French Society of ENT (SFORL) guidelines. Management of acute Bell's palsy

Fieux, M.; Franco-Vidal, V.; Devic, Perrine; Bricaire, François; Charpiot, Anne; Darrouzet, V.; Denoix, L.; Gatignol, Peggy; Guevara, N.; Montava, Marion; Roch, J. Albendea; Tankéré, F.; Tronche, Sébastien; Veillon, F.; Vergez, S.; Vincent, C.; Lamas, G.; Tringali, S.

doi:10.1016/j.anorl.2020.06.004

Cited by 32 publications

(41 citation statements)

References 39 publications

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“…This result showed us that there were no relationships between enhancement on MRI and prognosis and the course of the disease. Two recently published clinical guidelines on the diagnosis, treatment and follow-up of BP, supporting our results, emphasize that routine MRI should not be performed in BP patients for clinical follow-up ( 19 , 20 ).…”

Section: Discussionsupporting

confidence: 88%

Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy

Yücel¹,

Güneş²,

Keseroğlu³

et al. 2022

TAO

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Objective: To investigate the prognostic value of the magnetic resonance imaging in Bell’s palsy patients. Methods: Patients who were diagnosed and treated with Bell’s palsy between October 2013 and March 2016 retrospectively selected. House–Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell’s palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data. Results: No significant correlation was observed between pretreatment House–Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell’s palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement. Conclusion: The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell’s palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell’s palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression.

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Section: Discussionsupporting

confidence: 88%

Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy

Yücel¹,

Güneş²,

Keseroğlu³

et al. 2022

TAO

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“…The patient (weight 65 kg) received prednisone 25 mg/day (0.38 mg/kg/day) for 1 week then gradually tapered off over a period of 2 weeks until suspension. This steroid schedule was at a lower dose than that usually adopted for the treatment of cranial nerve palsies, 4 but eventually led to a fast recovery of the clinical manifestations in our patient after 5 days of treatment.…”

Section: Case Presentationmentioning

confidence: 64%

Third cranial nerve palsy in an 88-year-old man after SARS-CoV-2 mRNA vaccination: change of injection site and type of vaccine resulted in an uneventful second dose with humoral immune response

et al. 2022

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Vaccines for SARS-CoV-2 currently authorised by the European Medicine Agency are effective, safe and well tolerated in practice. Awareness of rare potential vaccine-related adverse effects (AEs) is important to improve their recognition, management and reporting. An 88-year-old man attended the emergency department with incomplete palsy of the right third cranial nerve 3 days after the first administration of Moderna mRNA-1273 SARS-CoV-2 vaccine. Imaging ruled out a vascular accident and a vaccine AE was hypothesised. Two weeks of oral steroids led to the patient’s recovery, but without evidence of humoral immune response to vaccine. Thus, full immunisation with a dose of Pfizer mRNA-BNT162b2 SARS-CoV-2 vaccine in a different site was attempted. This was uneventful and followed by a robust antibody response. Empirical change of site and vaccine brand may represent a tailored option to obtain full immune protection in selected patients, after vaccine AEs.

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“…Any acute or subacute (< 72 hours) onset PFP following primary vaccination against COVID-19 or following a booster vaccination should be reported to pharmacovigilance as soon as possible (after informing the patient). As this is a diagnosis of exclusion, a standardised clinical examination and complementary explorations should be systematically performed according to French ENT guidelines 4 . Any PFP that occurs after COVID-19 vaccination should be treated as soon as possible in the same way as idiopathic PFP according to the French ENT guidelines 4 (high-dose corticosteroid, 1 to 2 mg/kg/day depending on severity) for 8 to 10 days and antiviral treatment with valaciclovir (3 g/day for 7 days).…”

Section: Initial Management Of Pfpmentioning

confidence: 99%

“…In cases of severe PFP following vaccination against COVID-19 (grades V and VI 4 ) with poor prognostic factors for recovery 8 , and in the absence of early recovery (< 3 months) of symptoms, it is proposed that further doses be deferred. In this case, the patient should be discussed at a dedicated multidisciplinary consultation meeting (MCM) to assess the benefit-risk balance as best as possible according to the individual case, context and degree of recovery from PFP (clinical re-evaluation every two months).…”

Section: Attitude Towards Covid-19 Vaccine and Boostersmentioning

confidence: 99%

“…According to the current recommendations, the COVID- 19 vaccination scheme must then be completed. The risk of recurrence of idiopathic PFP, outside of a vaccine context, is about 6.5% 4 . Further studies are needed to determine whether this risk is higher in vaccinated patients with a history of PFP prior to vaccination against COVID-19.…”

Section: What To Offer In Case Of Prior History Of Pfp Before Covid-1...mentioning

confidence: 99%

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Peripheral facial palsy following COVID-19 vaccination: a practical approach to use the clinical situation as a guide

Foirest

Bihan

Tankéré

et al. 2022

Acta Otorhinolaryngol Ital

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French Society of ENT (SFORL) guidelines. Management of acute Bell's palsy

Cited by 32 publications

References 39 publications

Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy

Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy

Third cranial nerve palsy in an 88-year-old man after SARS-CoV-2 mRNA vaccination: change of injection site and type of vaccine resulted in an uneventful second dose with humoral immune response

Peripheral facial palsy following COVID-19 vaccination: a practical approach to use the clinical situation as a guide

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