Classification of central facial paralysis: an agreement analysis.
Nathallie Angel Conceição da Silva Andrade, Raquel Karoline Gonçalves Amaral, Laélia Cristina Caseiro Vicente and 1 others
PMID 40332201WHAT IT FOUND
Five speech-language pathologists rated 30 acute stroke patients with central facial paralysis.
The Sunnybrook scale showed better agreement between raters than the House-Brackmann scale. Both scales were consistent when the same rater re-evaluated cases ten days later.
Key findings
01Interrater agreement was good for the Sunnybrook Facial Grading System (SFGS) but only considerable for the House-Brackmann (HB) scale.
02Intrarater agreement was excellent for the HB scale and good for the SFGS when cases were re-evaluated ten days later.
03All participating speech-language pathologists preferred the SFGS for assessing central facial paralysis, citing its detailed quantitative analysis and ability to track functional evolution.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study only included patients in the acute flaccid phase (mean 2.75 days post-stroke), so findings may not apply to chronic phases or patients with synkineses. The raters were trained specifically for this study and did not habitually use these scales, which may affect generalizability to everyday clinical practice. The sample size of 30 patients and 5 raters is small, limiting the precision of the agreement estimates.
Declared interests
The authors declared no financial support or conflicts of interest.
The easy way to misread this
Do not assume the SFGS is validated specifically for central facial paralysis. The authors state it was not originally designed for this condition, but rather adapted from peripheral paralysis assessments, and the study only examined acute flaccid cases.