Annualized Incidence and Spectrum of Illness from an Outbreak Investigation of Bell’s Palsy

Abstract

Background: There are limited clinical and epidemiological data on patients diagnosed with Bell’s palsy. While investigating an apparent clustering of Bell’s palsy, we sought to characterize the spectrum of illness in patients with this diagnosis. Methods: A telephone survey of persons with idiopathic facial (Bell’s) palsy in the Greater Toronto Area (GTA, population = 4.99 million) and Nova Scotia (population = 0.93 million) from August 1 to November 15, 1997 collected information on subject demographics, neurological symptoms, constitutional symptoms, medical investigation and management. Information regarding potential risks for exposure to infectious agents, past medical history, and family history of Bell’s palsy was also collected. Subjects with other secondary causes of facial palsy were excluded. Results: In the GTA and Nova Scotia, 222 and 36 patients were diagnosed with idiopathic facial (Bell’s) palsy, respectively. The crude annualized incidence of Bell’s palsy was 15.2 and 13.1 per 100,000 population in the GTA and Nova Scotia, respectively. There was no temporal or geographical clustering, and symptomatology did not differ significantly between the two samples. The mean age was 45 years, with 55% of subjects being female. The most common symptoms accompanying Bell’s palsy were increased tearing (63%), pain in or around the ear (63%), and taste abnormalities (52%). A significant number of patients reported neurological symptoms not attributable to the facial nerve. Conclusion: No clustering of cases of Bell’s palsy was observed to support an infectious etiology for the condition. Misdiagnosis of the etiology of facial weakness is common. Patients diagnosed with Bell’s palsy have a variety of neurological symptoms, many of which cannot be attributed to a facial nerve disorder.

Can blood parameters be used to assess the recovery time of Bell's palsy patients? A retrospective case-controlled study

“…In our study, four patients (8%) showed recurrence. [14,15] Recovery rate of Bell's palsy without treatment is reported as 70%. [16] This rate reaches 90% with steroid treatment.…”

Bell Paralizisi: Bir Olgu Sunumu ve Gözden Geçirme

“…The Bell's palsy characterizes by the involvement of one nerve but sometimes patients have myriad neurological symptoms like tingling sensation of the face, mild to moderate neck pain or head ache, balance problems, ipsilateral limb weakness and memory problems 9 .…”

Ophthalmic management of facial nerve palsy

“…Many aetiologies have been proposed, including a viral/inflammatory mechanism 3,4 and systemic steroids and/or acyclovir been recommended as treatment. However, two population-based studies from the UK 5 and Canada 6 have estimated an incidence of 13.1-20.2/100 000. Both studies found no temporal or geographical clustering to suggest a viral aetiology.…”