The Significance of Bell's Palsy That Presents as Monocranial Versus Polycranial Neuropathy: A Case Series and Systematic Literature Review.
Journal
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
ISSN: 1537-4505
Titre abrégé: Otol Neurotol
Pays: United States
ID NLM: 100961504
Informations de publication
Date de publication:
01 Dec 2023
01 Dec 2023
Historique:
medline:
10
11
2023
pubmed:
14
10
2023
entrez:
13
10
2023
Statut:
ppublish
Résumé
To investigate the effect of Bell's palsy (BP) presenting as polycranial neuropathy (PCN) compared with BP caused by isolated facial nerve (CNVII). We carried out a retrospective cohort study of the medical records of all consecutive patients who were diagnosed with BP at a single tertiary referral center between 2010 and 2017. Included were patients 18 years or older who were clinically diagnosed with BP and completed 7 days of systemic steroidal treatment and at least 6 months of follow-up. The patients were divided into two groups according to whether the BP derived from a monocranial neuropathy or a PCN. Demographics and BP severity and outcome were compared between these groups. A systematic literature review using Medline via "PubMed," "Embase," and "Web of Science" was conducted. In total, 321 patients with BP were enrolled. The median (interquartile range) age at presentation was 44 (33-60) years. Sex distribution showed male predominance of 57.6% (n = 185) versus 42.4% (n = 136), and 21.2% (n = 68) had PCN. The most concomitantly affected cranial nerve (CN) was the trigeminal (CNV; n = 32, 47%), followed by the glossopharyngeal nerve (CNIX; n = 14, 21%) and the audiovestibular nerve (CNVIII; n = 10, 15%). Age, House-Brackmann score on presentation, and diabetes mellitus (DM) were independent predictors for PCN etiology ( p = 0.001, p = 0.034, and p < 0.001, respectively). Each increase in 1 year of age was associated with additional odds ratio (95% confidence interval) of 0.97 (0.95-0.99) for PCN. The odds ratio (95% confidence interval) associated with DM was 8.19 (4.02-16.70). Our systematic literature review identified 1,440 patients with the PCN type of BP. The most commonly affected CN was the trigeminus (25-48%), followed by the glossopharyngeal and audiovestibular nerves (2-19% and 0-43%, respectively). The severity of facial weakness on initial presentation among PCN patients was significantly higher compared with the monocranial neuropathy-type BP patients. The authors believe that the significant association and prevalence rate ratio between DM and PCN warrant that a patient presenting with PCN undergo screening for DM.
Identifiants
pubmed: 37832579
doi: 10.1097/MAO.0000000000004017
pii: 00129492-990000000-00420
doi:
Types de publication
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1086-1093Informations de copyright
Copyright © 2023, Otology & Neurotology, Inc.
Déclaration de conflit d'intérêts
The authors have no financial conflicts of interest relevant to this article to disclose.
Références
Ljøstad U, Økstad S, Topstad T, Mygland Å, Monstad P. Acute peripheral facial palsy in adults. J Neurol 2005;252:672–6.
Loukas M. The neurologist's dilemma: A comprehensive clinical review of Bell's palsy, with emphasis on current management trends. Med Sci Monit 2014;20:83–90.
Peitersen E. Bell's palsy: The spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol 2002;122:4–30.
Schirm J, Mulkens PS. Bell's palsy and herpes simplex virus. APMIS 1997;105:815–23.
Murakami S, Mizobuchi M, Nakashiro Y, et al. Bell palsy and herpes simplex virus: Identification of viral DNA in endoneurial fluid and muscle. Ann Intern Med 1996;124(1 Pt 1):27–30.
Katusic SK, Beard CM, Wiederholt WC, Bergstralh EJ, Kurland LT. Incidence, clinical features, and prognosis in Bell's palsy, Rochester, Minnesota, 1968–1982. Ann Neurol 1986;20:622–7.
Gilden D. Bell's palsy. N Engl J Med 2004;351:1323–31.
Akcan F, Dundar Y, Uluat A, Korkmaz H, Ozdek A. Clinical prognostic factors in patients with idiopathic peripheral facial nerve paralysis (Bell's palsy). Eur Res J 2017;3:170–4.
Adour K. Diagnosis and management of facial paralysis. N Engl J Med 1982;307:348–51.
Benatar M, Edlow J. The spectrum of cranial neuropathy in patients with Bell's palsy. Arch Intern Med 2004;164:2383–5.
Maller T, Goldenstein S, Ronen O. Prevalence and characteristics of hearing loss in patients diagnosed with Bell's palsy. Eur Arch Otorhinolaryngol 2017;275:99–102.
Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg 2013;149(3 Suppl):S1–S27.
Williams DM. Clinical pharmacology of corticosteroids. Respir Care 2018;63:655–70.
Streck WF, Lockwood DH. Pituitary adrenal recovery following short-term suppression with corticosteroids. Am J Med 1979;66:910–4.
Holland J. Bell's palsy. BMJ Clin Evid 2008;2011:1204.
House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93:184–93.
Ozgur A, Semai B, Hidir UU, et al. Which electrophysiological measure is appropriate in predicting prognosis of facial paralysis? Clin Neurol Neurosurg 2010;112:844–8.
Klein L, Handzel O, Shilo S, et al. Is sudden sensorineural hearing loss an otologic emergency? Evidence-based cutoff for optimal treatment initiation for sudden unilateral sensorineural hearing loss: a case series and meta-analyses. Otol Neurotol 2023;44:216–22.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev 2021;10:89.
Simani L, Oron Y, Handzel O, et al. Paper patching versus watchful waiting of traumatic tympanic membrane perforations: A meta-analysis. Laryngoscope 2021;131:2091–7.
