Familial Bell's Palsy in Females: A Phenotype with a Predilection for Eyelids and Lacrimal Gland

Zaidi, F H; Gregory-Evans, Kevin; Acheson, James; Ferguson, Veronica

doi:10.1080/01676830490916082

Cited by 14 publications

(12 citation statements)

References 14 publications

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“…However, if dry eye tests were used, no consensus has been reached regarding the optimal appropriate diagnostic criterion are or combination of criteria. 24,25 We did not assess certain factors such as wearing of contact lens, [26][27][28] LASIK surgery, 29 keratoplasty 12 eyelid and conjunctival disease, 30 allergic conjunctivitis, 31 seventh nerve palsy, 32 gout, 33 total body irradiation, 34 Sjogren's syndrome, 35 and participants' compliance with dry eye treatment, 36 which might be associated with symptomatic dry eye and diminished visual function.…”

Section: Eyementioning

confidence: 99%

Impact of symptomatic dry eye on vision-related daily activities: The Singapore Malay Eye Study

Tong

Waduthantri

Wong

et al. 2010

Eye

105

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Purpose To examine the impact of symptomatic dry eye on vision-related daily activities. Methods A population-based survey of eye diseases was conducted on 3280 (78.7% response rate) Malay persons aged X40 years, who were randomly selected from designated areas in southwestern Singapore. Participants were administered a standardized dry eye questionnaire consisting of six questions on symptoms, a questionnaire on vision-related daily activities, and underwent a comprehensive systemic and ocular examination. Symptomatic dry eye was defined as one or more self-reported symptoms that were frequently present (ranked as often or all the time). Logistic regression method was used to examine the relationship of symptomatic dry eye with difficulty in performing daily activities. Results In adults without visual impairment, symptomatic dry eye after adjusting for age, gender, and presenting visual acuity was significantly associated with difficulty in vision-related activities such as navigating stairs (odds ratio (OR) ¼ 1.96, 95% confidence interval (CI): 1.28-3.00), recognizing friends (OR ¼ 1.99, 95% CI: 1.45-2.73), reading road signs (OR ¼ 1.87, 95% CI: 1.36-2.57), reading newspaper (OR ¼ 1.50, 95% CI: 1.11-2.04), watching television (OR ¼ 1.90, 95% CI: 1.26-2.87), cooking (OR ¼ 1.94, 95% CI: 1.02-3.71), and driving at night (OR ¼ 2.06, 95% CI: 1.32-3.21). Conclusion Symptomatic dry eye was associated with difficulty in performing vision-dependent tasks, independent of visual acuity and other factors. These findings have public health significance and suggest that the visual dysfunction in dry eye should be further characterized.

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Section: Eyementioning

confidence: 99%

Impact of symptomatic dry eye on vision-related daily activities: The Singapore Malay Eye Study

Tong

Waduthantri

Wong

et al. 2010

Eye

105

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“…Other considerations may ultimately include the use of botulinum toxin injections, or temporary or permanent tarsorrhaphy or surgery to weight the upper eyelid. [26][27][28]96 Botulinum injections may improve eyelid closure for a period of months, whereas surgical options improve lid closure permanently, thereby mitigating the ongoing risk for ocular complications. 27,29 In summary, although there have been no direct comparisons of various protective methods, based on the corneal abrasion risk, ICU literature, and expert opinion, the GDG feels it is critical to recommend supportive eye care for all Bell's palsy patients with incomplete eye closure.…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Bell's Palsy

Baugh

Basura

Ishii

et al. 2013

Otolaryngol.--head neck surg.

