Bell's Palsy: A Prospective Study

Bell's palsy is an acute idiopathic facial nerve paralysis of sudden onset. It is the most common cause of lower motor neuron facial nerve paralysis with an annual incidence of 15-30 per 100,000 population. The objective of this work is to study the grade of the attack and the associated symptoms of Bell's palsy in a group of Sudanese patients. The study type is an analytical prospective-based study. The study was carried out at Khartoum Teaching Dental Hospital, Khartoum General Teaching Hospital. In this prospective of the study, 48 patients with Bell's palsy were evaluated using the House-Brackman scale in relation to the above mentioned variables.

The study showed 18 patients (37.5%) were grade II, and 24 patients (50%) had postauricular pain before and during the attack. By the end of the study period, 40 patients recovered completely (83.3%), and 8 (16.7%) patients did not recover completely, 5 (10.4%) patients complained of hearing changes during the attack, and 13 (27.1) patients gave a history of exposure to cold before the attack.

Based on our prospective study, we conclude that the percentage of complete recovery decreases with increased severity of the attack at onset. We failed to demonstrate any relation between postauricular pain and prognosis of Bell's palsy. The percentage of taste changes in our study is low in comparison with those obtained in the literature. In addition, all the patients showed complete regain of taste sensation. The percentage of patients with hearing changes in our study is high compared with some studies. In literature, we have no explanation for that, and it may be related to severity of the attack. In the present study, we found a strong association between exposure to cold and development of Bell's palsy. As the number of patients in our study is small and there is a limited period of follow-up, the study may not reflect the real situation; therefore, we need a large population-based study.