Ungar OJ, Handzel O, Oron Y, et al. The actual incidence and types of hearing losses in bullous myringitis: Case series and systematic review. Otol Neurotol 2021;42:1008–13.
Ungar OJ, Baris H, Oron Y, et al. Meta-analysis of time to extrusion of tympanostomy tubes by tympanic membrane quadrant. Clin Otolaryngol 2021;46:1165–71.
Nieuwmeyer PA, Visser SL, Feenstra L. Bell's palsy: A polyneuropathy. Am J Otol 1985;6:250–2.
Nieuwmeyer PA, Koch PAM, Visser SL, Feenstra L. Bill's palsy: A polyneuropathy. Clin Otolaryngol Allied Sci 1982;7:293–8.
Sandstedt P, Hydén D, Ödkvist L. Bell's palsy—part of a polyneuropathy? Acta Neurol Scand 1981;64:66–73.
Aviel A, Ostfeld E, Marshak G, Burstein R, Bentwich Z. Peripheral blood T and B lymphocyte subpopulations in Bell's palsy. Ann Otol Rhinol Laryngol 1983;92:187–91.
Rauchbach E, May M, Stroud MH. Vestibular involvement in Bell's palsy. Laryngoscope 1975;85:1396–8.
Abdel-Baki F, Moghazi H, Eassa A, Talaat F. Peripheral nerve involvement in acute Bell's palsy. J Laryngol Otol 1988;102:447–8.
Bueri JA, Cohen LG, Panizza ME, Sanz OP, Sica REP. Peripheral nerve involvement in Bell's palsy. Arq Neuropsiquiatr 1984;42:341–5.
Adour KK, Byl FM, Hilsinger RL Jr., Kahn ZM, Sheldon MI. The true nature of Bell's palsy: Analysis of 1,000 consecutive patients. Laryngoscope 1978;88:787–801.
Kaviani M, Jafary AH. Auditory brain-stem response audiometry in patients with Bell's palsy. Clin Otolaryngol Allied Sci 1995;20:135–8.
Edstrom S, Hanner P, Andersen O, et al. Elevated levels of myelin basic protein in CSF in relation to auditory brainstem responses in Bell's palsy. Acta Otolaryngol 1987;103(3–4):198–203.
Sajadi MM, Sajadi MRM, Tabatabaie SM. The history of facial palsy and spasm: Hippocrates to Razi. Neurology 2011;77:174–8.
Dumitru D, Walsh NE, Porter LD. Electrophysiologic evaluation of the facial nerve in Bell's palsy. A review. Am J Phys Med Rehabil 1988;67:137–44.
May M, Klein SR, Taylor FH. Idiopathic (Bell's) facial palsy: Natural history defies steroid or surgical treatment. Laryngoscope 1985;95:406–9.
Adour KK. Cranial polyneuritis and Bell palsy. Arch Otolaryngol 1976;102:262–4.
Djupesland G, Degré M, Stien R, Skrede S. Acute peripheral facial palsy: Part of a cranial polyneuropathy? Arch Otolaryngol 1977;103:641–4.
May M, Hardin WB. Facial palsy: Interpretation of neurologic findings. Laryngoscope 1978;88(8 Pt 1):1352–62.
Möller F. Critical viewpoints on the pathogenesis in Bell's palsy. Acta Neurologica Scandinavica 1967;43:228–238.
Naufal PM, Schuknecht HF. Vestibular, facial, and oculomotor neuropathy in diabetes mellitus. Arch Otolaryngol 1972;96:468–74.
Holland NJ, Weiner GM. Recent developments in Bell's palsy. BMJ 2004;329:553–7.
Hopf HC. Electromyographic study on so-called mononeuritis. Arch Neurol 1963;9:307–12.
Psillas G, Dimas GG, Sarafidou A, et al. Evaluation of effects of diabetes mellitus, hypercholesterolemia and hypertension on Bell's palsy. J Clin Med 2021;10:2357.
Yoo MC, Soh Y, Chon J, et al. Evaluation of factors associated with favorable outcomes in adults with Bell palsy. JAMA Otolaryngol Head Neck Surg 2020;146:256–63.
Fujiwara T, Hato N, Gyo K, Yanagihara N. Prognostic factors of Bell's palsy: Prospective patient collected observational study. Eur Arch Otorhinolaryngol 2014;271:1891–5.
Kanazawa A, Haginomori SI, Takamaki A, et al. Prognosis for Bell's palsy: A comparison of diabetic and nondiabetic patients. Acta Otolaryngol 2007;127:888–91.
Xu G, Liu B, Sun Y, et al. Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: Population based study. BMJ 2018;362:k1497.
Pecket P, Schattner A. Concurrent Bell's palsy and diabetes mellitus: A diabetic mononeuropathy? J Neurol Neurosurg Psychiatry 1982;45:652–5.
Riga M, Kefalidis G, Danielides V. The role of diabetes mellitus in the clinical presentation and prognosis of Bell palsy. J Am Board Fam Med 2012;25:819–26.
Thomas PK, Lascelles RG. The pathology of diabetic neuropathy. QJM Int J Med 1966;35:489–509.
Winegrad AI. Diabetic neuropathy. N Engl J Med 1972;286:1261–2.
Kariya S, Cureoglu S, Morita N, et al. Vascular findings in the facial nerve canal in human temporal bones with diabetes mellitus. Otol Neurotol 2009;30:402–7.
Scheller C, Wienke A, Tatagiba M, et al. Interobserver variability of the House-Brackmann facial nerve grading system for the analysis of a randomized multi-center phase III trial. Acta Neurochir (Wien) 2017;159:733–8.