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Clinical Case Reports May 2022Bell's palsy in pregnancy is not frequently seen. The association of preeclampsia with Bell's palsy is reported in the research, however, the exact link between Bell's...
Bell's palsy in pregnancy is not frequently seen. The association of preeclampsia with Bell's palsy is reported in the research, however, the exact link between Bell's palsy and preeclampsia is unknown. The treatment of Bell's palsy during the pregnancy is difficult and controversial. We report two cases of Bell's palsy with preeclampsia diagnosed during the third trimester of the pregnancy. The first case was diagnosed with Bell's palsy with severe preeclampsia with placental abruption with fetal distress; the pregnancy was terminated by cesarean section. Another case was diagnosed with Bell's palsy with mild preeclampsia. She had a spontaneous vaginal delivery at term. Both the cases achieved complete recovery from Bell's palsy after treatment with corticosteroid and antiviral drugs. Every obstetrician should be able to recognize Bell's palsy in pregnancy and initiate early treatment with corticosteroid and mount surveillance for preeclampsia.
PubMed: 35620256
DOI: 10.1002/ccr3.5918 -
Laryngoscope Investigative... Oct 2023There are limited studies reporting on Bell's palsy and pregnancy. Our study aimed to evaluate risk factors, current treatment options and facial function outcomes in... (Review)
Review
OBJECTIVE
There are limited studies reporting on Bell's palsy and pregnancy. Our study aimed to evaluate risk factors, current treatment options and facial function outcomes in women who developed Bell's palsy in pregnancy. To our knowledge this is the first review analyzing these factors.
DATA SOURCES/REVIEW METHODS
A search of PubMed/MEDLINE, Embase, Web of Sciences and Scopus was carried out. Studies describing risk factors, treatment and/or facial function outcomes of Bell's palsy in pregnancy were included. PRISMA-Scr guidelines were followed.
RESULTS
The search yielded 392 abstracts, of which 15 studies were included for analysis. It was not possible to perform a meta-analysis due to small numbers and quality of studies. There were 559 patients included from the 15 studies. The third trimester was the most common time for Bell's palsy to occur ( = 364, 65%). Pre-eclampsia was the most common co-morbidity reported. The most common treatment was corticosteroids and the majority of patients had a complete recovery of their palsy (58%, = 192).
CONCLUSION
This analysis has evaluated all available data concerning risk factors, treatment and facial function outcomes of BP in pregnancy. The third trimester is the most common time for Bell's palsy to occur in pregnancy. There is currently a lack of high quality evidence into this condition in pregnancy.
LEVEL OF EVIDENCE
1.
PubMed: 37899862
DOI: 10.1002/lio2.1136 -
International Journal of Environmental... Nov 2020We intended to determine the relationship between previous statin use and Bell's palsy in a large study population receiving statins for the past 2 years. The Korean...
We intended to determine the relationship between previous statin use and Bell's palsy in a large study population receiving statins for the past 2 years. The Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 were collected. Participants with Bell's palsy ( = 3203) were matched with participants without Bell's palsy ( = 12,812). The number of days of previous statin use for 2 years before the onset of Bell's palsy was analyzed using conditional logistic regression. Subgroups of age, sex, obesity, smoking, alcohol consumption, total cholesterol, and blood pressure were analyzed for any association between Bell's palsy and prior statin use. The Bell's palsy group reported greater statin use than the non-Bell's palsy group (84.6 (standard deviation, SD = 201.7) vs. 74.4(SD = 189.4), = 0.009). Previous statin use was associated with Bell's palsy in the crude model (95% confidence intervals = 1.03-1.19, = 0.006). However, this relationship disappeared when the possible covariates were adjusted for in model 2. All subgroups showed no increased odds for Bell's palsy in previous statin users. We did not find an association between Bell's palsy and previous statin use in this Korean population aged ≥40 years.
