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

Yücel, Volkan; Güneş, Serra Özbal; Keseroğlu, Kemal; Bayır, Ömer; Çırakoğlu, Mehmet Furkan; Tatar, Emel Çadallı; Saylam, Güleser; Karahan, Sevilay; Yılmaz, Orhan; Korkmaz, Hakan

doi:10.4274/tao.2022.2022-2-14

Cited by 3 publications

(3 citation statements)

References 21 publications

(34 reference statements)

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“…Although clinical and neurophysiological improvements in facial nerve function during recovery from Bell's palsy were associated with the disappearance of facial nerve enhancement, the presence of enhancement on the initial MRI scan was suggested to not necessarily indicate a poor prognosis for recovery [ 10 ]. Yücel et al reported that there was no significant correlation between pre-treatment HB grades and enhancement and between clinical recovery and enhancement [ 17 ]. Song et al reported that quantitative analysis of the facial nerve on both the lesion side and the normal side, which allowed for more accurate measurement of facial nerve enhancement in patients with facial palsy.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced MRI Is Useful for Prognostic Prediction on Idiopathic Bilateral Simultaneous Facial Nerve Palsy: A Case Report and Literature Review

Shiozaki,

Kaneko,

Murakami

et al. 2024

Cureus

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Idiopathic bilateral facial nerve palsy is a rare condition and presents a diagnostic and prognostic challenge. Specifically, when bilateral nerves are damaged, it is difficult to predict the prognosis. We showcase the usefulness of contrast-enhanced magnetic resonance imaging (MRI) by providing information about localization and severity of degeneration of facial nerve. A 70-year-old Japanese man presented with bilateral simultaneous facial nerve palsy of House-Brackmann Grade VI on both sides. Contrast-enhanced MRI revealed bilateral intensity enhancement of intratemporal facial nerves. The signal intensity was higher on the left side than on the right side. Facial nerve decompression was performed on the left side. The left facial nerve palsy was finally improved eight months after the onset, while the right side was improved just under two months after the onset. Contrast-enhanced MRI for facial nerve palsy can provide valuable information for the evaluation of damaged facial nerves. In our patient’s case, it was useful as a prognostic predictor of bilateral facial nerve palsy.

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Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced MRI Is Useful for Prognostic Prediction on Idiopathic Bilateral Simultaneous Facial Nerve Palsy: A Case Report and Literature Review

Shiozaki,

Kaneko,

Murakami

et al. 2024

Cureus

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“…[13] However, another study reported contrast enhancement of the facial nerve had no effect on the severity and prognosis of Bell palsy. [14] This study was based on the registration ledger of facial nerve palsy, but there was a limitation in that detailed data were obtained by reviewing the medical records retrospectively. In addition, since the results were from a single tertiary care hospital and all participants were Korean, it may not be generalizable.…”

Section: Discussionmentioning

confidence: 99%

“…[ 13 ] However, another study reported contrast enhancement of the facial nerve had no effect on the severity and prognosis of Bell palsy. [ 14 ]…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced MRI findings of patients with acute Bell palsy within 7 days of symptom onset: A retrospective study

Seok,

Park,

Park

et al. 2023

Medicine

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The brain magnetic resonance imaging (MRI) findings seen in patients with Bell palsy are abnormal contrast enhancement of affected facial nerves. Previous studies were conducted on a few patients, mainly those who had experienced palsy for several weeks. This study investigated the diagnostic usefulness of MRI by examining MRI findings of acute Bell palsy (within 7 days of symptom onset) in a large cohort. Among the patients with Bell palsy (idiopathic unilateral facial palsy) who visited the hospital, 123 patients who underwent contrast-enhanced MRI of the internal auditory canal within 7 days of symptom onset were reviewed retrospectively. MRI examination results were investigated along with the patient’s clinical symptoms and electrodiagnostic test results. Based on the MRI results, the frequency of abnormal contrast enhancement and contrast-enhanced areas were investigated. Of the 123 patients, 13 (11%) had normal brain MRI results, and 110 (89%) had abnormal findings. The frequency of abnormal contrast enhancement was not significantly associated with test timing (P = .56). Of the 110 patients with abnormal findings, 65 (59%) showed contrast enhancement in the labyrinthine segment and 36 (33%) in both the labyrinthine segment and geniculate ganglion. Most patients with Bell palsy who are in the acute phase showed abnormal contrast enhancement in their facial nerves, and similar findings were even observed in the examination conducted on the day of symptom onset. Brain MRI helps in the diagnosis of acute Bell palsy.

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How Long Could the Enhancement of Facial Nerve Last in Bell’s Palsy?

Oh,

Gil,

Seok

2024

Korean J Neuromuscul Disord

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Background: The brain magnetic resonance imaging (MRI) findings seen in patients with Bell's palsy are abnormal contrast enhancement of affected facial nerves. Previous evaluation included mainly patients who had experienced palsy for several weeks and there are no studies to date on patients with late stage of Bell’s palsy. This study investigated the findings of MRI of Bell's palsy after 3 months of symptom onset to assess how long the enhancement last.Methods: Among the patients with Bell's palsy (idiopathic unilateral facial palsy) who visited the hospital, 9 patients who underwent contrast-enhanced MRI of the internal auditory canal after 3 months of symptom onset were reviewed retrospectively. MRI examination results were investigated along with the patient's clinical symptoms and electrodiagnostic test results. Based on the MRI results, the frequency of abnormal contrast enhancement and contrast-enhanced areas were investigated.Results: 9 patients were included. 6 of them did MRI imaging because of incomplete recovery of facial palsy and the others did because of complication of facial palsy including synkinesis and hemifacial spasm. Time interval between symptom onset and evaluation was 17 months (3-84). Of 9 patients, 2 showed abnormal enhancement of affected nerve and they performed MRI after 5 months and 12 months of symptom onset, respectively.Conclusions: Abnormal enhancement of facial nerve in Bell’s palsy could last up to one year. This awareness can be helpful in interpretation of MRI of Bell’s palsy.

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

Cited by 3 publications

References 21 publications

Contrast-Enhanced MRI Is Useful for Prognostic Prediction on Idiopathic Bilateral Simultaneous Facial Nerve Palsy: A Case Report and Literature Review

Contrast-Enhanced MRI Is Useful for Prognostic Prediction on Idiopathic Bilateral Simultaneous Facial Nerve Palsy: A Case Report and Literature Review

Contrast-enhanced MRI findings of patients with acute Bell palsy within 7 days of symptom onset: A retrospective study

How Long Could the Enhancement of Facial Nerve Last in Bell’s Palsy?

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