Is There a Relationship Between Bell’s Palsy and White Matter Lesions?

Abstract

Background The present study aimed to investigate the relationship between Bell’s palsy (BP) and cerebral white matter lesions (CWMLs) on brain gadolinium-enhanced magnetic resonance imaging (MRI). Material/Methods The study included 51 patients who were diagnosed with BP and a control group of 40 individuals who underwent brain MRI for investigation of headache etiology. The brain MRIs of the patients were reviewed with respect to CWMLs. CWMLs were compared between the 2 groups, and within the BP group, the correlation between CWML and House-Brackmann (HB) facial nerve palsy grade was investigated as well. Results There were significantly more CWMLs in the BP group than in the control group ( P =0.003). There was a statistically significant difference between the HB subgroups in terms of absence/presence of CWMLs ( P =0.040). Within the BP patient group, there were significantly more CWMLs in the HB grade 5 and 6 groups compared with the HB grade 2 group ( P =0.025 and P =0.042, respectively). Overall, the CWML scores correlated positively with HB grade. When absence/presence of CWMLs was compared between the BP and control groups in only patients aged <50 years, there was a statistically significant difference between the groups ( P =0.008). No statistically significant difference in absence/presence of CWMLs, however, was found between the BP and control groups when only patients age ≥50 years were considered ( P =0.809). Conclusions We showed that as the severity of Bell’s palsy increased, CWMLs increased and there was an association between CWMLs and BP. Microvascular ischemic pathologies may be among the most important factors in the etiopathogenesis of BP.

Development of a clinical diagnostic model for Bell's palsy in patients with facial muscle weakness

“…In some cases, if patients present with atypical symptoms like eye tremors, hearing loss, or tinnitus, magnetic resonance imaging (MRI) may be used to rule out more serious conditions like brain tumors or cerebrovascular diseases [29,30,31,32]. However, for most Bell's palsy patients, MRI results may appear normal, highlighting the importance of relying on clinical assessment in the absence of precise biomarkers [33,34,35]. Despite these challenges, clinicians can still make a highly confident diagnosis of Bell's palsy by integrating multiple indicators derived from clinical symptoms.…”