Topics: Adult; Aged; Aged, 80 and over; Alcohol Drinking; Bell Palsy; Cohort Studies; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Middle Aged; Republic of Korea; Risk Factors; Smoking
PubMed: 33202921
DOI: 10.3390/ijerph17228408 -
European Annals of Otorhinolaryngology,... Dec 2020AQFThe authors present the guidelines of the French Society of ENT and Head and Neck Surgery (SFORL) regarding the management of Bell's palsy in adults. After a...
AQFThe authors present the guidelines of the French Society of ENT and Head and Neck Surgery (SFORL) regarding the management of Bell's palsy in adults. After a literature review by a multidisciplinary workgroup, guidelines were drawn up based on retrieved articles and group-members' experience, then read over by an independent group to edit the final version. Guidelines were graded A, B, C or "expert opinion" according to decreasing level of evidence. Thorough ENT and neurological clinical examination is recommended in all patients presenting with peripheral facial palsy to confirm diagnosis of Bell's palsy. MRI with gadolinium enhancement should explore the entire course of the facial nerve, if possible within the first month. ENMG should be performed to assess prognosis for recovery. In confirmed Bell's palsy, corticosteroid therapy should be implemented as early as possible (ideally within 72h) at a dose of 1mg/kg/day for 7-10 days. Antiviral therapy should be associated to steroids in patients with severe and early-onset disease and in Ramsay-Hunt syndrome. Isolated antiviral therapy is not recommended. To date, there is no evidence that surgical facial nerve decompression provides benefit.
Topics: Acute Disease; Adrenal Cortex Hormones; Antiviral Agents; Bell Palsy; Contrast Media; Decompression, Surgical; Drug Administration Schedule; Drug Therapy, Combination; Facial Nerve; Facial Paralysis; France; Gadolinium; Herpes Zoster Oticus; Humans; Hyperbaric Oxygenation; Magnetic Resonance Imaging; Neurologic Examination; Otolaryngology; Physical Therapy Modalities; Prognosis; Recovery of Function; Societies, Medical
PubMed: 32636146
DOI: 10.1016/j.anorl.2020.06.004 -
Medicine Mar 2020This study aimed to evaluate the relationship between Bell's palsy and rheumatoid arthritis in a national sample cohort from Korea.Data were collected for individuals... (Comparative Study)
Comparative Study Observational Study
This study aimed to evaluate the relationship between Bell's palsy and rheumatoid arthritis in a national sample cohort from Korea.Data were collected for individuals ≥20 years old from 2002 to 2013 in the Korean National Health Insurance Service-National Sample Cohort. We extracted data for patients with rheumatoid arthritis (n = 7628) and 1:4-matched controls (n = 30,512) and analyzed the occurrence of Bell's palsy in both groups. Matching was performed based on age, sex, income, and region of residence. Rheumatoid arthritis was diagnosed according to International Classification of Disease-10 (ICD-10) codes (M05-M06) and the prescription of biological agents and/or disease-modifying antirheumatic drugs. Bell's palsy patients were diagnosed according to ICD-10 code H912 and treatment ≥2 times with steroids. Adjusted hazard ratios (HRs) were calculated using stratified Cox proportional hazard models for the Charlson comorbidity index and 95% confidence intervals (CIs). Subgroup analyses based on age and sex were also performed.The rates of Bell's palsy were similar between the rheumatoid arthritis group (0.5% [38/7628]) and the control group, with no significant difference (0.4% [124/30,512], P = .270). The adjusted HR for Bell's palsy was 1.12 (95% CI, 0.78-1.62) in the rheumatoid arthritis group (P = .540). In the subgroup analyses according to age and sex, the relationship between Bell's palsy and rheumatoid arthritis did not reach statistical significance.The risk of Bell's palsy was not increased in patients with rheumatoid arthritis.
