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Published on: March 1, 2015
Diagnostic errors in peripheral facial palsy: A systematic review and meta-analysis
P Gatignol1, C Fauvet2, L Baverel3
1Sorbonne Université DUEFO, Paris, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France; ENT Department, Fondation Rothschild, Paris, France.
Summary
Diagnostic errors in peripheral facial palsy are common, with tumors often misdiagnosed as Bell's palsy. Gradual symptom onset and being female are linked to delayed diagnosis, emphasizing the need for thorough clinical evaluation.
Area of Science:
- Neurology
- Medical Diagnostics
- Epidemiology
Background:
- Peripheral facial palsy (PFP) diagnosis can be challenging, leading to potential diagnostic errors.
- Bell's palsy is a common diagnosis, but other serious conditions can mimic its presentation.
- Accurate and timely diagnosis is crucial for effective patient management and outcomes.
Purpose of the Study:
- To systematically review and meta-analyze diagnostic errors in adult peripheral facial palsy.
- To investigate the impact of diagnostic errors on medical and paramedical care.
- To identify factors associated with delayed diagnosis in PFP.
Main Methods:
- Systematic review and meta-analysis conducted following PRISMA guidelines.
- Searched four databases for articles published between 2015 and 2024.
- Analyzed 23 selected articles using CARE and JBI grids, identifying 50 cases of diagnostic error.
Main Results:
- Tumors were the cause in 56% of cases initially diagnosed as Bell's palsy.
- Gradual symptom onset and tumor diagnosis were significantly associated with longer time to diagnosis (P=0.04).
- Women experienced longer diagnostic delays compared to men, despite similar symptom presentation.
Conclusions:
- Vigilance for atypical PFP presentations and thorough diagnostic assessment are essential.
- Diagnosis by exclusion is critical, especially given the diverse etiologies of PFP.
- Paramedical professionals play a vital role in identifying and reporting atypical PFP progression.
