The effect of insulin resistance on House-Brackmann grade of facial paralysis in patients with Bell’s palsy

Abstract

How to cite / Atıf için: Özer G. The effect of insulin resistance on the House-Brackmann grade of facial paralysis in patients with Bell's palsy.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. AbstractAim: Bell's palsy is the most common cause of facial nerve lesion and is frequently observed in diabetic patients and the duration of healing is delayed in diabetic patients. To investigate the effect of insulin resistance on the facial paralysis as graded by the House-Brackmann classification in patients with Bell's palsy and to determine the importance of insulin resistance assessed primarily prior to treatment planning. Methods: Patients admitting to our emergency department and outpatient neurology clinic with suspected facial paralysis who were not administered steroid therapy within the first 24 hours were studied. Demographic data were collected for patients with Bell's palsy from different age groups with a normal body mass index (BMI) and no chronic endocrine disease. The House-Brackmann (HB) grading scale was used to assess the clinical severity of the facial paralysis. In addition to routine laboratory tests, fasting insulin level was obtained to estimate HOMA-IR (Homeostatic model assessment for insulin resistance) for all patients. Results: Of 19 patients enrolled, 10 were female (52.6%). Patients had a mean age of 33 years, mean glucose value of 106 mg/dL, mean insulin value of 15.9 µU/mL and mean HOMA-IR value of 4.1. A moderate positive correlation and a statistically significant association were found between mean glucose values and HOMA-IR values (r=0.548; p=0.015) Age and glucose values were not statistically significantly associated with insulin and HOMA-IR values (p=0.858 and p=0.015, respectively). Conclusion: Higher blood glucose and average insulin levels were found in patients with facial nerve paralysis in comparison to general population. Most of the patients were IR-positive. Therefore, assessment of insulin resistance would be beneficial for both treatment planning and taking proactive measures against future development of diabetes in all patients presenting with Bell's palsy. Öz Amaç: Bell's palsi fasial sinir lezyonun en sık nedenidir ve diyabetli hastalarda sık izlenir ve iyileşme süresi diyabetli hastalarda gecikmiştir. Bell's palys geçiren hastalarda insulin resistansının House -Brackman evrelemesi üzerine etkisini araştırmak ve bu araştırma sonucunda Bell' palsi tedavisi planlamadan önce öncelikli olarak insulin direncinin bakılmasının önemini araştırmak. Yöntemler: Çalışmaya fasial paralizi şüphesiyle ilk 24 saat içinde acile veya polikliniğe başvuran ve bu nedenle steroid almamış hastalar dahil edildi. Bell's palys'li hastaların demografik verileri toplanıldı. Endokrin hastalığı olmayan çeşi...

Increased C-Peptide and Insulin Resistance are Important in the Development of Paralysis in Patients with Idiopathic Peripheral Facial Paralysis

“…Özer et al, in a similar way to our study, found a higher incidence of hyperglycemia and IR positivity and increased insulin values in most of their BP patients compared to the general population. 31 On the contrary, Bosco et al reported that IR could not provide helpful information about BP when compared to the oral glucose tolerance test (OGTT) and also noted that IR led to an increased risk of BP in obese patients. 9 In the same study, a significant relationship was found between BP and glucose metabolism dysfunction after 2-hour OGTT in patients with normal fasting glycemia compared to the control group and the authors suggested that IR could be a risk factor for neuropathic damage due to BMI.…”