Materiały źródłowe

• #1 Bell Palsy: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0400/bell-palsy.html

  Bell palsy should be suspected in patients with acute onset of unilateral facial weakness or paralysis involving the forehead in the absence of other neurologic abnormalities. The overall prognosis is good. More than two-thirds of patients with typical Bell palsy have a complete spontaneous recovery. […] Up to 90% of children younger than 14 years and pregnant patients will experience complete spontaneous recovery. […] Patients with bilateral disease or more severe peak symptoms (determined by the Sunnybrook or House-Brackmann scale) are less likely to experience full recovery. […] The recurrence rate of Bell palsy has been reported as 6.5%, with a mean interval of 10 years. Of patients with recurrence, 66% experience complete recovery. […] Synkinesis affects 26% of patients one year after onset of Bell palsy. […] Long-term sequelae of Bell palsy, especially the impairment of smiling, may lead to severe anxiety, depression, and other psychological problems.

• #2 Predicting Early Treatment Effectiveness in Bell’s Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals

  https://www.dovepress.com/predicting-early-treatment-effectiveness-in-bells-palsy-using-machine–peer-reviewed-fulltext-article-IJGM

  Facial nerve paralysis, particularly Bells palsy, manifests as a rapid onset of unilateral facial weakness or paralysis. Despite most patients recovering within three to six months, a significant proportion experience poor recovery. […] The results highlight the potential of machine learning models in predicting the effectiveness of early treatment. […] Additionally, feature ranking using logistic regression supported the importance of Prednisolone in treatment. Notably, our findings revealed the significance of age in prognosis evaluation for the first time. […] This suggests that future research should further develop age-specific prognostic models, enabling clinicians to tailor individualized treatment strategies more effectively. […] Recovery of facial nerve function is an important indicator guiding treatment recommendations.

• #2 Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis

  https://www.mdpi.com/2075-4426/11/3/171

  Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis […] Study Objectives: This retrospective study investigated prognostic factors and recovery time in patients with Bell’s palsy after different doses and durations of oral glucocorticoid treatments. […] A favorable outcome was defined as patients who improved to grade ≤ II, and an unfavorable outcome was defined as patients who improved to grade ≥ III in 6 months according to the House–Brackmann (HB) grading system. […] The rate of favorable outcomes was 89.4% (354 of 396 patients) at the 6-month follow-up. […] A favorable outcome (HB less than grade II) was associated with a delayed BR (odds ratio, OR, 5.38; 95% CI, 1.82 to 15.90) and fENoG values (the lesion side/the healthy side) over 33% (OR, 6.67; 95% CI, 3.02 to 14.71). […] The recovery time was significantly shorter for those with a delayed BR than for those with an absent BR and shorter for those with good fENoG values (>33%) than for those with poor values (≤33%). […] However, treatment without or with different doses and durations of oral glucocorticoid did not influence the final outcome or recovery time in this study. […] The fENoG and BR tests were significant and highly valuable examinations for predicting the final outcome. Moreover, age younger than 60 years, a delayed BR, and fENoG values > 33% were associated with shorter recovery times. […] The prognosis of Bell’s palsy is generally good, with approximately 70% of patients recovering spontaneously by three to six months. […] Unfavorable fENoG values and an absent BR test are associated with a worse outcome in patients with Bell’s palsy. […] In our study, a total of 382 (96.5%) patients received steroid treatment within 72 h. However, there were no significant differences between the high dose (≤0.5 mg/kg/day) and low dose (>0.5 mg/kg/day) or between the shorter regimen (≤7 days) and longer regimen (>7 days) in terms of the final outcome and recovery time. […] Our findings showed that a favorable outcome in Bell’s palsy was associated with a delayed BR and a large fENoG value. In addition, age younger than 60 years, delayed BR and fENoG values > 33% were associated with shorter recovery times.

