Skip to main content
Log in

Comparative prognosis in patients with Ramsay-Hunt syndrome and Bell’s palsy

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Holland NJ, Weiner GM (2004) Recent developments in Bell’s palsy. BMJ 329:553–557

    Article  PubMed  PubMed Central  Google Scholar 

  2. Adour KK, Wingerd J, Doty HE (1975) Prevalence of concurrent diabetes mellitus and idiopathic facial paralysis (Bell’s palsy). Diabetes 24:449–451

    Article  CAS  PubMed  Google Scholar 

  3. 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

    Article  CAS  PubMed  Google Scholar 

  4. Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, Lesperance MM (2014) Cummings Otolaryngology-Head and Neck Surgery 6th edn. Saunders

  5. Hunt JR (1968) On herpetic inflammations of the geniculate ganglion. A new syndrome and its complications. Arch Neurol Chic 18:584–589

    Article  Google Scholar 

  6. Ragozzino M, Kurland L, Chu C, Perry H (1988) Population-based study of herpes zoster and its sequelae. Medicine 61:310–316

    Article  Google Scholar 

  7. Devriese P, Moesker W (1988) The natural history of facial paralysis in herpes zoster. Clin Otolaryngol 13:289–298

    Article  CAS  PubMed  Google Scholar 

  8. Adour KK (1994) Otological complications of herpes zoster. Ann neurol 35:62–64

    Article  Google Scholar 

  9. Byl FM, Adour KK (1977) Auditory symptoms associated with herpes zoster or idiopathic facial paralysis. Laryngoscope 87:372–379

    Article  CAS  PubMed  Google Scholar 

  10. 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

    Article  PubMed  Google Scholar 

  11. 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

    Article  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. 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

    Article  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. 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

    Article  CAS  PubMed  Google Scholar 

  16. 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

    Article  CAS  Google Scholar 

  17. Dalton G (1960) Bell’s palsy: Some problems of prognosis and treatment. BMJ 1:1765–1770

    Article  CAS  PubMed  Google Scholar 

  18. Meier JL, Straus SE (1992) Comparative biology of latent varicella-zoster virus and herpes simplex virus infections. J Infect Dis 166:13–23

    Article  Google Scholar 

  19. Sweeney C, Gilden D (2001) Ramsay hunt syndrome. J Neurol Neurosurg Psychiatry 71:149–154

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. 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

    Article  CAS  PubMed  Google Scholar 

  22. 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

    Article  Google Scholar 

  23. 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

    Article  PubMed  Google Scholar 

  24. 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

    Article  PubMed  Google Scholar 

  25. Lee DH (2016) Clinical efficacy of electroneurography in acute facial paralysis. J Audiol Otol 20:8–12

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The authors have no funding or financial relationships to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Seung Geun Yeo.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to report.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-019-05300-3

Keywords

Navigation