Topics: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Bell Palsy; Comorbidity; Female; Humans; Incidence; International Classification of Diseases; Longitudinal Studies; Male; Middle Aged; Prevalence; Republic of Korea; Risk Factors; Young Adult
PubMed: 32195966
DOI: 10.1097/MD.0000000000019568 -
Journal of Neurology, Neurosurgery, and... Aug 2001The strict definition of the Ramsay Hunt syndrome is peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear (zoster oticus) or in the... (Review)
Review
The strict definition of the Ramsay Hunt syndrome is peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear (zoster oticus) or in the mouth. J Ramsay Hunt, who described various clinical presentations of facial paralysis and rash, also recognised other frequent symptoms and signs such as tinnitus, hearing loss, nausea, vomiting, vertigo, and nystagmus. He explained these eighth nerve features by the close proximity of the geniculate ganglion to the vestibulocochlear nerve within the bony facial canal. Hunt's analysis of clinical variations of the syndrome now bearing his name led to his recognition of the general somatic sensory function of the facial nerve and his defining of the geniculate zone of the ear. It is now known that varicella zoster virus (VZV) causes Ramsay Hunt syndrome. Compared with Bell's palsy (facial paralysis without rash), patients with Ramsay Hunt syndrome often have more severe paralysis at onset and are less likely to recover completely. Studies suggest that treatment with prednisone and acyclovir may improve outcome, although a prospective randomised treatment trial remains to be undertaken. In the only prospective study of patients with Ramsay Hunt syndrome, 14% developed vesicles after the onset of facial weakness. Thus, Ramsay Hunt syndrome may initially be indistinguishable from Bell's palsy. Further, Bell's palsy is significantly associated with herpes simplex virus (HSV) infection. In the light of the known safety and effectiveness of antiviral drugs against VZV or HSV, consideration should be given to early treatment of all patients with Ramsay Hunt syndrome or Bell's palsy with a 7-10 day course of famciclovir (500 mg, three times daily) or acyclovir (800 mg, five times daily), as well as oral prednisone (60 mg daily for 3-5 days). Finally, some patients develop peripheral facial paralysis without ear or mouth rash, associated with either a fourfold rise in antibody to VZV or the presence of VZV DNA in auricular skin, blood mononuclear cells, middle ear fluid, or saliva. This indicates that a proportion of patients with "Bell's palsy" have Ramsay Hunt syndrome zoster sine herpete. Treatment of these patients with acyclovir and prednisone within 7 days of onset has been shown to improve the outcome of recovery from facial palsy.
Topics: Bell Palsy; Humans; Parkinsonian Disorders
PubMed: 11459884
DOI: 10.1136/jnnp.71.2.149 -
The Cochrane Database of Systematic... Aug 2010Bell's palsy or idiopathic facial palsy is an acute facial paralysis due to inflammation of the facial nerve. A number of studies published in China have suggested... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Bell's palsy or idiopathic facial palsy is an acute facial paralysis due to inflammation of the facial nerve. A number of studies published in China have suggested acupuncture is beneficial for facial palsy.
OBJECTIVES
The objective of this review was to examine the efficacy of acupuncture in hastening recovery and reducing long-term morbidity from Bell's palsy.
SEARCH STRATEGY
We updated the searches of the Cochrane Neuromuscular Disease Group Trials Specialized Register (24 May 2010), The Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2010), MEDLINE (January 1966 to May 2010), EMBASE (January 1980 to May 2010), AMED (January 1985 to May 2010), LILACS (from January 1982 to May 2010) and the Chinese Biomedical Retrieval System (January 1978 to May 2010) for randomised controlled trials using 'Bell's palsy' and its synonyms, 'idiopathic facial paralysis' or 'facial palsy' as well as search terms including 'acupuncture'. Chinese journals in which we thought we might find randomised controlled trials relevant to our study were handsearched. We reviewed the bibliographies of the randomised trials and contacted the authors and known experts in the field to identify additional published or unpublished data.
SELECTION CRITERIA
We included all randomised controlled trials involving acupuncture by needle insertion in the treatment of Bell's palsy irrespective of any language restrictions.
DATA COLLECTION AND ANALYSIS
Two review authors identified potential articles from the literature search, extracted data and assessed quality of each trial independently. All disagreements were resolved by discussion between the review authors.