• #3 Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis

  https://www.mdpi.com/2075-4426/11/3/171

  Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis […] Study Objectives: This retrospective study investigated prognostic factors and recovery time in patients with Bell’s palsy after different doses and durations of oral glucocorticoid treatments. […] A favorable outcome was defined as patients who improved to grade ≤ II, and an unfavorable outcome was defined as patients who improved to grade ≥ III in 6 months according to the House–Brackmann (HB) grading system. […] The rate of favorable outcomes was 89.4% (354 of 396 patients) at the 6-month follow-up. […] A favorable outcome (HB less than grade II) was associated with a delayed BR (odds ratio, OR, 5.38; 95% CI, 1.82 to 15.90) and fENoG values (the lesion side/the healthy side) over 33% (OR, 6.67; 95% CI, 3.02 to 14.71). […] The recovery time was significantly shorter for those with a delayed BR than for those with an absent BR and shorter for those with good fENoG values (>33%) than for those with poor values (≤33%). […] However, treatment without or with different doses and durations of oral glucocorticoid did not influence the final outcome or recovery time in this study. […] The fENoG and BR tests were significant and highly valuable examinations for predicting the final outcome. Moreover, age younger than 60 years, a delayed BR, and fENoG values > 33% were associated with shorter recovery times. […] The prognosis of Bell’s palsy is generally good, with approximately 70% of patients recovering spontaneously by three to six months. […] Unfavorable fENoG values and an absent BR test are associated with a worse outcome in patients with Bell’s palsy. […] In our study, a total of 382 (96.5%) patients received steroid treatment within 72 h. However, there were no significant differences between the high dose (≤0.5 mg/kg/day) and low dose (>0.5 mg/kg/day) or between the shorter regimen (≤7 days) and longer regimen (>7 days) in terms of the final outcome and recovery time. […] Our findings showed that a favorable outcome in Bell’s palsy was associated with a delayed BR and a large fENoG value. In addition, age younger than 60 years, delayed BR and fENoG values > 33% were associated with shorter recovery times.

• #4

  https://link.springer.com/article/10.1007/s12070-021-02935-9

  Electrophysiological studies can objectively predict the functional recovery in Bells palsy but, the clinical prognostic indicators seem to be more practical where the nerve conduction studies are not available. […] 91.17% (31/34) of Bells palsy patients had complete facial nerve function recovery at the end of 8 weeks. Higher Age40 years (p=0.022) and BP patients with coronary artery disease (p=0.005) were the only two significant indicators for incomplete recovery. […] We suggest that all Bells palsy patients seek medical advice early at the onset, especially the BP patients of older age and with coronary artery disease for faster recovery.

• #5 Evaluation of prognostic factors in patients with Bell’s palsy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8613409/

  Age was an important determinant of outcome, with advancing age having worse outcome than younger patients. […] Hypertension at the time of onset of Bell’s palsy measured during initial presentation to hospital was significantly associated with worse outcome. […] In patients with Bell palsy, diabetes was found to be associated with a poor outcome. […] Lower HB grade was associated with favorable outcome while higher HB grade was associated with worse prognosis. […] Greater degree of amplitude reduction was associated with worse outcome. […] Age, diabetes mellitus, hypertension, initial HB grade, and extent of facial nerve degeneration as recorded by nerve conduction studies, affect clinical outcome of Bell’s palsy at 3 months after its onset.

