scholarly journals Association between Initial Severity of Facial Weakness and Outcomes of Bell’s Palsy

2021 ◽  
Vol 10 (17) ◽  
pp. 3914
Author(s):  
Myung Chul Yoo ◽  
Dong Choon Park ◽  
Seung Geun Yeo
Keyword(s):  
Antiviral Therapy ◽  
Bell’S Palsy ◽  
University Hospital ◽  
Multivariable Logistic Regression Analysis ◽  
Clinical Factors ◽  
Facial Weakness ◽  
Bell's Palsy ◽  
Factors Affecting ◽  
Initial Severity ◽  
Combination Antiviral Therapy

To establish whether clinical prognostic factor outcomes differed based on the initial severity of facial weakness and to determine the association between the initial severity of facial weakness and favorable outcomes. This retrospective cohort study analyzed all patients with Bell’s palsy who visited the outpatient clinic of our university hospital from 1 January 2005 through 31 January 2021. The primary outcome was the rate of recovery at 6 months, evaluated separately in patients with initial House–Brackmann (H-B) grades 3–4 and 5–6. Secondary outcomes included clinical factors associated with favorable outcomes stratified by the initial H-B grade. The rate of favorable recovery was higher in patients with initial H-B grades 3–4 than initial H-B grades 5–6 (82.9% vs. 68.2%, p < 0.001). Multivariable logistic regression analysis showed that age 19–65 years and good electromyography (EMG) results were prognostic of good outcomes in patients with initial H-B grades 3–4. In addition, good EMG results, controlled hypertension, and combination antiviral therapy were significantly prognostic of favorable outcomes in patients with initial H-B grades 5–6. Subgroup analysis interactions showed that combination antiviral therapy (OR: 3.06, 95% CI 1.62–5.78, p < 0.001) in initial H-B grades 5–6 were associated with more favorable outcomes at 6 months than with initial H-B grades 3–4. Our results showed that the proportion of patients who achieved favorable outcomes at 6 months and multiple clinical factors affecting favorable outcomes differed significantly among patients differing in initial severity of Bell’s palsy.

scholarly journals Clusters of Bell's palsy

1997 ◽  
Vol 55 (4) ◽  
pp. 722-727 ◽  
Author(s):  
Thiago D. Gonçalves-Coêlho ◽  
Carlos Newton D. Pinheiro ◽  
Ezon V.A.P. Ferraz ◽  
José Luiz Alonso-Nieto
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Temporal Distribution ◽  
Female Gender ◽  
Bell’S Palsy ◽  
Seasonal Distribution ◽  
Upper Respiratory Tract ◽  
Bell's Palsy ◽  
Factors Affecting ◽  
Upper Respiratory

The idiopathic facial paralysis or Bell's palsy installs abruptly or within a few hours, without any apparent cause. It corresponds to approximately 75% of all peripheral facial palsies. Three theories try to explain its pathogenecity: vascular-ischemic, viral and auto-immune. We reviewed the records of the EMG Sector, Hospital do Servidor Público Estadual (São Paulo, Brazil), from 1985 to 1995 and found 239 cases of Bell's palsy. Data were analysed according to age, gender, seasonal distribution of cases. There was a predominance of cases in the 31 - 60 age bracket (40.59 %). The female gender was responsible to 70.71 % of cases. There was a predominance of cases in winter (31.38 %) and autumn (30.13 %), which was statiscally significant. These findings let us to suppose that Bell's palsy predominates in females, in 41-60 years age bracket, and occurs predominantly in cold months. There are groups of clusters throughout temporal distribution of cases and cases are dependent on one each other or on factors affecting them all, which reinforces the infectious hypothesis (there is a rise in the incidence of viral upper respiratory tract infection during cold months).

Prognostic Factors Associated With Recovery in Children With Bell’s Palsy

2019 ◽  
Vol 34 (14) ◽  
pp. 891-896 ◽  
Author(s):  
Elif Karatoprak ◽  
Sila Yilmaz
Keyword(s):  
Prognostic Factors ◽  
Facial Nerve ◽  
Bell’S Palsy ◽  
Steroid Treatment ◽  
Grading System ◽  
Bell's Palsy ◽  
Early Recovery ◽  
Laboratory Findings ◽  
Distribution Width ◽  
Factors Affecting

Objectives: The aim of the study was to determine the prognosis of children with Bell’s palsy and analyze the prognostic factors affecting early recovery. Methods: The records of children with a diagnosis of Bell’s palsy were retrospectively analyzed. Demographic and clinical features including age, gender, House-Brackmann Facial Nerve Grading System House-Brackmann Grading Scale (HBGS) grade at admission and follow-up, and the dosage and onset of steroid treatment were reviewed. Laboratory findings such as red blood cell distribution width and neutrophil-to-lymphocyte ratio were noted. The patients who were recovered within the first month (early recovery) were compared with the patients who were recovered after first month (late recovery) in terms of demographic, clinical characteristics, laboratory findings and treatment modalities in order to determine the risk factors affecting early recovery. Results: A total of 102 children (65 girls and 37 boys) with a mean age of 10.37 ± 4.2 years were included in the study. The complete recovery was detected in 101 children (%99) with Bell’s palsy. Statistically significant difference was found in terms of dosage and time of onset of steroid treatment ( P = .04, P = .035, respectively) and House-Brackmann Facial Nerve Grading System grade on the 10th day ( P = .001) between the early and late recovery groups. Conclusion: The prognosis of Bell’s palsy in children was very good. The prognostic factors affecting the early recovery were being House-Brackmann Facial Nerve Grading System grade 2 or 3 on the 10th day and receiving steroid treatment in the first 24 hours. Neutrophil-to-lymphocyte ratio and red blood cell distribution width were not found to be predictive factors for early recovery.

