Association between vaccination with the BNT162b2 mRNA COVID-19 vaccine and Bell's palsy: a population-based study

ABSTRACT:Background:As part of an investigation of a suspected "outbreak" of Bell's palsy in the Greater Toronto Area, a population-based sample of patients with Bell's palsy was investigated electrophysiologically to help understand the spectrum of abnormalities that can be seen in this setting.Methods:Two hundred and twenty-four patients were surveyed, of whom 91 underwent formal neurological assessment. Of the latter, 44 were studied electrophysiologically using standard techniques. Thirty-two of the 44 patients fulfilled clinical criteria for Bell's palsy.Results:A wide range of electrophysiological changes was observed. Blink responses were the most useful test showing diagnostic sensitivity of 81% and specificity of 94% compared to the contralateral control side. Needle electromyography was additionally helpful in only one patient of six with normal conduction studies.Conclusions:There is a wide spectrum of electrophysiological abnormalities in Bell's palsy. Blink reflex latencies may be under-utilized in the assessment of the facial nerve in Bell's palsy. Facial EMG is not generally useful in routine assessment.

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Association between COVID-19 vaccination, infection, and risk of Guillain-Barre syndrome, Bell's palsy, encephalomyelitis and transverse myelitis: a population-based cohort and self-controlled case series analysis

10.1101/2021.09.08.21263276 ◽

2021 ◽

Author(s):

Xintong Li ◽

Eugenia Martinez-Hernandez ◽

Elena Roel Herranz ◽

Antonella Delmestri ◽

Talita Duarte-Salles ◽

...

Keyword(s):

General Population ◽

Statistical Power ◽

Case Series ◽

Transverse Myelitis ◽

Bell’S Palsy ◽

Population Based ◽

Guillain Barre Syndrome ◽

Bell's Palsy ◽

Guillain Barré Syndrome ◽

Guillain Barré

OBJECTIVE We aimed to study the association between COVID-19 vaccines, SARS-CoV-2 infection, and the risk of immune-mediated neurological events. METHODS Design Population-based historical rate comparison study and self-controlled case series (SCCS) analysis. Setting Primary care records from the United Kingdom. Participants Individuals who received the first dose of ChAdOx1 or BNT162b2 between 8 December 2020 and 6 March 2021. A cohort with a first positive RT-PCR test for SARS-CoV-2 between 1 September 2020 and 28 February 2021 was used for comparison. Main outcome measures Outcomes included Guillain-Barre syndrome (GBS), Bell's palsy, encephalomyelitis, and transverse myelitis. Incidence rates were estimated in the 28 days post first-dose vaccine, 90 days post-COVID-19, and between 2017 to 2019 for the general population cohort for background rates. Indirectly standardised incidence ratios (SIRs) were estimated. Adjusted incidence rate ratios (IRR) were estimated from the SCCS when sufficient statistical power was reached. Results We included 1,868,767 ChAdOx1 and 1,661,139 BNT162b2 vaccinees; 299,311 people infected with COVID-19; and 2,290,537 from the general population. SIRs for GBS were 1.91 [95% CI: 0.86 to 4.26] after ChAdOx1, 1.29 [0.49 to 3.45] after BNT162b2, and 5.20 [1.95 to 13.85] after COVID-19. In the same cohorts, SIRs for Bell's palsy were 1.34 [1.05 to 1.72], 1.15 [0.88 to 1.50], and 1.23 [0.80 to 1.89], and for encephalomyelitis 1.62 [0.61 to 4.31], 0.86 [0.22 to 3.46], and 11.05 [5.27 to 23.17], respectively. Transverse myelitis was too rare to analyse (n<5 in all cohorts). SCCS analysis was only conducted for Bell's palsy due to limited statistical power. We found no association between either vaccine and Bell's palsy, with an IRR of 1.10 [0.81 to 1.46] and 1.15 [0.87 to 1.49] for BNT162b2 and ChAdOx1, respectively. Conclusions We found no consistent association between either vaccine and any of the studied neuro-immune adverse events studied. Conversely, we found a 5-fold increase in risk of GBS and an 11-fold of encephalomyelitis following COVID-19.

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Increased risk of stroke after Bell's palsy: a population-based longitudinal follow-up study: Table 1

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.2011.240390 ◽

2011 ◽

Vol 83 (3) ◽

pp. 341-343 ◽

Cited By ~ 5

Author(s):

Ya-Ning Chiu ◽

Ming-Fang Yen ◽

Li-Sheng Chen ◽

Shin-Liang Pan

Keyword(s):

Bell’S Palsy ◽

Population Based ◽

Bell's Palsy ◽

Follow Up Study ◽

Increased Risk

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Bidirectional association between Bell's palsy and anxiety disorders: A nationwide population-based retrospective cohort study

Journal of Affective Disorders ◽

10.1016/j.jad.2017.03.051 ◽

2017 ◽

Vol 215 ◽

pp. 269-273 ◽

Cited By ~ 11

Author(s):

Chih-Chieh Tseng ◽

Li-Yu Hu ◽

Mu-En Liu ◽

Albert C. Yang ◽

Cheng-Che Shen ◽

...

Keyword(s):

Cohort Study ◽

Anxiety Disorders ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Bell’S Palsy ◽

Population Based ◽

Bell's Palsy ◽

Bidirectional Association

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Chinese Herbal Medicine and Acupuncture Reduced the Risk of Stroke After Bell's Palsy: A Population-Based Retrospective Cohort Study

The Journal of Alternative and Complementary Medicine ◽

10.1089/acm.2018.0496 ◽

2019 ◽

Vol 25 (9) ◽

pp. 946-956 ◽

Cited By ~ 2

Author(s):

Gil Ton ◽

Hsien-Yin Liao ◽

Jen-Huai Chiang ◽

Yi-Hung Chen ◽

Yu-Chen Lee

Keyword(s):

Cohort Study ◽

Herbal Medicine ◽

Chinese Herbal Medicine ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Bell’S Palsy ◽

Population Based ◽

Bell's Palsy ◽

Chinese Herbal

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Risk factors for Bell’s palsy based on the Korean National Health Insurance Service National Sample Cohort data

Scientific Reports ◽

10.1038/s41598-021-02816-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Junhui Jeong ◽

So Ra Yoon ◽

Hyunsun Lim ◽

Jangwon Oh ◽

Hyun Seung Choi

Keyword(s):

Risk Factors ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Metabolic Diseases ◽

National Sample ◽

Sociodemographic Factors ◽

Bell’S Palsy ◽

Population Based ◽

Bell's Palsy

AbstractThe associations between hypertension, diabetes, and dyslipidemia with Bell’s palsy have been controversial and only a few studies have assessed risk factors for Bell’s palsy based on population-based data. The aim of the present study was to evaluate whether sociodemographic factors such as sex, age, residence, household income, and metabolic diseases such as hypertension, diabetes, and dyslipidemia were risk factors for Bell’s palsy using the National Health Insurance Service National Sample Cohort data of Korea. Patients who visited an outpatient clinic twice or more or had one or more admission and received steroid medication under the International Classification of Diseases diagnostic codes for Bell’s palsy from 2006 to 2015 were defined as patients with Bell’s palsy in this study. The associations between sociodemographic factors and metabolic diseases to Bell’s palsy were analyzed with univariate and multivariate Cox proportional hazard regression models. There were 2708 patients with Bell’s palsy recorded from 2006 to 2015. Male sex, advanced age, residence in a location other than the capital and metropolitan cities, hypertension, and diabetes were significant risk factors for Bell’s palsy. This study is significant for patients and providers because we analyzed the relationships using a population-based database over a long-term follow-up period.

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