• #6 Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis

  https://www.mdpi.com/2075-4426/11/3/171

  Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis […] Study Objectives: This retrospective study investigated prognostic factors and recovery time in patients with Bell’s palsy after different doses and durations of oral glucocorticoid treatments. […] A favorable outcome was defined as patients who improved to grade ≤ II, and an unfavorable outcome was defined as patients who improved to grade ≥ III in 6 months according to the House–Brackmann (HB) grading system. […] The rate of favorable outcomes was 89.4% (354 of 396 patients) at the 6-month follow-up. […] A favorable outcome (HB less than grade II) was associated with a delayed BR (odds ratio, OR, 5.38; 95% CI, 1.82 to 15.90) and fENoG values (the lesion side/the healthy side) over 33% (OR, 6.67; 95% CI, 3.02 to 14.71). […] The recovery time was significantly shorter for those with a delayed BR than for those with an absent BR and shorter for those with good fENoG values (>33%) than for those with poor values (≤33%). […] However, treatment without or with different doses and durations of oral glucocorticoid did not influence the final outcome or recovery time in this study. […] The fENoG and BR tests were significant and highly valuable examinations for predicting the final outcome. Moreover, age younger than 60 years, a delayed BR, and fENoG values > 33% were associated with shorter recovery times. […] The prognosis of Bell’s palsy is generally good, with approximately 70% of patients recovering spontaneously by three to six months. […] Unfavorable fENoG values and an absent BR test are associated with a worse outcome in patients with Bell’s palsy. […] In our study, a total of 382 (96.5%) patients received steroid treatment within 72 h. However, there were no significant differences between the high dose (≤0.5 mg/kg/day) and low dose (>0.5 mg/kg/day) or between the shorter regimen (≤7 days) and longer regimen (>7 days) in terms of the final outcome and recovery time. […] Our findings showed that a favorable outcome in Bell’s palsy was associated with a delayed BR and a large fENoG value. In addition, age younger than 60 years, delayed BR and fENoG values > 33% were associated with shorter recovery times.

• #7 Predicting Early Treatment Effectiveness in Bell’s Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals

  https://www.dovepress.com/predicting-early-treatment-effectiveness-in-bells-palsy-using-machine–peer-reviewed-fulltext-article-IJGM

  The primary pharmacologic therapy for Bells palsy or facial nerve palsy is early short-term oral corticosteroid treatment. […] The potential benefit of adding antiviral therapy to the corticosteroid regimen for patients with new-onset Bells palsy remains uncertain. […] Our research findings demonstrate that the logistic regression model exhibited the highest predictive performance for both 3-month and 9-month recovery outcomes. […] The feature ranking analysis revealed that the patients age and Prednisolone administration were the most significant predictors of recovery. […] The identification of age and Prednisolone administration as critical predictors of recovery holds substantial implications for tailoring treatment plans. […] This underscores the importance of early intervention, especially in older patients who may face a higher likelihood of incomplete recovery. […] The study underscores the potential of machine learning in enhancing prognostic predictions for Bells palsy treatment outcomes.

• #8 Evaluation of prognostic factors in patients with Bell’s palsy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8613409/

  Bell’s palsy is a common neurological problem that leads to peripheral palsy of the facial nerve. Most patients have a favorable response with or without treatment while some are left with significant facial deformity. […] Most of the patients with Bell’s palsy have favorable outcomes. Age, hypertension, initial HB grade, and extent of facial nerve degeneration as recorded by nerve conduction studies are important predictors of outcome. […] The outcome of Bell’s palsy depends on the severity of facial nerve degeneration which is best seen using nerve conduction studies. […] Lower HB grade at the time of presentation to hospital was associated with favorable outcome while higher HB grade was associated with worse prognosis. […] A greater degree of amplitude reduction was associated with worse outcome.

• #9 Evaluation of prognostic factors in patients with Bell’s palsy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8613409/

  Age was an important determinant of outcome, with advancing age having worse outcome than younger patients. […] Hypertension at the time of onset of Bell’s palsy measured during initial presentation to hospital was significantly associated with worse outcome. […] In patients with Bell palsy, diabetes was found to be associated with a poor outcome. […] Lower HB grade was associated with favorable outcome while higher HB grade was associated with worse prognosis. […] Greater degree of amplitude reduction was associated with worse outcome. […] Age, diabetes mellitus, hypertension, initial HB grade, and extent of facial nerve degeneration as recorded by nerve conduction studies, affect clinical outcome of Bell’s palsy at 3 months after its onset.

