My brother was diagnosed with Bell's palsy last fall. He woke up in the morning with a terrible pain in his neck and throughout the day he had lost all facial function of the right side of his face. He couldn't blink, he could barely drink anything without all the water coming out the side of this mouth. He described it as going to the dentist and getting those awful numbing shots that completely immobilize the effected area. Since he couldn't close his eye fully, he had eye drops that he used daily to prevent drying. These are just a few of the issues he faced everyday. He began to regain a little function over the following months and has almost complete function a year later! Patients with Bell's palsy have to drastically change their mannerisms because of how quickly this condition can arise.
Beginning with some background information, Bell's palsy is a common condition caused by unilateral, acute onset facial paralysis. Approximately every 1 in 65 people will experience Bell's palsy throughout their lifetime. The majority will recover full facial function. Initial treatment involves oral corticosteroids or antiviral drugs. Inflammation is thought to play an important in the pathogenesis.
A recent study examined ninety-nine patients that were diagnosed with Bells palsy and ninety-nine healthy individuals with same demographic characteristics as the Bell's palsy group. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), which are indicative of inflammation, were calculated.
The NLR and the PLR were significantly higher in patients diagnosed with Bell's palsy. This has been the first known study showing the relationship between Bell's palsy and PLR. These ratios (PLR and NLR) can be used for additional characteristics in the diagnosis of Bell's palsy.
A link to this study can be found here: http://www.ncbi.nlm.nih.gov/pubmed/26167340
Balkan Med J. 2015 Apr;32(2):167-70. doi: 10.5152/balkanmedj.2015.15456. Epub 2015 Apr 1.
Vakharia K. Facial Plast Surg Clin North Am. 2016 Feb;24(1):1-10. doi: 10.1016/j.fsc.2015.08.001.
Wow! I had no idea about this disease, thanks for sharing and I'm glad your brother is okay. Is Bell's palsy a genetic disorder or due to a random mutation? Also regarding PLR, does this cause an increase in cases of patient's with Bell's palsy also having cardiovascular or immune issues with increased platelet counts and lowered lymphocyte levels? It seems like this could cause hypertension or atherosclerosis and also gaining secondary infections. But as far as detection that's awesome they found out a more proactive way to diagnose Bell's palsy.
ReplyDeleteDani, thanks for sharing this interesting information. My dad also had Bell's palsy several years ago, during a time when he was undergoing an acutely stressful situation. Have there been any studies or information on how PLR and NLR are influenced by stress? I would imagine these would be up-regulated during times of stress, leading to the pathogenesis of Bell's palsy. I wonder if stress is the primary cause that induces a secondary immune response (NLR/PLR) that ultimately triggers Bell's palsy.
ReplyDeleteDani, thanks for sharing this interesting information. My dad also had Bell's palsy several years ago, during a time when he was undergoing an acutely stressful situation. Have there been any studies or information on how PLR and NLR are influenced by stress? I would imagine these would be up-regulated during times of stress, leading to the pathogenesis of Bell's palsy. I wonder if stress is the primary cause that induces a secondary immune response (NLR/PLR) that ultimately triggers Bell's palsy.
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