The technical critique on recording of electroneurography is unfortunately based on rather outdated articles reporting data collected with different equipment than what our university clinic is using. Technical factors are known to play a role in neurophysiology; however, I took great care to keep all conditions as similar as possible in consecutive recordings. On the critique on clinical evaluation, I refer to a new report to restate that the House-Brackmann grading system is a robust method of assessing facial function, and its reliability improves with clinical experience.2 When it comes to the patients’ compliance, I affirm that none of our patients dropped out of the study, and afterward they were willing to participate still further. The first paragraph of the results section already addresses this issue quite thoroughly, and as stated, the treatment was given while the patients were sleeping.
Every one of our patients was in the chronic phase, >1 yr after the initial incident, with no expectations for spontaneous recovery. I encountered no side effects in our patients and as the principle in medicine is “do not harm,” I consider it our responsibility to try new therapeutic options in the management of a chronic disabling disease.
I am looking forward to a larger sample and a more thorough double-blind study on the effectiveness of cutaneous stimulation, and thus I encourage those physicians who take care of patients with chronic facial paralysis to conduct such a study.

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