• #10 Evaluation of prognostic factors in patients with Bell’s palsy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8613409/

  Age was an important determinant of outcome, with advancing age having worse outcome than younger patients. […] Hypertension at the time of onset of Bell’s palsy measured during initial presentation to hospital was significantly associated with worse outcome. […] In patients with Bell palsy, diabetes was found to be associated with a poor outcome. […] Lower HB grade was associated with favorable outcome while higher HB grade was associated with worse prognosis. […] Greater degree of amplitude reduction was associated with worse outcome. […] Age, diabetes mellitus, hypertension, initial HB grade, and extent of facial nerve degeneration as recorded by nerve conduction studies, affect clinical outcome of Bell’s palsy at 3 months after its onset.

• #11 Bell’s palsy: clinical and neurophysiologic predictors of recovery | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-020-00171-6

  The annual incidence of Bells palsy (BP) is 15 to 20 per 100,000 with 40,000 new cases each year, and the lifetime risk is 1 in 60. […] The present study was designed to verify in BP which clinical or electrophysiological parameters could be considered as predictive of the degree of recovery of normal facial muscle function. […] We could not find statistically significant differences between BP with good and poor prognosis as regard age, sex, onset, diabetes, hypertension, dyslipidemia, or the initial HB Score. […] The initial ENoG is more predictive of recovery of Bells palsy than the initial clinical grading using the HB system. Age, sex, hypertension, diabetes, and dyslipidemia do not seem to correlate with the degree of recovery in Bells palsy. […] The prognosis of Bells palsy has been predicted based mainly on various electrophysiologic tests especially electroneurography ENoG. […] Our work showed less decrease in the amplitude of frontalis, nasalis, and orbicularis oris muscles in group 1 (good prognosis) than group 2 (poor prognosis) with statistically significant difference.

• #12

  https://link.springer.com/article/10.1007/s12070-021-02935-9

  Electrophysiological studies can objectively predict the functional recovery in Bells palsy but, the clinical prognostic indicators seem to be more practical where the nerve conduction studies are not available. […] 91.17% (31/34) of Bells palsy patients had complete facial nerve function recovery at the end of 8 weeks. Higher Age40 years (p=0.022) and BP patients with coronary artery disease (p=0.005) were the only two significant indicators for incomplete recovery. […] We suggest that all Bells palsy patients seek medical advice early at the onset, especially the BP patients of older age and with coronary artery disease for faster recovery.

• #13 Bell Palsy: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0400/bell-palsy.html

  Bell palsy should be suspected in patients with acute onset of unilateral facial weakness or paralysis involving the forehead in the absence of other neurologic abnormalities. The overall prognosis is good. More than two-thirds of patients with typical Bell palsy have a complete spontaneous recovery. […] Up to 90% of children younger than 14 years and pregnant patients will experience complete spontaneous recovery. […] Patients with bilateral disease or more severe peak symptoms (determined by the Sunnybrook or House-Brackmann scale) are less likely to experience full recovery. […] The recurrence rate of Bell palsy has been reported as 6.5%, with a mean interval of 10 years. Of patients with recurrence, 66% experience complete recovery. […] Synkinesis affects 26% of patients one year after onset of Bell palsy. […] Long-term sequelae of Bell palsy, especially the impairment of smiling, may lead to severe anxiety, depression, and other psychological problems.

• #14 Evaluation of prognostic factors in patients with Bell’s palsy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8613409/

  Bell’s palsy is a common neurological problem that leads to peripheral palsy of the facial nerve. Most patients have a favorable response with or without treatment while some are left with significant facial deformity. […] Most of the patients with Bell’s palsy have favorable outcomes. Age, hypertension, initial HB grade, and extent of facial nerve degeneration as recorded by nerve conduction studies are important predictors of outcome. […] The outcome of Bell’s palsy depends on the severity of facial nerve degeneration which is best seen using nerve conduction studies. […] Lower HB grade at the time of presentation to hospital was associated with favorable outcome while higher HB grade was associated with worse prognosis. […] A greater degree of amplitude reduction was associated with worse outcome.