Outcome of Treatment with Valacyclovir and Prednisone in Patients with Bell's Palsy

2003 ◽  
Vol 112 (3) ◽  
pp. 197-201 ◽  
Author(s):  
Sara Axelsson ◽  
Sven Lindberg ◽  
Anna Stjernquist-Desatnik
Keyword(s):  
Treatment Group ◽  
Medical Treatment ◽  
Antiviral Drug ◽  
Complete Recovery ◽  
Bell’S Palsy ◽  
Adult Patients ◽  
University Hospital ◽  
Control Group ◽  
Type I ◽  
Bell's Palsy

Idiopathic facial paralysis, or Bell's palsy, shows a nonepidemic pattern that might indicate reactivation of a latent microorganism such as herpes simplex type I as a causative agent. Thirty percent of patients with Bell's palsy given no treatment will not recover completely, and 5% will have severe sequelae. The aim of this study was to find out whether treatment with an antiviral drug in combination with corticosteroids is more effective than no medical treatment at all in patients with Bell's palsy. Fifty-six consecutive adult patients attending the otorhinolaryngology department of the University Hospital of Lund from 1997 to 1999 were treated with 1 g of valacyclovir hydrochloride 3 times per day for 7 days and 50 mg of prednisone daily for 5 days, with the dose being reduced by 10 mg daily for the next 5 days. Fifty-six adult patients with Bell's palsy attending the same department between 1995 and 1996 who were given no medical treatment were studied retrospectively and used as the control group. Forty-nine patients (87.5%) in the treatment group recovered completely, as compared with 38 patients (68%) in the control group (p <.05). One patient (1.8%) in the treatment group displayed severe sequelae, defined as a House-Brackmann score of IV or worse, as compared with 10 of 56 patients (18%) in the control group (p <.01). Among patients over 60 years old, 10 of 10 in the treatment group had complete recovery, as compared with 5 of 12 patients in the control group (p <.01). The present study showed a significantly better outcome in patients with Bell's palsy treated with valacyclovir and prednisone as compared with patients given no medical treatment. This difference in outcome was especially pronounced among elderly patients.

scholarly journals Medial Pontomedullary Stroke Mimicking Severe Bell’s Palsy: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 380-383
Author(s):  
Benjamin Boodale ◽  
Manish Amin ◽  
Katayoun Sabetian ◽  
Daniel Quesada ◽  
Tyler Torrico
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Bell’S Palsy ◽  
Facial Weakness ◽  
Bell's Palsy ◽  
Sensory Deficits ◽  
Contralateral Motor ◽  
Pontomedullary Junction ◽  
Gaze Palsy ◽  
Pontine Infarct

Introduction: Patients with acute unilateral upper and lower facial palsy frequently present to the emergency department fearing they have had a stroke, but many cases are benign Bell’s palsy. Case Report: We present a rare case of a medial pontomedullary junction stroke causing upper and lower hemifacial paralysis associated with severe dysphagia and contralateral face and arm numbness. Conclusion: Although rare, pontine infarct must be considered in patients who present with both upper and lower facial weakness. Unusual neurologic symptoms (namely diplopia, vertigo, or dysphagia) and signs (namely gaze palsy, nystagmus, or contralateral motor or sensory deficits) should prompt evaluation for stroke.

Mo1532 Clinical Factors Affecting NAFLD and NASH Progression in African-American Patients at a Local University Hospital

2016 ◽  
Vol 150 (4) ◽  
pp. S716
Author(s):  
Zaki A. Sherif ◽  
Armana Saeed ◽  
Syed-Mehdi Nouraie ◽  
Angesom Kibreab ◽  
Edward L. Lee ◽  
...  
Keyword(s):  
African American ◽  
University Hospital ◽  
Clinical Factors ◽  
Factors Affecting

Facial Weakness

2015 ◽  
Author(s):  
Aziz Shaibani
Keyword(s):  
Facial Palsy ◽  
Neuromuscular Disorders ◽  
Bell’S Palsy ◽  
Facial Weakness ◽  
Bell's Palsy ◽  
Upper Face

Unilateral or bilateral facial weakness is an important manifestation of many neuromuscular disorders; some of them are as simple as Bell’s palsy while others are as serious as Guillain-Barrésyndrome. Facial weakness can be easily mimicked, and therefore psychogenic etiology should always be borne in mind. Peripheral facial weakness affects all functions and parts, while central weakness may save the upper face and may affect emotional and voluntary functions differentially. There are several causes of bilateral facial palsy but statistically, Bell’s palsy is still the most common. Long term complications of facial palsy can be devastating and facial rejuvination surgery is usually only modestly effective.

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