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Elevated levels of myelin basic protein in CSF in relation to auditory brainstem responses in Bell's Palsy
S Edstrom1, P Hanner, O Andersen
1Departments of Otolaryngology, University of Göteborg, Göteborg, Sweden.
Abstract:
Myelin basic protein (MBP) in the cerebrospinal fluid (CSF) was quantified from 28 patients with acute facial palsy. The mean value of MBP in CSF in the study group was 3.4±0.22 μg/1 (mean±SEM), which was significantly higher than the found in 37 healthy subjects (2.4±0.13 μg/1). Using a 95% confidence interval, 10 patients demonstrated significantly increased CSF concentrations of MBP (>3.95 μg/I). Auditory brainstem response (ABR) test showed that 5 patients had abnormal brainstem responses. No significant correlation was observed between elevated MBP in CSF and either pathologic auditory brainstem responses or the clinical degree of the palsy. These results suggest that a brainstem involvement may occur in patients with Bell's palsy. Furthermore, our data accord with previous reports suggesting Bell's palsy to be part of a polyneuropathy.
Insights
Elevated myelin basic protein (MBP) in cerebrospinal fluid (CSF) was found in acute facial palsy patients, suggesting potential brainstem involvement and supporting Bell's palsy as a polyneuropathy.
Area of Science:
- Neuroscience
- Neurology
- Biochemistry
Background:
- Bell's palsy is a common neurological disorder affecting facial nerves.
- Myelin basic protein (MBP) is a key component of myelin sheath, and its presence in cerebrospinal fluid (CSF) can indicate demyelination.
- Previous studies suggest Bell's palsy may be linked to broader polyneuropathies.
Purpose of the Study:
- To quantify myelin basic protein (MBP) levels in the cerebrospinal fluid (CSF) of patients with acute facial palsy.
- To investigate the correlation between elevated MBP levels and auditory brainstem response (ABR) abnormalities or clinical severity in Bell's palsy.
- To explore the potential for brainstem involvement in acute facial palsy.
Main Methods:
- Cerebrospinal fluid (CSF) samples were collected from 28 patients with acute facial palsy and 37 healthy controls.
- Myelin basic protein (MBP) concentrations in CSF were measured.
- Auditory brainstem response (ABR) tests were performed on patients.
Main Results:
- Mean MBP levels in CSF were significantly higher in patients with acute facial palsy (3.4±0.22 μg/l) compared to healthy subjects (2.4±0.13 μg/l).
- Ten patients showed significantly increased CSF MBP concentrations (>3.95 μg/l).
- Five patients exhibited abnormal ABR test results, but no significant correlation was found between elevated MBP and ABR abnormalities or clinical palsy severity.
Conclusions:
- Elevated CSF MBP levels in acute facial palsy suggest possible demyelination or central nervous system involvement.
- The findings support the hypothesis that Bell's palsy may be a manifestation of a polyneuropathy.
- Brainstem involvement should be considered in the pathophysiology of some Bell's palsy cases.