• #15 Evaluation of prognostic factors in patients with Bell’s palsy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8613409/

  Age was an important determinant of outcome, with advancing age having worse outcome than younger patients. […] Hypertension at the time of onset of Bell’s palsy measured during initial presentation to hospital was significantly associated with worse outcome. […] In patients with Bell palsy, diabetes was found to be associated with a poor outcome. […] Lower HB grade was associated with favorable outcome while higher HB grade was associated with worse prognosis. […] Greater degree of amplitude reduction was associated with worse outcome. […] Age, diabetes mellitus, hypertension, initial HB grade, and extent of facial nerve degeneration as recorded by nerve conduction studies, affect clinical outcome of Bell’s palsy at 3 months after its onset.

• #16 Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis

  https://www.mdpi.com/2075-4426/11/3/171

  Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis […] Study Objectives: This retrospective study investigated prognostic factors and recovery time in patients with Bell’s palsy after different doses and durations of oral glucocorticoid treatments. […] A favorable outcome was defined as patients who improved to grade ≤ II, and an unfavorable outcome was defined as patients who improved to grade ≥ III in 6 months according to the House–Brackmann (HB) grading system. […] The rate of favorable outcomes was 89.4% (354 of 396 patients) at the 6-month follow-up. […] A favorable outcome (HB less than grade II) was associated with a delayed BR (odds ratio, OR, 5.38; 95% CI, 1.82 to 15.90) and fENoG values (the lesion side/the healthy side) over 33% (OR, 6.67; 95% CI, 3.02 to 14.71). […] The recovery time was significantly shorter for those with a delayed BR than for those with an absent BR and shorter for those with good fENoG values (>33%) than for those with poor values (≤33%). […] However, treatment without or with different doses and durations of oral glucocorticoid did not influence the final outcome or recovery time in this study. […] The fENoG and BR tests were significant and highly valuable examinations for predicting the final outcome. Moreover, age younger than 60 years, a delayed BR, and fENoG values > 33% were associated with shorter recovery times. […] The prognosis of Bell’s palsy is generally good, with approximately 70% of patients recovering spontaneously by three to six months. […] Unfavorable fENoG values and an absent BR test are associated with a worse outcome in patients with Bell’s palsy. […] In our study, a total of 382 (96.5%) patients received steroid treatment within 72 h. However, there were no significant differences between the high dose (≤0.5 mg/kg/day) and low dose (>0.5 mg/kg/day) or between the shorter regimen (≤7 days) and longer regimen (>7 days) in terms of the final outcome and recovery time. […] Our findings showed that a favorable outcome in Bell’s palsy was associated with a delayed BR and a large fENoG value. In addition, age younger than 60 years, delayed BR and fENoG values > 33% were associated with shorter recovery times.

• #17 Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis

  https://www.mdpi.com/2075-4426/11/3/171

  Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis […] Study Objectives: This retrospective study investigated prognostic factors and recovery time in patients with Bell’s palsy after different doses and durations of oral glucocorticoid treatments. […] A favorable outcome was defined as patients who improved to grade ≤ II, and an unfavorable outcome was defined as patients who improved to grade ≥ III in 6 months according to the House–Brackmann (HB) grading system. […] The rate of favorable outcomes was 89.4% (354 of 396 patients) at the 6-month follow-up. […] A favorable outcome (HB less than grade II) was associated with a delayed BR (odds ratio, OR, 5.38; 95% CI, 1.82 to 15.90) and fENoG values (the lesion side/the healthy side) over 33% (OR, 6.67; 95% CI, 3.02 to 14.71). […] The recovery time was significantly shorter for those with a delayed BR than for those with an absent BR and shorter for those with good fENoG values (>33%) than for those with poor values (≤33%). […] However, treatment without or with different doses and durations of oral glucocorticoid did not influence the final outcome or recovery time in this study. […] The fENoG and BR tests were significant and highly valuable examinations for predicting the final outcome. Moreover, age younger than 60 years, a delayed BR, and fENoG values > 33% were associated with shorter recovery times. […] The prognosis of Bell’s palsy is generally good, with approximately 70% of patients recovering spontaneously by three to six months. […] Unfavorable fENoG values and an absent BR test are associated with a worse outcome in patients with Bell’s palsy. […] In our study, a total of 382 (96.5%) patients received steroid treatment within 72 h. However, there were no significant differences between the high dose (≤0.5 mg/kg/day) and low dose (>0.5 mg/kg/day) or between the shorter regimen (≤7 days) and longer regimen (>7 days) in terms of the final outcome and recovery time. […] Our findings showed that a favorable outcome in Bell’s palsy was associated with a delayed BR and a large fENoG value. In addition, age younger than 60 years, delayed BR and fENoG values > 33% were associated with shorter recovery times.

