Recurrent Bell's palsy. Etiology, frequency, prognosis

Area of Science:

• Neurology
• Otolaryngology

Background:

• Bell's palsy, a common cause of facial nerve paralysis, can recur in a subset of patients.
• Understanding the factors influencing recurrent Bell's palsy is crucial for patient management.

Purpose of the Study:

• To investigate the etiology, frequency, and prognosis of recurrent facial nerve paralysis.
• To identify potential predisposing factors and immune mechanisms in recurrent Bell's palsy.

Main Methods:

• Retrospective analysis of 117 patients with peripheral facial nerve paresis.
• Categorization of recurrent cases by etiology (idiopathic, viral, etc.) and type (homolateral, contralateral).
• Assessment of functional recovery and electrophysiological parameters (compound action potential).

Main Results:

• 11.9% of Bell's palsy patients experienced recurrent facial paralysis.
• Recurrences were associated with various etiologies, including idiopathic, viral, diabetes, pregnancy, and Melkersson-Rosenthal syndrome.
• Recurrent homolateral facial palsy showed greater denervation and poorer prognosis compared to single episodes.

Conclusions:

• The heterogeneous etiology of recurrent facial palsy suggests underlying predisposing factors or immune system involvement.
• Prognosis for recurrent Bell's palsy varies, with homolateral cases indicating poorer outcomes.
• Prophylactic surgical decompression may be considered to prevent further recurrences.