Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy

Abstract

Background and ObjectivesWe aimed to assess the clinical significance of dizziness associated with acute peripheral facial palsy (APFP).Subjects and MethodsMedical records of patients who visited an otorhinolaryngology clinic at a university hospital and were admitted for treatment of APFP between 2014 and 2016 were thoroughly reviewed.ResultsIn total, 15.3% (n=15) of patients had dizziness. Continuous, rotatory dizziness without exacerbating factors was most common and frequently accompanied by nausea/vomiting. Dizziness disappeared within 1 week during the hospitalization period. Patients with Ramsay Hunt syndrome (31.0%) had dizziness more frequently than those with Bell’s palsy (8.7%). In addition, higher hearing thresholds and pain around the ear was reported more often in dizzy patients (p<0.05). Logistic regression analysis revealed that the initial House-Brackmann grade of facial paralysis was solely associated with final recovery, but dizziness was not associated with prognosis.ConclusionsPatients with APFP may have transient dizziness in the early stage, which may be more frequently accompanied by worse hearing thresholds and/or pain around the ear. However, these symptoms including dizziness seem to be unrelated to final prognosis.

Clinical signs, MRI findings and outcome in dogs with peripheral vestibular disease: a retrospective study

“…Surprisingly, cerebrospinal analysis in the present study, performed in 79 dogs with suspected IVS, revealed only mild mixed pleocytosis in 2 dogs and albuminocytological dissociation in 4 dogs. In human patients presenting with acute facial neuropathy, 15% report associated dizziness [20] and spontaneous nystagmus is also seen in approximately one third of patients with Bell's palsy (a peripheral-type facial nerve paralysis) most commonly associated with reactivation of herpes simplex virus type 1 [21]. The most common cause for vestibular and concurrent facial nerve impairment in people is a viral inflammation caused by Herpes zoster oticus, which generally also causes severe hearing loss and does not typically resolve with corticosteroids or antiviral drugs [22].…”

Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

“…The following conditions were reported to be related to the occurrence of facial palsy ( Table 1 ). 1 5 6 7 11 14 15 …”

“…The most common disease causing peripheral facial nerve palsy is idiopathic Bell's palsy. 1 For the pathogenesis of idiopathic Bell's palsy, reactivation of Herpes simplex virus type 1 is presumed to be the most relevant infection. Other viral infections such as varicella zoster virus and human herpes virus 6 are quite common.…”

Relato de caso: Síndrome de Ramsay Hunt

“…Pode-se utilizar para o diagnóstico mais preciso a reação em cadeia da polimerase (PCR) pois permite a identificação do genoma do VVZ, porém não pode fazer um diagnóstico com rapidez no início dos sintomas. Por isso o citodiagnóstico de Tzanck é mais útil e rápido em casos de emergência (Magalhães et al, 2014;Paiva et al, 2017;Song et al, 2018;Kim et al, 2021;Pupic-Barack et al, 2021). Além disso, a paciente realizou uma ressonância magnética de crânio que apresentou um discreto favorecimento a possibilidade de um processo inflamatório/infeccioso do nervo facial direito (neurite).…”