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Published on: June 2, 2014
Increased risk of Bell palsy in patients with migraine: a nationwide cohort study
Kuan-Po Peng1, Yung-Tai Chen1, Jong-Ling Fuh1
1From the Department of Internal Medicine (K.-P.P.), Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan; Institute of Brain Science (K.-P.P., S.-J.W.), National Yang-Ming University, Taipei; Faculty of Medicine (K.-P.P., Y.-T.C., J.-L.F., S.-J.W.), National Yang-Ming University School of Medicine, Taipei; Department of Nephrology (Y.-T.C.), Institute of Internal Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei; Department of Neurology (J.-L.F., S.-J.W.), Neurological Institute, Taipei Veterans General Hospital, Taipei; and School of Health Care Administration (C.-H.T.), Taipei Medical University, Taipei, Taiwan.
Objective:
To evaluate the association between migraine and Bell palsy and to examine the effects of age, sex, migraine subtype, and comorbid risk factors for Bell palsy.
Methods:
This nationwide cohort study was conducted using data from the Taiwan National Health Insurance Research Database. Subjects aged 18 years or older with neurologist-diagnosed migraine from 2005 to 2009 were included. A nonheadache age- and propensity score-matched control cohort was selected for comparison. All subjects were followed until the end of 2010, death, or the occurrence of a Bell palsy event. Cox proportional hazards regression was used to calculate the adjusted hazard ratios and 95% confidence intervals to compare the risk of Bell palsy between groups.
Results:
Both cohorts (n = 136,704 each) were followed for a mean of 3.2 years. During the follow-up period, 671 patients (424,372 person-years) in the migraine cohort and 365 matched control subjects (438,677 person-years) were newly diagnosed with Bell palsy (incidence rates, 158.1 and 83.2/100,000 person-years, respectively). The adjusted hazard ratio for Bell palsy was 1.91 (95% confidence interval, 1.68-2.17; p < 0.001). The association between migraine and Bell palsy remained significant in sensitivity analyses, and tests of interaction failed to reach significance in all subgroup analyses.
Conclusion:
Migraine is a previously unidentified risk factor for Bell palsy. The association between these 2 conditions suggests a linked disease mechanism, which is worthy of further exploration.
