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. 2018 May;30(98):145-152.

Peripheral Facial Palsy in Emergency Department

José Ferreira-Penêda  1 , Raquel Robles  1 , Isabel Gomes-Pinto  1 , Pedro Valente  1 , Nuno Barros-Lima  1 , Artur Condé  1
Affiliations

Peripheral Facial Palsy in Emergency Department

José Ferreira-Penêda et al. Iran J Otorhinolaryngol. 2018 May.

Abstract

Introduction: Peripheral facial palsy (PFP) is commonly diagnosed in every emergency department. Despite being a benign condition in most cases, PFP causes loss in quality of life mostly due to facial dysmorphia. The etiology of PFP remains unknown in most cases, while medical opinion on epidemiology, risk factors and optimal treatment is not consensual. The aim of this study was to review the demographic characteristics of our patients and the medical care administered in our emergency department.

Materials and methods: Emergency episodes occurring in a 4-year period and codified as facial nerve pathology were analyzed. IBM SPSS software was used for statistical analysis.

Results: In total, 582 emergency episodes were obtained. Due to inexpressive representation of other causes of PFP in our study, we focused our analyses on the 495 patients who were considered to have idiopathic PFP. There was equal distribution among genders, and all age ranges were affected. There were no clear epidemic phenomena. Hypertension was not a statistically significant risk factor for Bell's palsy. Most patients sought medical care in the early stages of the disease and complained of isolated facial weakness. Most patients had mild-to-moderate symptoms. Previous upper way infections (PUAI) were more frequent among children. There was a statistically significant difference regarding computed tomography (CT) scan requests among specialties.

Conclusion: Epidemiologic findings were consistent with most literature on Bell's palsy. Drug therapy is widely used and follows current guidelines. The role of PUAI in the pediatric population must be investigated. Despite evidence of good medical practice, there was an excess of CT scans requested by physicians other than otorhinolaryngologists.

Keywords: Bell Palsy; Herpes simplex; Otorhinolaryngologic disease; Peripheral Facial paralyses.

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Figures

Fig 1
Fig 1
Age distribution of Bell’s palsy
Fig 2
Fig 2
Number of cases of Bell’s palsy per month of study
Fig 3
Fig 3
Bell’s palsy cases grouped per month
Fig 4
Fig 4
PFP severity on presentation (House-Brackmann Grading System
Fig 5
Fig 5
Influence of otolaryngologist observation in CT scan ordering in patients referred to general physician
Fig 6
Fig 6
Drug therapy in Bell’s palsy patients; SS: systemic steroids; AV: systemic antiviral
See this image and copyright information in PMC

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