Non-idiopathic peripheral facial palsy: prognostic factors for outcome

AbstractObjectivesThere is a lack of data on patients ’ and diagnostic factors for prognostication of complete recovery in patients with non-idiopathic peripheral facial palsy (FP).MethodsCohort register-based study of 264 patients with non-idiopathic peripheral FP and uniform diagnostics and standardized treatment in a university hospital from 2007 to 2017 (47% female, median age: 57  years). Clinical data, facial grading, electrodiagnostics, motor function tests, non-motor function tests, and onset of prednisolone therapy were assessed for their impact on the probability of complete recovery using univariable and multivariable statistics.ResultsThe most frequent reason for a non-idiopathic peripheral FP was a reactivation of Varicella Zoster Virus (VZV; 36.4%). Traumatic origin had a higher proportion of complete FP (52.9%). Furthermore, in traumatic FP, the mean interval between onset and start of prednisolone therapy was longer than in other cases (5.6  ± 6.2 days). Patients with reactivation of VZV, Lyme disease or otogenic FP had a significant higher recovery rate (p = 0.002,p 
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research

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Etiologies for Bell's palsy include herpes viruses and Lyme disease, with highest incidence in the colder and warmer months, respectively. In New Jersey, a Lyme-endemic area, the months with the most Lyme disease (80% of cases) are May through October ( “Lyme months”).
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Original Contributions Source Type: research
We report the case of an older patient presenting with bilateral facial palsy due to Lyme disease. Multiple non-specific clinical signs preceded facial palsy with falls, fatigue and pain of both legs especially during the night. Our case illustrates the difficulty to diagnose this infectious disease, especially in older patients who have rare outdoor activities and a low risk of tick exposure.
Source: Age and Ageing - Category: Geriatrics Source Type: research
Conclusions: Because serum serology can be negative at presentation, lumbar puncture is a valuable tool when diagnosing LB among children with facial palsy. Pleocytosis and increased protein and CXCL13 values in the CSF suggest LB as the cause of facial palsy.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
ConclusionsAlthough peripheral facial palsy was predominantly idiopathic (75.3%) in our cohort, the disease was caused in approximately 25% of the patients by factors which require specific treatment. In the present study, CSF analysis proved to be the leading method for the diagnosis of Ramsay-Hunt-Syndrome, Lyme Neuroborreliosis, and other CNS infections. These subgroups made up approximately 15% of our cohort. To detect these subgroups reliably, routine use of CSF analysis in peripheral facial palsy may be advisable, whereas MRI proved to be useful for exclusion of otogenic and neoplastic processes with a sensitivity of...
Source: Journal of Neurology - Category: Neurology Source Type: research
AbstractPrimary Sj ögren’s syndrome (pSS) is a chronic autoimmune disorder associated with a variety of systemic presentations. Varied neurological dysfunctions of newly diagnosed adult patients with pSS have been observed in recent years. We aimed to describe a rare case of acute bilateral facial paralysis diagnos ed with pSS for the first time and review the previous studies including similar cases. A 69-year-old female, who had experienced ocular and oral dryness for more than 10 years, presented with bilateral facial palsy. Her laboratory test results showed positive anti-Ro (SSA) and anti-Ro-52 antibod...
Source: Rheumatology International - Category: Rheumatology Source Type: research
We report nine cases of pediatric neuroborreliosis collected by the National Observatory of Pediatric Bacterial Meningitis in France between 2001 and 2012. The nine children, aged 4-13 years, were identified in northern and eastern France and had the following clinical features: meningeal irritation alone or with facial palsy, or isolated facial palsy. All cases showed anti-Borrelia antibodies in cerebrospinal fluid or serum, or with a positive Borrelia PCR in the CSF. The outcome was favorable in all cases after a 2- to 3-week course of third-generation cephalosporin. On the basis of these nine pediatric cases, this study...
Source: Archives de Pediatrie - Category: Pediatrics Authors: Tags: Arch Pediatr Source Type: research
We report the case of a 9-year-old girl who suffered from headaches for several days and was shown to have opsoclonus and left peripheral facial palsy. Work-up excluded the diagnosis of neuroblastoma, but CSF analysis showed aseptic meningitis, and serology for Borrelia burgdorferi (Lyme) was positive. The outcome was favorable with complete regression of symptoms after treatment with ceftriaxone 2g/day for 3 weeks. Although rare, the diagnosis of Lyme neuroborreliosis must be raised in the presence of isolated opsoclonus, particularly if the clinical picture is incomplete and if other features, such as peripheral fac...
Source: Archives de Pediatrie - Category: Pediatrics Authors: Tags: Arch Pediatr Source Type: research
Publication date: Available online 6 December 2018Source: Ticks and Tick-borne DiseasesAuthor(s): Tereza Rojko, Petra Bogovič, Stanka Lotrič-Furlan, Katarina Ogrinc, Tjaša Cerar-Kišek, Urška Glinšek Biškup, Miroslav Petrovec, Eva Ružić-Sabljić, Andrej Kastrin, Franc StrleAbstractThe aims of the study were to determine the frequency of borrelial infection in patients with peripheral facial palsy (PFP) and to compare clinical and laboratory characteristics of patients with borrelial PFP and patients with PFP of unknown etiology.Adult patients with PFP who presented at our department be...
Source: Ticks and Tick borne Diseases - Category: Zoology Source Type: research
This article can educate those engaged in imaging of the nervous system and serve as a comprehensive tool in clinical cases.Key Points•Diagnostic criteria for LNB emphasise exclusion of an alternative cause to the clinical symptoms.•MRI makes a crucial contribution in the diagnosis and follow-up of LNB.•MRI may have normal findings, or show neuritis, meningitis, myelitis, encephalitis or vasculitis.•White matter lesions are not a prominent feature of LNB.
Source: Insights into Imaging - Category: Radiology Source Type: research
We present the case of a 10-year old patient from southeastern Ontario with severe bilateral facial palsy. MRI was performed that showed extensive symmetric enhancement of cervical cranial nerve roots and multiple cranial nerves (III, V, VI, VII, VIII, X and XII). Lumbar puncture was performed that revealed pleocytosis and elevated proteins in the cerebrospinal fluid. Serology confirmed the diagnosis of neuroborreliosis. The patient was treated with a 4-week course of IV ceftriaxone, following which he returned to baseline.
Source: IDCases - Category: Infectious Diseases Source Type: research
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