Bell’s Palsy—Retroauricular Pain Threshold

Kopitović, Aleksandar; Katanić, Filip; Kalember, Sandro; Simić, Svetlana; Vico, Nina; Sekulić, Slobodan

doi:10.3390/medicina57030263

Cited by 4 publications

(6 citation statements)

References 49 publications

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“…During the COVID pandemic era, there has been a noticeable increase in otalgia among patients, a symptom linked to worse prognosis and higher severity in Bell’s palsy cases. 30 31 32 Zoster sine herpes (ZSH), caused by VZV, is a clinical manifestation of neuropathic pain in the absence of a rash. The suggested etiology of ZSH is that viral reactivation occurs only in the enteric nervous system, which does not project to the skin, and the severity and duration of pain worse.…”

Section: Discussionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Bell’s Palsy and Ramsay-Hunt Syndrome: A Multicenter Retrospective Study

Kwak,

Lee,

Lee

et al. 2024

J Korean Med Sci

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Background This article presents a comprehensive review of data on the impact of facial palsy during the coronavirus disease 2019 (COVID-19) pandemic. The possible causes and pathophysiological mechanisms of changes in the epidemiology of facial palsy during the COVID-19 pandemic are also discussed. Methods This multicenter retrospective cohort study included 943 patients diagnosed with Bell’s palsy or Ramsay Hunt syndrome. This study compared patient demographics, comorbidities, symptoms, and treatments before the COVID-19 pandemic (from 2017 to 2019) and during the COVID-19 pandemic, from 2020 to 2022). Results Following the COVID-19 outbreak, there has been a significant increase in the number of cases of Bell’s palsy, particularly among elderly individuals with diabetes. Bell’s palsy increased after the COVID-19 outbreak, rising from 75.3% in the pre-COVID-19 era to 83.6% after the COVID-19 outbreak. The complete recovery rate decreased from 88.2% to 73.9%, and the rate of recurrence increased from 2.9% to 7.5% in patients with Bell’s palsy. Ramsay Hunt syndrome showed fewer changes in clinical outcomes. Conclusion This study highlights the impact of the COVID-19 pandemic on the presentation and management of facial palsy, and suggests potential associations with COVID-19. Notably, the observed increase in Bell’s palsy cases among elderly individuals with diabetes emphasizes the impact of the pandemic. Identifying the epidemiological changes in facial palsy during the COVID-19 pandemic has important implications for assessing its etiology and pathological mechanisms of facial palsy disease.

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Section: Discussionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Bell’s Palsy and Ramsay-Hunt Syndrome: A Multicenter Retrospective Study

Kwak,

Lee,

Lee

et al. 2024

J Korean Med Sci

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“…The first occurs after the onset of the palsy and is not equal to pain, whereas the latter is a prodromal syndrome before the palsy occurs ( 28 ). It might be that the pain threshold is decreased in the retroauricular region in the acute phase of the disease ( 29 ). Hence, it might be of interest to perform a QST study in the ear region of the patients.…”

Section: Discussionmentioning

confidence: 99%

Sensory function in the faces of patients with facial palsy: A prospective observational study using quantitative sensory testing

et al. 2022

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Objectives/HypothesisTo determine the sensory function of both sides of the face in patients with acute or chronic facial palsy.Study designProspective observational study.MethodsThe standardized quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain (DFNS), including thermal or mechanical stimuli (touch, pain, vibration, and pressure), was used to investigate somatosensory function in the faces of patients. A patient-reported outcome measures for the assessment of disturbed facial comfort or facial pain, the facial Clinimetric Evaluation Scale (FaCE) Facial Comfort Subscale, and the 36-Item Short Form Survey (SF-36) pain subdomain were used.ResultsA total of 29 patients (22 female, median age of 48 years; 7 acute palsy; 22 chronic palsy; House-Brackmann grade II–VI) were included. The median FaCE Facial Comfort Subscale score and the median SF-36 pain subdomain score were 50 and 100, respectively. Most patients had, at an individual level, a normal sensory function in all or most tests. On average, the frequencies for all parameters were not different between the paretic side and the contralateral side (all p > 0.05). Additionally, when z-scores were used to compare our patient sample with healthy controls from the DFNS reference database, there was no difference between the paretic side and the contralateral side (all p > 0.05). Furthermore, there were no differences between patients with acute facial palsy and those with chronic facial palsy (all p > 0.05). The FaCE Facial Comfort Subscale score and the SF-36 pain subdomain score did not correlate with the QST parameters (all p > 0.05).ConclusionPatients with acute or chronic unilateral peripheral facial palsy had normal sensory function on the paretic and contralateral sides compared with the reference values of healthy controls, and there was no significant difference between the sides. The numbness frequently felt in the affected hemiface is not related to a peripheral sensory disorder and is most likely a manifestation of an unsolved cortical somatosensory-motor mismatch.

