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Elevated levels of myelin basic protein in CSF in relation to auditory brainstem responses in Bell's palsy
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 micrograms/l (mean +/- SEM), which was significantly higher than the found in 37 healthy subjects (2.4 +/- 0.13 micrograms/l). Using a 95% confidence interval, 10 patients demonstrated significantly increased CSF concentrations of MBP (greater than 3.95 micrograms/l). 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) suggests potential brainstem involvement in acute facial palsy patients. This finding supports the idea that Bell's palsy may be linked to a broader polyneuropathy.
Area of Science:
- Neurology
- Neuroimmunology
- Clinical Neuroscience
Background:
- Bell's palsy, a form of acute facial palsy, is often idiopathic.
- Myelin basic protein (MBP) is a marker of demyelination.
- Cerebrospinal fluid (CSF) analysis can provide insights into neurological conditions.
Purpose of the Study:
- To quantify MBP levels in the CSF of patients with acute facial palsy.
- To investigate potential correlations between elevated MBP, auditory brainstem responses (ABR), and clinical palsy severity.
- To explore the association between MBP levels and central nervous system involvement in Bell's palsy.
Main Methods:
- MBP concentrations in CSF were measured using quantitative analysis.
- Auditory brainstem response (ABR) tests were performed on a subset of patients.
- Clinical assessment of facial palsy severity was conducted.
Main Results:
- Patients with acute facial palsy showed significantly higher mean MBP levels in CSF compared to healthy controls.
- A notable proportion of patients exhibited elevated CSF MBP concentrations.
- No significant correlation was found between increased MBP levels and abnormal ABR or clinical palsy severity.
Conclusions:
- Elevated CSF MBP in acute facial palsy suggests possible demyelination or central nervous system involvement.
- The findings support the hypothesis that Bell's palsy might be a manifestation of a polyneuropathy.
- Further research is warranted to elucidate the role of MBP in the pathophysiology of Bell's palsy.