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Kim and Lee: Clinical Analysis of Recurrent Bell’s Palsy in One University Hospital
Original Article

Korean J Community Nutr 2013;15(1):1-6.

Published online: 19 January 2013

DOI: https://doi.org/10.14253/kjcn.2013.15.1.1

Clinical Analysis of Recurrent Bell’s Palsy in One University Hospital

Chang Hyeong Kim, Dong Kuck Lee

Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Korea

Address for correspondence; Dong Kuck Lee Department of Neurology, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro, 17-gil, Nam-gu, Daegu 705-718, Korea Tel: +82-53-650-4267 Fax: +82-53-654-9786 E-mail: dklee@cu.ac.kr

Received 2 January 201319 April 2013       Accepted 17 May 2013

Copyright © 2013 Journal of the Korean Society of Community Nutrition

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

Bell’s palsy (BP) is the most common cause of unilateral lower motor facial palsy. Recurrent paralysis of the facial nerve is unusual and reported in only 7-8%.

Methods:

A total of 394 consecutive patients with acute BP patients were enrolled at Daegu Catholic University Hospital from July 2005 to September 2012. We classified the patients into two groups-single BP and recurrent BP-and compared them by patient characteristics, clinical features, MRI findings, electrophysiologic findings and prognosis. The degree of BP was graded according to the House and Brackmann facial nerve grading system.

Results:

Recurrent BP was observed in 31 (7.9%) patients. The number of recurrence was varied from 2 to 5. The recurrent BP (9.7%) had more incidence of family history and MRI enhancement than those of single BP (2.2%, p=0.047). The single BP (63.4%) had better recovery than recurrent BP (45.2%, p=0.045).

Conclusions:

The recurrent BP had more incidence of family history, MRI enhancement and poor prognosis than the single BP.

Keywords: Bell’s, palsy, Clinical analysis, Recurrence

REFERENCES

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Table 1.
Demographics, clinical features, and MRI findings of Bell’s palsy
Single attack N=363 (92.1%) Recurrent attack N=31 (7.9%) p-value
Gender (Women) 196 (54.0%) 20 (64.5%) 0.347
Onset age (mean, yrs) 48.9 46.1 0.417
Duration before hospitalization (days) 3.8 11.5 0.167
Previous history of oriental medical treatment 96 (26.4%) 13 (41.9%) 0.092
Family history of facial palsy 8 (2.2%) 3 (9.7%) 0.047
Affected side (right) 176 (48.5%) 18 (58.1%) 0.352
Preceding event
Idiopathic 213 (58.7%) 21 (67.7%) 0.348
Viral infection 83 (22.9%) 2 (3.2%) 0.038
Exposure to cold temperature 9 (2.5%) 2 (6.5%) 0.211
Stress 35 (9.6%) 4 (12.9%) 0.531
Fatigue 31 (8.5%) 1 (3.2%) 0.495
Pregnancy 3 (0.8%) 1 (3.2%) 0.280
Underlying disease
Hypertension 75 (20.7%) 4 (12.9%) 0.359
Diabetes mellitus 50 (13.8%) 4 (12.9%) 1.000
Obesity 2 (0.6%) 1 (3.2%) 0.218
Hyperlipidemia 60 (16.5%) 10 (32.3%) 0.046
Previous history of stroke 13 (3.6%) 1 (3.2%) 1.000
Etc. 6 (1.7%) 1 (3.2%) 0.439
Associated symptoms
Drooling 92 (25.3%) 8 (25.8%) 1.000
Hyperacusis 91 (25.1%) 10 (32.3%) 0.394
Postauricular pain 186 (51.2%) 18 (58.1%) 0.575
Impairment of taste 51 (14.0%) 5 (16.1%) 0.788
Lacrimation 229 (63.1%) 19 (61.3%) 0.848
MRI enhancement 237 (76.9%) 27 (87.1%) 0.016
Table 2.
Electrodiagnostic findings in two groups of Bell’s palsy
Facial nerve conduction study p-value
Group Single attack Recurrent attack 0.023
A (normal) 174 (48.7%) 10 (32.2%)
B (reduced amplitude) 179 (50.1%) 19 (61.3%)
C (absent wave) 4 (1.1%) 2 (6.5%)
Blink reflex p-value
Group Single attack Recurrent attack 0.458
A (normal) 20 (5.5%) 1 (3.2%)
B (delayed latency) 274 (75.5%) 26 (83.9%)
C (absent wave) 63 (17.4%) 3 (9.7%)
Table 3.
Initial grad e of facial palsy (House and Brackmann n grade) and prognosis of Bell’s pa alsy
Single attack Recurrent attack p-value
Initial grade 0.829
Grade I 0 (0%) 0 (0%) 0.045
Grade II 18 (5%) 3 (9.7%)
Grade III 96 (26.4%) 6 (19.4%)
Grade IV 179 (49.3%) 15 (48.4%)
Grade V 68 (18.7%) 7 (22.6%)
Grade VI 2 (0.6%) 0 (0%)
Recovery 230 (63.4%) 14 (45.2%)
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