Evaluation of prognostic factors in patients with Bell's palsy

Abstract

Background: Bell's palsy is a common neurological problem that leads to peripheral palsy of the facial nerve. Most patients have a favorable response with or without treatment while some are left with significant facial deformity. Identification of factors which influence the outcome in patients with Bell's palsy may help clinicians counsel better. Methods:A prospective cross-sectional study was carried out in the Department of Neurology Nobel Medical College, Biratnagar, between February 2020 and February 2021 after obtaining ethical clearance from the institutional review committee.Patients were assessed at the time of presentation to hospital and followed up at 1 week, 1 month, and 3 months after the onset of illness to evaluate for recovery. Results: Sixty-two (61.4%) of 101 patients had a favorable outcome at the follow up on the third month, achieving H-B grade 2 or lower, while 33 (32.7%) had moderate dysfunction and 6 (5.9%) had severe dysfunction. The following factors were associated with favorable outcome: younger age of onset (p < .001), lower initial H-B grade of III or IV (p = .001), lesser degree of amplitude reduction on affected side as compared to unaffected side (p = .001) and absence of hypertension and diabetes. The following factors did not influence outcome at three months: duration of Bell's palsy (p = 0.142), side of face affected, and gender (p = .09). Conclusions: Most of the patients with Bell's palsy have favorable outcomes. Age, hypertension, initial H-B grade, and extent of facial nerve degeneration as recorded by nerve conduction studies are important predictors of outcome.

Risk and characteristics of Bell’s palsy in adults as an adverse event following COVID-19 vaccination: a retrospective study

“…In our study, the patients with vaccine-related BP were younger than those with vaccine-unrelated BP, which may have affected the difference in recovery between the two groups. Age has been considered an important prognostic factor affecting the final outcome and recovery time of BP in several previous studies that showed a higher final recovery rate and shorter recovery time in younger patients [38][39][40]. It has been suggested that the better recovery outcome in younger patients may be due to the greater ability of damaged facial nerve axons to regenerate faster in younger patients than in older patients.…”

Comparing the Use of High-Dose to Standard-Dose Corticosteroids for the Treatment of Bell’s Palsy in Adults—A Systematic Review and Meta-analysis

“…Patients included by Inamura et al (18) generally had a less severe facial palsy with Yanagihara scores <20 more similar to House-Brackmann scores of IV (moderately severe dysfunction) or worse. Other predictors of facial palsy recovery include hypertension and age (30), both of which were not documented in the baselines characteristics of included patients in all three studies. This therefore represents a confounder that may have unknowingly influenced the results and heterogeneity between studies.…”

Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy

“…Most cases of BP resolve after a few months. However, age and the severity of facial paralysis based on the House-Brackmann scale may predict poor outcomes …”

“…However, age and the severity of facial paralysis based on the House-Brackmann scale may predict poor outcomes. 27 Because vaccination has been conducted globally, identifying the related short-and long-term adverse events is of great significance. A review of the literature reveals several studies reporting BP occurrence following SARS-CoV-2 vaccination.…”