Increased stroke risk in <scp>B</scp>ell's palsy patients without steroid treatment

Lee, C.-C.; Su, Yu Chieh; Chien, Shu; Ho, Han‐Chen; Hung, Shih‐Kai; Lee, M.-S.; Chou, Pesus; Chiu, Brian C.‐H.; Huang, Yung-Sung

doi:10.1111/j.1468-1331.2012.03765.x

Cited by 16 publications

(16 citation statements)

References 22 publications

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“…This association was confirmed in the various subgroup and sensitivity analyses that were performed. These data suggest that isolated OCNP is a previously unrecognized risk factor for ischemic stroke, and they strengthen the hypothesis that certain CN palsies are associated with a higher incidence of ischemic stroke [11,12,13]. …”

Section: Discussionsupporting

confidence: 67%

“…In addition to the above microvascular ischemia etiology, emerging data suggest that some peripheral CN injuries or disorders are associated with a higher risk of stroke, particularly those involving CN5, CN7 or CN8 [11,12,13]. However, to our knowledge, there have been no reports regarding a possible association between risk of ischemic stroke and isolated CN 3/4/6 palsies in adults [14,15].…”

Section: Introductionmentioning

confidence: 81%

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Increased Risk of Stroke in Patients with Isolated Third, Fourth, or Sixth Cranial Nerve Palsies: A Nationwide Cohort Study

Hoi¹,

Chen²,

Fuh³

et al. 2016

Cerebrovasc Dis

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Background and Purpose: The aim of this nationwide cohort study was to evaluate whether the occurrence of isolated 3rd, 4th or 6th cranial nerve (CN) palsies is associated with a higher risk of ischemic stroke. Methods: This study utilized data from Taiwan Longitudinal Health Insurance Database during 1995-2012. Subjects aged 20 years or older who had isolated CN 3/4/6 palsies diagnosed by a neurologist or ophthalmologist between January 2000 and December 2011 were included. A set of propensity score matched, randomly sampled patients who had never been diagnosed with CN 3/4/6 palsies were extracted to constitute the control group (cases and controls = 1:4). All subjects were followed until death, loss due to follow-up or completion of the study. Cox proportional hazard regression model stratified by matched pairs was used to estimate the hazards ratio (HR) of ischemic stroke. Results: A total of 657 patients with isolated CN 3/4/6 palsies (61.1% male, mean age 54.8 years) were identified. Compared with control group, the patients with isolated CN 3/4/6 palsies exhibited an increased risk of ischemic stroke (CN3: adjusted HR 3.69 (95% CI 2.20-6.19); CN4: 2.71 (95% CI 1.11-6.64); CN6: 2.15 (95% CI 1.31-3.52)). The association between CN 3/4/6 palsies and ischemic stroke was detected in both separate subgroup and sensitivity analyses. Conclusions: The patients with CN 3/4/6 palsies exhibited an increased risk of developing ischemic stroke. Therefore, isolated ocular motor nerves palsies appear to represent an unrecognized risk factor for ischemic stroke, and these require further confirmation and exploration.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 81%

Increased Risk of Stroke in Patients with Isolated Third, Fourth, or Sixth Cranial Nerve Palsies: A Nationwide Cohort Study

Hoi¹,

Chen²,

Fuh³

et al. 2016

Cerebrovasc Dis

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“…The incidence of peripheral arterial occlusive disease was 1.5 times higher in Bell's palsy patients than in the control group 25 . Patients with Bell's palsy had a 2.02-fold higher risk of stroke than the control group (95% CI = 1.42-2.86) 26 .…”

Section: Discussionmentioning

confidence: 87%

“…Another longitudinal follow-up study demonstrated an excess relative risk of hospital admissions of 2.8% for myocardial infarction and 4.9% for hemorrhagic stroke 22 . Several epidemiological studies have suggested the association of cardiovascular diseases with Bell's palsy 25,26 . The incidence of peripheral arterial occlusive disease was 1.5 times higher in Bell's palsy patients than in the control group 25 .…”

Section: Discussionmentioning

confidence: 99%

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

Kim

Min

Choi

et al. 2020

Sci Rep

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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 (So 2) (ppm), nitrogen dioxide (no 2) (ppm), ozone (o 3) (ppm), carbon monoxide (co) (ppm), and pM 10 (particulate matter ≤ 10 μg/m 3) 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 no 2 and pM 10 concentrations for 60 days were higher, while that of O 3 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 NO 2 for 60 days (0.1 ppm) than the control group (95% CI = 10.18-27.16, P < 0.001). The ORs of PM 10 , and o 3 for 60 days showed inconsistent results according to the included variables. Bell's palsy was related to high concentrations of no 2 .

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“…Neurology is a huge area of clinical activity and we have seen publications that cannot easily be incorporated into the major categories above [218][219][220][221][222][223][224][225][226][227][228][229][230][231][232]. The overlaps with psychiatry, oncology and cardiology in particular are a source of valuable clinical insight.…”

Section: Recent Advances In Neurology 2013-2014mentioning

confidence: 99%

Recent advances in neurology 2013–2014

Schapira¹

2014

Euro J of Neurology

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Increased stroke risk in Bell's palsy patients without steroid treatment

Abstract: Patients with Bell's palsy carry a higher risk of stroke than the general population. Our data suggest that these patients might benefit from a more intensive stroke prevention therapy and regular follow-up after initial diagnosis.

Cited by 16 publications

References 22 publications

Increased Risk of Stroke in Patients with Isolated Third, Fourth, or Sixth Cranial Nerve Palsies: A Nationwide Cohort Study

Increased Risk of Stroke in Patients with Isolated Third, Fourth, or Sixth Cranial Nerve Palsies: A Nationwide Cohort Study

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

Recent advances in neurology 2013–2014

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