• #18 Prognostic factors for the outcome of Bells’ palsy: A cohort register-based study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/32395899/

  Objectives: There is a lack of data on patients’ and diagnostic factors for prognostication of complete recovery in patients with Bell’s palsy. […] Results: Median onset of treatment was 1.5 days. 46% of patients had a House-Brackmann scale at baseline of III. The median recovery time was 2.6 months (95% confidence interval [CI] = 2.1-3.0). 54.9% achieved a complete recovery. If prednisolone therapy started later than 96 hours after onset, the recovery rate decreased significantly. Beyond less severe palsy, no abnormal electroneurography side difference, no pathological spontaneous activity in electromyography and normal stapedius reflex testing were the most powerful tool for prognostication of recovery after Bell’s palsy. […] Conclusion: Beyond severity of the palsy, facial electrodiagnostics and stapedius reflex testing are the most powerful tool for prognostication of recovery time after Bell’s palsy. Prednisolone therapy should have started at best within a time window of 96 hours after onset to reach the highest probability of complete recovery.

• #19 NLR and Idiopathic Facial Nerve Palsy | IJGM

  https://www.dovepress.com/predictive-value-of-the-neutrophil-to-lymphocyte-ratio-and-c-reactive–peer-reviewed-fulltext-article-IJGM

  Objective: This study aims to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in patients with idiopathic facial nerve palsy. […] Conclusion: Elevated NLR and CRP are associated with a poor prognosis of idiopathic facial nerve palsy and can serve as an indicator for clinical prognosis, and can be widely used in clinical. […] The higher the Portmann score, the higher the probability of good prognosis, while the higher the NLR and CRP levels, the higher the probability of poor prognosis, as shown in Table 2. […] Taken together, the increasing in NLR and CRP levels was related to poor 3-month prognosis of facial nerve function and had a certain predictive value. The combination of the two had a higher predictive value.

• #20 NLR and Idiopathic Facial Nerve Palsy | IJGM

  https://www.dovepress.com/predictive-value-of-the-neutrophil-to-lymphocyte-ratio-and-c-reactive–peer-reviewed-fulltext-article-IJGM

  Objective: This study aims to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in patients with idiopathic facial nerve palsy. […] Conclusion: Elevated NLR and CRP are associated with a poor prognosis of idiopathic facial nerve palsy and can serve as an indicator for clinical prognosis, and can be widely used in clinical. […] The higher the Portmann score, the higher the probability of good prognosis, while the higher the NLR and CRP levels, the higher the probability of poor prognosis, as shown in Table 2. […] Taken together, the increasing in NLR and CRP levels was related to poor 3-month prognosis of facial nerve function and had a certain predictive value. The combination of the two had a higher predictive value.

• #21 Prognostic factors for the outcome of Bells’ palsy: A cohort register-based study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/32395899/

  Objectives: There is a lack of data on patients’ and diagnostic factors for prognostication of complete recovery in patients with Bell’s palsy. […] Results: Median onset of treatment was 1.5 days. 46% of patients had a House-Brackmann scale at baseline of III. The median recovery time was 2.6 months (95% confidence interval [CI] = 2.1-3.0). 54.9% achieved a complete recovery. If prednisolone therapy started later than 96 hours after onset, the recovery rate decreased significantly. Beyond less severe palsy, no abnormal electroneurography side difference, no pathological spontaneous activity in electromyography and normal stapedius reflex testing were the most powerful tool for prognostication of recovery after Bell’s palsy. […] Conclusion: Beyond severity of the palsy, facial electrodiagnostics and stapedius reflex testing are the most powerful tool for prognostication of recovery time after Bell’s palsy. Prednisolone therapy should have started at best within a time window of 96 hours after onset to reach the highest probability of complete recovery.