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“…The prevalence of pain has been reported to range from 50% to 65% in patients of any age with Bell’s palsy 3 8–11. The pain typically occurs as either a prodromal symptom preceding facial paralysis or concurrently with the onset of facial paralysis 3 8–10 12–16. There is no consensus on whether pain has prognostic significance or its aetiology.…”

Section: Introductionmentioning

confidence: 99%

“…There is no consensus on whether pain has prognostic significance or its aetiology. Some studies show no prognostic significance,10–12 while others report more severe disease or higher rates of incomplete recovery in patients with pain 3 8 9 13–16…”

Section: Introductionmentioning

confidence: 99%

“…Despite many studies evaluating pain in patients with Bell’s palsy, none of them have been conducted exclusively in a paediatric population, or published age disaggregated data in studies with mixed populations of adults and children 3 8–10 12–16. As part of a larger body of work to improve the care of children with Bell’s palsy, we recently completed a randomised controlled trial (RCT) of prednisolone for the treatment of Bell’s palsy.…”

Section: Introductionmentioning

confidence: 99%

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Pain in children with Bell’s palsy: secondary analysis of a randomised controlled trial

Babl,

Eapen,

Herd

et al. 2023

Arch Dis Child

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ObjectiveTo describe the prevalence and severity of pain experienced by children with Bell’s palsy over the first 6 months of illness and its association with the severity of facial paralysis.MethodsThis was a secondary analysis of data obtained in a phase III, triple-blinded, randomised, placebo-controlled trial of prednisolone for the treatment of Bell’s palsy in children aged 6 months to <18 years conducted between 13 October 2015 and 23 August 2020 in Australia and New Zealand. Children were recruited within 72 hours of symptom onset and pain was assessed using a child-rated visual analogue scale (VAS), a child-rated Faces Pain Score-Revised (FPS-R) and/or a parent-rated VAS at baseline, and at 1, 3 and 6 months until recovered, and are reported combined across treatment groups.ResultsData were available for 169 of the 187 children randomised from at least one study time point. Overall, 37% (62/169) of children reported any pain at least at one time point. The frequency of any pain reported using the child-rated VAS, child-rated FPS-R and parent-rated VAS was higher at the baseline assessment (30%, 23% and 27%, respectively) compared with 1-month (4%, 0% and 4%, respectively) and subsequent follow-up assessments. At all time points, the median pain score on all three scales was 0 (no pain).ConclusionsPain in children with Bell’s palsy was infrequent and primarily occurred early in the disease course and in more severe disease. The intensity of pain, if it occurs, is very low throughout the clinical course of disease.Trial registration numberACTRN12615000563561.

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Bell’s Palsy—Retroauricular Pain Threshold

Cited by 4 publications

References 49 publications

The Impact of the COVID-19 Pandemic on Bell’s Palsy and Ramsay-Hunt Syndrome: A Multicenter Retrospective Study

The Impact of the COVID-19 Pandemic on Bell’s Palsy and Ramsay-Hunt Syndrome: A Multicenter Retrospective Study

Sensory function in the faces of patients with facial palsy: A prospective observational study using quantitative sensory testing

Pain in children with Bell’s palsy: secondary analysis of a randomised controlled trial

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