Bell’s palsy: a manifestation of prediabetes?

Bosco, Domenico; Plastino, Massimiliano; Bosco, Francesca; Consoli, Arturo; Labate, Angelo; Pirritano, Domenico; Consoli, Domenico; Fava, Antonietta

doi:10.1111/j.1600-0404.2010.01365.x

Cited by 26 publications

(27 citation statements)

References 22 publications

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“…It has also been reported to occur more frequently in persons with prediabetes or diabetes [13,27]. Most of the cases in our study did not have any documented prior or concurrent illness at the time of vaccination.…”

Section: Discussionmentioning

confidence: 55%

Bell’s Palsy Cases Following Administration of Influenza A (H1N1) 2009 Monovalent Vaccine Reported to the Vaccine Adverse Event Reporting System (VAERS)

Cano¹,

Lewis²

2012

J Vaccines Vaccin

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Section: Discussionmentioning

confidence: 55%

Bell’s Palsy Cases Following Administration of Influenza A (H1N1) 2009 Monovalent Vaccine Reported to the Vaccine Adverse Event Reporting System (VAERS)

Cano¹,

Lewis²

2012

J Vaccines Vaccin

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“…The condition typically presents with unilateral facial weakness without sparing of frontalis which differentiates the condition from upper motor neurone lesions. In one study, and in relation with the subsection below, impaired glucose metabolism, rather than frank diabetes, was found to be significantly more frequent in patients with facial nerve palsy compared to controls [63].…”

Section: Cranial Neuropathiesmentioning

confidence: 96%

Common and Less Common Peripheral Nerve Disorders Associated with Diabetes

Knopp

Rajabally²

2012

CDR

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Diabetes can be associated with a number of peripheral nerve disorders. The commonest is slowly-progressive axonal distal symmetrical sensori-motor neuropathy. Sensory loss and positive sensory symptoms are its main manifestations. Lumbosacral radiculoplexus neuropathy (LSRPN) is a distinct entity, accompanied by severe lumbar, hip, leg pain and weight loss, with subsequent weakness. Although typically unilateral, bilaterality is described, with spontaneous recovery usual over several months. The upper limb counterpart, cervical radiculoplexus neuropathy is rare. Acute painful neuropathies, including "diabetic neuropathic cachexia", are infrequent. Accompanying weight loss is usual and burning pains in the extremities are severe. Insulin-triggered acute painful neuropathy is well-described although infrequent and still poorly-understood. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) represents an immune-mediated treatable disorder, usually causing prominent diffuse motor weakness, which was described as more common in diabetics. More recent epidemiological data have however been conflicting and it is possible that CIDP is no more frequent in diabetics than in the general population. Diagnosis is made by electrophysiology and cerebrospinal fluid analysis. A painless diabetic motor neuropathy, thought to be caused by ischaemic injury and microvasculitis, has recently been postulated as separate from LSRPN and CIDP. Other focal and multifocal neuropathies that can occur in diabetics are cranial or truncal. Entrapment neuropathies are more often of median and ulnar nerves, and may in some cases benefit from decompression. Finally, autonomic neuropathies are well-described in diabetes and can be diverse in presentation with cardiovascular, gastrointestinal, urogenital and sudomotor manifestations. Their management can be difficult with debilitating symptoms despite treatment.

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“…Epidemiological studies report that Bell’s palsy affects 11–40 persons per 100,000 each year, with peak incidence usually between the ages of 15 and 50 years [8–10]. In the United States alone, more than 60 000 cases are diagnosed annually [11], with similar incidence rates reported among males and females [12]. Pregnant women, often during the third trimester and early postpartum periods, have also been shown to have higher incidence and risk of Bell’s palsy – up to 3 times greater compared to the general population [5,13].…”

Section: Epidemiologymentioning

confidence: 99%

The neurologist’s dilemma: A comprehensive clinical review of Bell’s palsy, with emphasis on current management trends

Loukas

2014

Med Sci Monit

114

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BackgroundRecent advances in Bell’s palsy (BP) were reviewed to assess the current trends in its management and prognosis.Material/MethodsWe retrieved the literature on BP using the Cochrane Database of Systematic Reviews, PubMed, and Google Scholar. Key words and phrases used during the search included ‘Bell’s palsy’, ‘Bell’s phenomenon’, ‘facial palsy’, and ‘idiopathic facial paralysis’. Emphasis was placed on articles and randomized controlled trails (RCTs) published within the last 5 years.ResultsBP is currently considered the leading disorder affecting the facial nerve. The literature is replete with theories of its etiology, but the reactivation of herpes simplex virus isoform 1 (HSV-1) and/or herpes zoster virus (HZV) from the geniculate ganglia is now the most strongly suspected cause. Despite the advancements in neuroimaging techniques, the diagnosis of BP remains one of exclusion. In addition, most patients with BP recover spontaneously within 3 weeks.ConclusionsCorticosteroids are currently the drug of choice when medical therapy is needed. Antivirals, in contrast, are not superior to placebo according to most reliable studies. At the time of publication, there is no consensus as to the benefit of acupuncture or surgical decompression of the facial nerve. Long-term therapeutic agents and adjuvant medications for BP are necessary due to recurrence and intractable cases. In the future, large RCTs will be required to determine whether BP is associated with an increased risk of stroke.

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Bell’s palsy: a manifestation of prediabetes?

Abstract: In this study we found that prediabetes is frequently associated with facial palsy. We propose to perform a 2h-OGTT in patients with peripheral facial palsy and normal fasting glycaemia. HOMA-index should be evaluated in obese facial palsy patients.

Cited by 26 publications

References 22 publications

Bell’s Palsy Cases Following Administration of Influenza A (H1N1) 2009 Monovalent Vaccine Reported to the Vaccine Adverse Event Reporting System (VAERS)

Bell’s Palsy Cases Following Administration of Influenza A (H1N1) 2009 Monovalent Vaccine Reported to the Vaccine Adverse Event Reporting System (VAERS)

Common and Less Common Peripheral Nerve Disorders Associated with Diabetes

The neurologist’s dilemma: A comprehensive clinical review of Bell’s palsy, with emphasis on current management trends

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