• #22 Predicting Early Treatment Effectiveness in Bell’s Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals

  https://www.dovepress.com/predicting-early-treatment-effectiveness-in-bells-palsy-using-machine–peer-reviewed-fulltext-article-IJGM

  The primary pharmacologic therapy for Bells palsy or facial nerve palsy is early short-term oral corticosteroid treatment. […] The potential benefit of adding antiviral therapy to the corticosteroid regimen for patients with new-onset Bells palsy remains uncertain. […] Our research findings demonstrate that the logistic regression model exhibited the highest predictive performance for both 3-month and 9-month recovery outcomes. […] The feature ranking analysis revealed that the patients age and Prednisolone administration were the most significant predictors of recovery. […] The identification of age and Prednisolone administration as critical predictors of recovery holds substantial implications for tailoring treatment plans. […] This underscores the importance of early intervention, especially in older patients who may face a higher likelihood of incomplete recovery. […] The study underscores the potential of machine learning in enhancing prognostic predictions for Bells palsy treatment outcomes.

• #23 Predicting Early Treatment Effectiveness in Bell’s Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals

  https://www.dovepress.com/predicting-early-treatment-effectiveness-in-bells-palsy-using-machine–peer-reviewed-fulltext-article-IJGM

  The primary pharmacologic therapy for Bells palsy or facial nerve palsy is early short-term oral corticosteroid treatment. […] The potential benefit of adding antiviral therapy to the corticosteroid regimen for patients with new-onset Bells palsy remains uncertain. […] Our research findings demonstrate that the logistic regression model exhibited the highest predictive performance for both 3-month and 9-month recovery outcomes. […] The feature ranking analysis revealed that the patients age and Prednisolone administration were the most significant predictors of recovery. […] The identification of age and Prednisolone administration as critical predictors of recovery holds substantial implications for tailoring treatment plans. […] This underscores the importance of early intervention, especially in older patients who may face a higher likelihood of incomplete recovery. […] The study underscores the potential of machine learning in enhancing prognostic predictions for Bells palsy treatment outcomes.

• #24 Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis

  https://www.mdpi.com/2075-4426/11/3/171

  Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis […] Study Objectives: This retrospective study investigated prognostic factors and recovery time in patients with Bell’s palsy after different doses and durations of oral glucocorticoid treatments. […] A favorable outcome was defined as patients who improved to grade ≤ II, and an unfavorable outcome was defined as patients who improved to grade ≥ III in 6 months according to the House–Brackmann (HB) grading system. […] The rate of favorable outcomes was 89.4% (354 of 396 patients) at the 6-month follow-up. […] A favorable outcome (HB less than grade II) was associated with a delayed BR (odds ratio, OR, 5.38; 95% CI, 1.82 to 15.90) and fENoG values (the lesion side/the healthy side) over 33% (OR, 6.67; 95% CI, 3.02 to 14.71). […] The recovery time was significantly shorter for those with a delayed BR than for those with an absent BR and shorter for those with good fENoG values (>33%) than for those with poor values (≤33%). […] However, treatment without or with different doses and durations of oral glucocorticoid did not influence the final outcome or recovery time in this study. […] The fENoG and BR tests were significant and highly valuable examinations for predicting the final outcome. Moreover, age younger than 60 years, a delayed BR, and fENoG values > 33% were associated with shorter recovery times. […] The prognosis of Bell’s palsy is generally good, with approximately 70% of patients recovering spontaneously by three to six months. […] Unfavorable fENoG values and an absent BR test are associated with a worse outcome in patients with Bell’s palsy. […] In our study, a total of 382 (96.5%) patients received steroid treatment within 72 h. However, there were no significant differences between the high dose (≤0.5 mg/kg/day) and low dose (>0.5 mg/kg/day) or between the shorter regimen (≤7 days) and longer regimen (>7 days) in terms of the final outcome and recovery time. […] Our findings showed that a favorable outcome in Bell’s palsy was associated with a delayed BR and a large fENoG value. In addition, age younger than 60 years, delayed BR and fENoG values > 33% were associated with shorter recovery times.

