Gadolinium‐enhanced magnetic resonance imaging in facial nerve lesions

Millen, Steven J.; Daniels, David L.; Meyer, Glenn A.

doi:10.1177/019459989010200105

Cited by 35 publications

(18 citation statements)

References 2 publications

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“…9 Although MR imaging shows great promise in aiding in the management of patients with facial nerve paralysis, it cannot always differentiate between a Bell palsy and neoplasm; nor can its findings be used to predict recovery completely. 5 Furthermore, normal-appearing features demonstrated on an MR image do not exclude the presence of a malignant facial nerve lesion. In one study of 486 patients with unilateral facial nerve paralysis, malignant tumors with facial nerve involvement were found 19 patients.…”

Section: Discussionmentioning

confidence: 99%

Facial paralysis caused by malignant skull base neoplasms

Marzo¹,

Leonetti²,

Petruzzelli³

2002

FOC

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Object Bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. Methods The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 and September 2001 and who presented with acute facial nerve paralysis mimicking Bell palsy. All patients were subsequently found to harbor an occult skull base neoplasm. A delay in diagnosis was demonstrated in all cases. Seven patients died of their disease, and four patients are currently free of disease. Conclusions Although Bell palsy remains the most common cause of peripheral facial nerve paralysis, patients in whom neoplasms invade of the facial nerve may present with acute paralysis mimicking Bell palsy that fails to resolve. Delays in diagnosis and treatment in such cases may result in increased rates of mortality and morbidity.

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Section: Discussionmentioning

confidence: 99%

Facial paralysis caused by malignant skull base neoplasms

Marzo¹,

Leonetti²,

Petruzzelli³

2002

FOC

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“…Metabolic derange ments and microvascular disease have been suggested as mechanisms causing peripheral neuropathy [63,64], Other authors suggest that Bell's palsy is part o f a cranial polyneuri tis [5,7,9,12] caused by reactivation of viruses in the herpes family. While not all authors have been able to substantiate this hypothesis [13,14], a recent study employing magnetic resonance imaging of the facial nerve [65] reported enhancement of the imag ing agent in the area of the geniculate ganglion in all patients with Bell's palsy examined. While this anatomical observation is consis tent with the hypothesis of herpes virus reacti vation in some cases of Bell's palsy, other causes of inflammation cannot be ruled out.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Bell's Palsy in Laredo, Texas: 1974–1982

Brandenburg

Annegers

1993

Neuroepidemiology

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Incidence rates of Bell''s palsy in the predominately Mexican-American population of Laredo, Texas, USA, are higher than those reported elsewhere, reaching 23.5 per 100,000 among males and 32.7 per 100,000 among females. During childbearing years (15–44) the risk of Bell''s palsy was greater for women than for men (incidence density ratio 2.0; 95% confidence interval 1.3–3.1). No evidence for seasonality or epidemicity was obtained. Using prevalence estimates from community surveys in south Texas or the Hispanic Health and Nutrition Survey, standardized prevalence ratios (SPR) calculated for hypertension revealed a 10 or 20% increased risk for women and a 50 or 60% increased risk for men. SPRs calculated for diabetes among men with Bell''s palsy were twice that expected, while risks of 60% or 90% were noted for women. The increased incidence of Bell''s palsy observed in Laredo appears to be due to the high prevalence of diabetes in Mexican-Americans and, to a lesser extent, uncontrolled hypertension.

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“…This was also seen in electron microscopy studies of biopsy specimens of the intratemporal facial nerve of patients suffering from Bell's palsy (8). Positive gadolinium enhancement near the geniculate ganglion, indicating inflammatory edema, was seen in magnetic resonance images taken in the acute stage of Bell's palsy (9,10). The existence of inflammatory edema 2-4.5 months after onset was confirmed by Gd-magnetic, resonance imaging (11,12).…”

Section: Discussionmentioning

confidence: 68%

Edematous Swelling of the Facial Nerve in Bell's Palsy

Yanagihara

Honda²,

Hato³

et al. 2000

Acta Oto-Laryngologica

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Surgical decompression of the intratemporal facial nerve from the geniculate ganglion to the stylomastoid foramen was carried out in 91 patients with Bell's palsy. All of the patients had denervation exceeding 95%, and a suprastapedial lesion. Edematous swelling of the nerve was assessed using the following three grades: + +, nerve swells beyond the bony facial canal; +, nerve swells beyond the nerve sheath, but within the bony canal, and -, no notable swelling observed. Varying degrees of swelling of the nerve were noted in all of the patients from onset to the end of the ninth week. The incidence of + + swelling was highest within 3 weeks of onset and then declined. + + swelling was most often noted in the vicinity of the geniculate ganglion, and was thought to be a manifestation of inflammation due to herpes simplex virus infection. There was a clear time dependency of the swelling in the horizontal and pyramidal segments, but not in the mastoid segment. After the ninth week, the incidence of swelling decreased sharply and no swelling of the nerve was observed in about one-third of the patients. Considering the etiology and the analysis of edematous swelling, we propose that the course of Bell's palsy be differentiated into an acute phase (the first 3 weeks after onset), a subacute phase (from the fourth to ninth weeks) and a chronic phase (after the tenth week).

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Gadolinium‐enhanced magnetic resonance imaging in facial nerve lesions

Cited by 35 publications

References 2 publications

Facial paralysis caused by malignant skull base neoplasms

Facial paralysis caused by malignant skull base neoplasms

Incidence and Risk Factors for Bell's Palsy in Laredo, Texas: 1974–1982

Edematous Swelling of the Facial Nerve in Bell's Palsy

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