MAIN RESULTS
The literature search and handsearching identified 49 potentially relevant articles. Of these, six RCTs were included involving 537 participants with Bell's palsy. Two more possible trials were identified in the update than the previous version of this systematic review, but both were excluded because they were not real RCTs. Of the six included trials, five used acupuncture while the other one used acupuncture combined with drugs. No trial reported on the outcomes specified for this review. Harmful side effects were not reported in any of the trials. Poor quality caused by flaws in study design or reporting (including uncertain method of randomisation, allocation concealment and blinding) and clinical differences between trials prevented reliable conclusions about the efficacy of acupuncture.
AUTHORS' CONCLUSIONS
The quality of the included trials was inadequate to allow any conclusion about the efficacy of acupuncture. More research with high quality trials is needed.
Topics: Acupuncture Therapy; Bell Palsy; Combined Modality Therapy; Humans; Randomized Controlled Trials as Topic
PubMed: 20687071
DOI: 10.1002/14651858.CD002914.pub5 -
Acta Otorhinolaryngologica Italica :... Oct 2019
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bell Palsy; Facial Paralysis; Female; Humans; Italy; Male; Middle Aged; Multivariate Analysis; Recurrence; Regression Analysis; Retrospective Studies; Risk Factors; Severity of Illness Index; Treatment Outcome; Young Adult
PubMed: 31708578
DOI: 10.14639/0392-100X-2415 -
Journal of Biomedical Physics &... Sep 2018Bell's palsy is an idiopathic peripheral nerve palsy involving the facial nerve. It accounts for 60 to 75% of all cases of unilateral facial paralysis. The main...
Bell's palsy is an idiopathic peripheral nerve palsy involving the facial nerve. It accounts for 60 to 75% of all cases of unilateral facial paralysis. The main mechanisms to induce BP remain unclear, but infection, ischemic condition and immunodeficiency may contribute to the development of Bell's palsy. Accumulating evidence has shown several factors can trigger the reactivation of latent HSV including psychological stressors, physical stressors and immunosuppression. Ionization and non-ionization radiations are of importance of physical stressors. Some data have shown radiation can reactivate HSVs. Based on preliminary studies showing radiation reactivation of HSVs, we aimed to hypothesize radiation (in both forms of ionization and non-ionization) may cause Bell's palsy. In the future, the role of radiotherapy, radiofrequency radiation from mobile phones and wireless devices in HSV reactivation and Bell's palsy should be investigated.
PubMed: 30320038
DOI: No ID Found -
American Journal of Translational... 2023Bell's palsy is an idiopathic, acute, unilateral peripheral facial nerve paralysis, where incomplete or failed recovery causes substantial social and psychological...
Bell's palsy is an idiopathic, acute, unilateral peripheral facial nerve paralysis, where incomplete or failed recovery causes substantial social and psychological stress to the patient, seriously influencing their quality of life and social activities. We conducted a bibliometric investigation of the knowledge structure and frontier hotspots in Bell's palsy research. Bell's palsy publications between 2002 and 2021 were retrieved from Web of Science. CiteSpace, VOSviewer, and an online bibliometric platform were used for visual, burst, citation, and co-occurrence analyses, respectively. A total of 1,378 publications were included. The annual Bell's palsy publication output followed an upward trend from 2002 to 2021. The USA and Harvard University published the most Bell's palsy research articles. Yeo SG and were the most prolific author and journal, respectively, on Bell's palsy. The results suggested that Bell's palsy research hotspots focused on rehabilitating facial nerve function and improving prognosis, and combining specific therapies (acupuncture) would be of future interest. The cited references timeline revealed that Bell's palsy following COVID-19 vaccination was an emerging research hotspot. The bibliometric analysis demonstrated that the USA dominates Bell's palsy research and that rehabilitating facial nerve function and prognosis were research hotspots. Emerging mechanistic studies mainly focused on Bell's palsy following COVID-19 vaccination. Our findings could be a reliable source for global scholars to rapidly identify research hotspots and potential research directions and frontiers.
PubMed: 37560237
DOI: No ID Found