Abstract
Purpose
Patients with Ramsay-Hunt syndrome have a poorer prognosis than patients with Bell’s palsy. Factors of metabolic syndrome affecting prognosis were therefore compared between patients with Ramsay-Hunt syndrome and those with Bell’s palsy.
Methods
This retrospective study included 106 with Ramsay-Hunt syndrome and 182 with Bell’s palsy. Age, sex, body mass index, blood pressure, blood test results, and ENoG results, stratified by House–Brackmann grade, were compared in patients with Ramsay-Hunt syndrome and Bell’s palsy. Both groups of patients were treated with steroids and the antiviral agent famciclovir.
Results
Age, sex, body mass index, dyslipidemia, triglyceride, diabetes, hypertension, and onset of palsy did not differ in patients with Ramsay-Hunt syndrome and Bell’s palsy. Rates of favorable recovery in patients with severe facial palsy and DM were lower in patients with Ramsay-Hunt syndrome than with Bell’s palsy and were also lower in low-weight, normal weight, and overweight patients with Ramsay-Hunt syndrome than with Bell’s palsy. Rates of favorable recovery in patients with severe facial palsy and normal HDL, as well as in patients with severe facial palsy and < 10% ENoG, were lower in patients with Ramsay-Hunt syndrome than with Bell’s palsy.
Conclusions
Among patients with severe facial palsy, along with diabetes and < 10% ENoG, unfavorable recovery rates were significantly higher in those with Ramsay-Hunt syndrome than with Bell’s palsy.
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References
Holland NJ, Weiner GM (2004) Recent developments in Bell’s palsy. BMJ 329:553–557
Adour KK, Wingerd J, Doty HE (1975) Prevalence of concurrent diabetes mellitus and idiopathic facial paralysis (Bell’s palsy). Diabetes 24:449–451
Sullivan FM, Swan IR, Donnan PT, Morrison JM, Smith BH, McKinstry B, Davenport RJ, Vale LD, Clarkson JE, Hammersley V (2007) Early treatment with prednisolone or acyclovir in Bell’s palsy. N Engl J Med 357:1598–1607
Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, Lesperance MM (2014) Cummings Otolaryngology-Head and Neck Surgery 6th edn. Saunders
Hunt JR (1968) On herpetic inflammations of the geniculate ganglion. A new syndrome and its complications. Arch Neurol Chic 18:584–589
Ragozzino M, Kurland L, Chu C, Perry H (1988) Population-based study of herpes zoster and its sequelae. Medicine 61:310–316
Devriese P, Moesker W (1988) The natural history of facial paralysis in herpes zoster. Clin Otolaryngol 13:289–298
Adour KK (1994) Otological complications of herpes zoster. Ann neurol 35:62–64
Byl FM, Adour KK (1977) Auditory symptoms associated with herpes zoster or idiopathic facial paralysis. Laryngoscope 87:372–379
Yeo SW, Lee DH, Jun BC, Chang KH, Park YS (2007) Analysis of prognostic factors in Bell’s palsy and Ramsay Hunt syndrome. Auris Nasus Larynx 34:159–164
Jung SY, Jung J, Byun JY, Park MS, Kim SH, Yeo SG (2018) The effect of metabolic syndrome on Bell’s palsy recovery rate. Acta Oto Laryngol 138:670–674
Zimmet P, Alberti KGM, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S (2007) The metabolic syndrome in children and adolescents—an IDF consensus report. Pediatr Diabetes 8:299–306
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 112:2735–2752
Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356–359
Kang H, Jung S, Byun J, Park M, Yeo S (2015) Steroid plus antiviral treatment for Bell’s palsy. J Intern Med 277:532–539
Lee HY, Byun JY, Park MS, Yeo SG (2013) Steroid-antiviral treatment improves the recovery rate in patients with severe Bell’s palsy. Am J Med 12:336–341
Dalton G (1960) Bell’s palsy: Some problems of prognosis and treatment. BMJ 1:1765–1770
Meier JL, Straus SE (1992) Comparative biology of latent varicella-zoster virus and herpes simplex virus infections. J Infect Dis 166:13–23
Sweeney C, Gilden D (2001) Ramsay hunt syndrome. J Neurol Neurosurg Psychiatry 71:149–154
Ikeda M, Abiko Y, Kukimoto N, Omori H, Nakazato H, Ikeda K (2005) Clinical factors that influence the prognosis of facial nerve paralysis and the magnitudes of influence. Laryngoscope 115:855–860
Katusic SK, Beard CM, Wiederholt W, Bergstralh EJ, Kurland LT (1986) Incidence, clinical features, and prognosis in Bell’s palsy, Rochester, Minnesota, 1968–1982. Ann Neurol 20:622–627
Peitersen E (2002) Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Oto Laryngol 122:4–30
Lee DH, Chae SY, Park YS, Yeo SW (2006) Prognostic value of electroneurography in Bell’s palsy and Ramsay–Hunt’s syndrome. Clin Otolaryngol 31:144–148
Byun H, Cho YS, Jang JY, Chung KW, Hwang S, Chung WH, Hong SH (2013) Value of electroneurography as a prognostic indicator for recovery in acute severe inflammatory facial paralysis: a prospective study of Bell’s palsy and Ramsay-Hunt syndrome. Laryngoscope 123:2526–2532
Lee DH (2016) Clinical efficacy of electroneurography in acute facial paralysis. J Audiol Otol 20:8–12
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Kim, S.H., Jung, J., Jung, S.Y. et al. Comparative prognosis in patients with Ramsay-Hunt syndrome and Bell’s palsy. Eur Arch Otorhinolaryngol 276, 1011–1016 (2019). https://doi.org/10.1007/s00405-019-05300-3
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DOI: https://doi.org/10.1007/s00405-019-05300-3