389

114

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Objective Bell’s palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mono-neuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis. Bell’s palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell’s palsy may cause significant temporary oral incompetence and an inability to close the eyelid, leading to potential eye injury. Additional long-term poor outcomes do occur and can be devastating to the patient. Treatments are generally designed to improve facial function and facilitate recovery. There are myriad treatment options for Bell’s palsy, and some controversy exists regarding the effectiveness of several of these options, and there are consequent variations in care. In addition, numerous diagnostic tests available are used in the evaluation of patients with Bell’s palsy. Many of these tests are of questionable benefit in Bell’s palsy. Furthermore, while patients with Bell’s palsy enter the health care system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell’s palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell’s palsy. Purpose The primary purpose of this guideline is to improve the accuracy of diagnosis for Bell’s palsy, to improve the quality of care and outcomes for patients with Bell’s palsy, and to decrease harmful variations in the evaluation and management of Bell’s palsy. This guideline addresses these needs by encouraging accurate and efficient diagnosis and treatment and, when applicable, facilitating patient follow-up to address the management of long-term sequelae or evaluation of new or worsening symptoms not indicative of Bell’s palsy. The guideline is intended for all clinicians in any setting who are likely to diagnose and manage patients with Bell’s palsy. The target population is inclusive of both adults and children presenting with Bell’s palsy. Action Statements The development group made a strong recommendation that (a) clinicians should assess the patient using history and physical examination to exclude identifiable causes of facial paresis or paralysis in patients presenting with acute-onset unilateral facial paresis or paralysis, (b) clinicians should prescribe oral steroids within 72 hours of symptom onset for Bell’s palsy patients 16 years and older, (c) clinicians should not prescribe oral antiviral therapy alone for patients with new-onset Bell’s palsy, and (d) clinicians should implement eye protection for Bell’s palsy patients with impaired eye closure. The panel made recommendations that (a) clinicians should not obtain routine laboratory testing in patients with new-onset Bell’s palsy, (b) clinicians should not routinely perform diagnostic imaging for patients with new-onset Bell’s palsy, (c) clinicians should not perform electrodiagnostic testing in Bell’s palsy patients with incomplete facial paralysis, and (d) clinicians should reassess or refer to a facial nerve specialist those Bell’s palsy patients with (1) new or worsening neurologic findings at any point, (2) ocular symptoms developing at any point, or (3) incomplete facial recovery 3 months after initial symptom onset. The development group provided the following options: (a) clinicians may offer oral antiviral therapy in addition to oral steroids within 72 hours of symptom onset for patients with Bell’s palsy, and (b) clinicians may offer electrodiagnostic testing to Bell’s palsy patients with complete facial paralysis. The development group offered the following no recommendations: (a) no recommendation can be made regarding surgical decompression for patients with Bell’s palsy, (b) no recommendation can be made regarding the effect of acupuncture in patients with Bell’s palsy, and (c) no recommendation can be made regarding the effect of physical therapy in patients with Bell’s palsy.

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“…Treatment options for crocodile tears syndrome include the partial resection of the lacrimal gland or section of the greater petrosal nerve. However, the direct injection of 2.5 or 5.0 U of BTX-A into the palpebral part of the lacrimal gland had been reported to improve hyperlacrimation in crocodile tears syndrome (5)(6)(7)(8)(9). Our case showed the efficacy of subcutaneous injection of BTX-A for hyperlacrimation, even if the injected dose was low.…”

Section: Discussionmentioning

confidence: 55%

“…However, the direct injection of 2.5 or 5.0 U of BTX-A into the palpebral part of the lacrimal gland had been reported to improve hyperlacrimation in crocodile tears syndrome (5)(6)(7)(8)(9). However, the direct injection of 2.5 or 5.0 U of BTX-A into the palpebral part of the lacrimal gland had been reported to improve hyperlacrimation in crocodile tears syndrome (5)(6)(7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

Low-dose subcutaneous injection of botulinum toxin type A for facial synkinesis and hyperlacrimation

2007

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Familial Bell's Palsy in Females: A Phenotype with a Predilection for Eyelids and Lacrimal Gland

Cited by 14 publications

References 14 publications

Impact of symptomatic dry eye on vision-related daily activities: The Singapore Malay Eye Study

Impact of symptomatic dry eye on vision-related daily activities: The Singapore Malay Eye Study

Clinical Practice Guideline: Bell's Palsy

Low-dose subcutaneous injection of botulinum toxin type A for facial synkinesis and hyperlacrimation

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