Increased risk of peripheral arterial occlusive disease in patients with Bell's palsy using population data

Predictive Value of the Neutrophil-to-Lymphocyte Ratio and C-Reactive Protein in Patients with Idiopathic Facial Nerve Palsy

Objective

This study aims to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in patients with idiopathic facial nerve palsy.

Methods

The clinical data of patients with idiopathic facial nerve palsy were retrospectively analyzed. After three months of follow-up, patients were divided into good prognosis and poor prognosis, and the correlation between NLR, CRP and idiopathic facial nerve palsy was analyzed.

Results

Negative correlation of NLR with Portmann score in idiopathic facial nerve palsy (r=-0.788, P<0.05); In contrast to the group with poor prognosis, patients in good prognosis group had low levels of body mass index (BMI), NLR, and C-reactive protein (CRP), and high Portmann score (P<0.05); Multivariate logistic regression analysis showed Portmann score (OR=1.268, 95% CI (1.005-1.616)), NLR (OR=0.262, 95% CI (0.128-0.533)) and CRP levels (OR=0.949, 95% CI (0.895-0.989)) were risk factors of poor prognosis for patients with idiopathic facial nerve palsy. The area under the receiver operator characteristic (ROC) curve of NLR and CRP levels in predicting poor facial nerve function was 0.764 and 0.697, the specificity was 85.5% and 75.0%, and the sensitivity was 74. 0% and 76.0%, respectively. The ROC curve of the combined diagnosis was 0.829, the specificity was 80.7%, and the sensitivity was 82.0%.

Conclusion

Elevated NLR and CRP are associated with a poor prognosis of idiopathic facial nerve palsy and can serve as an indicator for clinical prognosis, and can be widely used in clinical.

Association of plasma atherogenic index with the severity and prognosis of Bell's palsy

BACKGROUND

The plasma atherogenic index (AIP) is used as an indicator of cardiovascular risk. Abnormal lipid levels have been shown to potentially contribute to facial nerve inflammation observed in Bell's palsy. This study sought to investigate the association of AIP with the severity and prognosis of Bell's palsy.

MATERIAL AND METHODS

AIP is calculated using the equation Log (triglyceride [mg/dL]/high-density lipoprotein cholesterol [mg/dL]). The study was conducted prospectively on 79 patients diagnosed with Bell's palsy. The House-Brackmann (H-B) grade was used to determine the severity of Bell's palsy.

RESULTS

In total, 79 patients [45 (57%) male and 34 (43% female] with Bell's palsy were included to the study. The mean (SD) age was 54.1 (16.5). In multivariable analyses prediction of unrecovered patients, the Odds Ratio (OR) and Confidence Intervals for NLR was 1.322 (1.021-1.797), p = .032, for PLR was 1.100(1.068-1.250), p = .043, for total cholesterol was 1.038 (1.001-1.076), p = .039, for AIP was 4.250 (2.239-8.226), p = .005. The highest area under curve (0.74) was observed for AIP to predict unrecovered Bell's palsy with 71.4% sensitivity and 62.7% specificity.

CONCLUSIONS AND SIGNIFICANCES

AIP is associated with advanced-stage facial paralysis at the time of Bell's palsy diagnosis and can be used as a poor prognostic indicator.

Increased risk of ischemic stroke in patients with Bell's palsy: A longitudinal follow-up study using a national sample cohort

OBJECTIVE

To investigate the association between Bell's palsy and stroke according to the different types of stroke, using a sample cohort based on the national Korean population.

METHODS

Individuals aged ≥ 20 years were collected from the Korean National Health Insurance Service National Sample Cohort between 2002 and 2013. We extracted the data for Bell's palsy patients (n = 3658) and 1:4 matched controls (n = 14,632) and analyzed the occurrence of hemorrhagic or ischemic stroke in both groups. Matching was performed on the basis of age, gender, income, and region of residence. For Bell's palsy, we included only participants who received the diagnosis (ICD-10 code, G510) 2 or more times via ambulatory visits for the same episode with steroid treatment. Patient admission histories were used to identify occurrences of hemorrhagic stroke (I60, I61 and I62) and ischemic stroke (I63). Adjusted hazard ratios were calculated using stratified Cox proportional hazard models for the Charlson comorbidity index and 95% confidence intervals (CIs). For the subgroup analyses, we divided the participants by age, sex, and each time period after the onset of Bell's palsy (≤1 year, 1 to 2 years, 2 to 3years, > 3years).

RESULTS

The risk of ischemic stroke was significantly increased in Bell's palsy patients compared to that in the controls (adjusted HR = 1.74, 95% CI = 1.38-2.19, P < 0.001). In the subgroup analyses, a significant association between two clinical disorders was observed in patients aged ≥ 50 years old, regardless of gender. The risk of ischemic stroke was significantly increased, especially within 2 years after Bell's palsy. In contrast, the risk of hemorrhagic stroke was not significantly increased.

CONCLUSION

There is an association of Bell's palsy with ischemic stroke but not with hemorrhagic stroke.

Air pollution by NO2 is associated with the risk of Bell's palsy: A nested case-controlled study

This study investigated the relationship of weather and air pollution with the onset of Bell’s palsy. The Korean Health Insurance Review and Assessment Service-National Sample Cohort (HIRA-NSC) data from 2002 through 2013 were used. The 3,935 Bell’s palsy patients were matched with 15,740 control participants. The meteorological data, including daily mean temperature (°C), daily mean highest temperature (°C), daily mean lowest temperature (°C), daily mean temperature difference (°C), relative humidity (%), spot atmospheric pressure (hPa), sulfur dioxide (SO₂) (ppm), nitrogen dioxide (NO₂) (ppm), ozone (O₃) (ppm), carbon monoxide (CO) (ppm), and PM₁₀ (particulate matter ≤ 10 μg/m³) for 60 days, 30 days, 14 days, 7 days, and 3 days prior to the index date were analyzed for Bell’s palsy cases and controls. Conditional logistic regression analysis was used to estimate the odds ratios (ORs) of the association between the meteorological data and Bell’s palsy. The mean NO₂ and PM₁₀ concentrations for 60 days were higher, while that of O₃ was lower in the Bell’s palsy group than in the control group (both P < 0.001). The Bell’s palsy group showed 16.63-fold higher odds of NO₂ for 60 days (0.1 ppm) than the control group (95% CI = 10.18–27.16, P < 0.001). The ORs of PM₁₀, and O₃ for 60 days showed inconsistent results according to the included variables. Bell’s palsy was related to high concentrations of NO₂.