• #25 Bell Palsy: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0400/bell-palsy.html

  Bell palsy should be suspected in patients with acute onset of unilateral facial weakness or paralysis involving the forehead in the absence of other neurologic abnormalities. The overall prognosis is good. More than two-thirds of patients with typical Bell palsy have a complete spontaneous recovery. […] Up to 90% of children younger than 14 years and pregnant patients will experience complete spontaneous recovery. […] Patients with bilateral disease or more severe peak symptoms (determined by the Sunnybrook or House-Brackmann scale) are less likely to experience full recovery. […] The recurrence rate of Bell palsy has been reported as 6.5%, with a mean interval of 10 years. Of patients with recurrence, 66% experience complete recovery. […] Synkinesis affects 26% of patients one year after onset of Bell palsy. […] Long-term sequelae of Bell palsy, especially the impairment of smiling, may lead to severe anxiety, depression, and other psychological problems.

• #26 Bell Palsy: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0400/bell-palsy.html

  Bell palsy should be suspected in patients with acute onset of unilateral facial weakness or paralysis involving the forehead in the absence of other neurologic abnormalities. The overall prognosis is good. More than two-thirds of patients with typical Bell palsy have a complete spontaneous recovery. […] Up to 90% of children younger than 14 years and pregnant patients will experience complete spontaneous recovery. […] Patients with bilateral disease or more severe peak symptoms (determined by the Sunnybrook or House-Brackmann scale) are less likely to experience full recovery. […] The recurrence rate of Bell palsy has been reported as 6.5%, with a mean interval of 10 years. Of patients with recurrence, 66% experience complete recovery. […] Synkinesis affects 26% of patients one year after onset of Bell palsy. […] Long-term sequelae of Bell palsy, especially the impairment of smiling, may lead to severe anxiety, depression, and other psychological problems.

• #27 Bell Palsy: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0400/bell-palsy.html

  Bell palsy should be suspected in patients with acute onset of unilateral facial weakness or paralysis involving the forehead in the absence of other neurologic abnormalities. The overall prognosis is good. More than two-thirds of patients with typical Bell palsy have a complete spontaneous recovery. […] Up to 90% of children younger than 14 years and pregnant patients will experience complete spontaneous recovery. […] Patients with bilateral disease or more severe peak symptoms (determined by the Sunnybrook or House-Brackmann scale) are less likely to experience full recovery. […] The recurrence rate of Bell palsy has been reported as 6.5%, with a mean interval of 10 years. Of patients with recurrence, 66% experience complete recovery. […] Synkinesis affects 26% of patients one year after onset of Bell palsy. […] Long-term sequelae of Bell palsy, especially the impairment of smiling, may lead to severe anxiety, depression, and other psychological problems.

• #28 Predicting Early Treatment Effectiveness in Bell’s Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals

  https://www.dovepress.com/predicting-early-treatment-effectiveness-in-bells-palsy-using-machine–peer-reviewed-fulltext-article-IJGM

  The primary pharmacologic therapy for Bells palsy or facial nerve palsy is early short-term oral corticosteroid treatment. […] The potential benefit of adding antiviral therapy to the corticosteroid regimen for patients with new-onset Bells palsy remains uncertain. […] Our research findings demonstrate that the logistic regression model exhibited the highest predictive performance for both 3-month and 9-month recovery outcomes. […] The feature ranking analysis revealed that the patients age and Prednisolone administration were the most significant predictors of recovery. […] The identification of age and Prednisolone administration as critical predictors of recovery holds substantial implications for tailoring treatment plans. […] This underscores the importance of early intervention, especially in older patients who may face a higher likelihood of incomplete recovery. […] The study underscores the potential of machine learning in enhancing prognostic predictions for Bells palsy treatment outcomes.

• #29 Predicting Early Treatment Effectiveness in Bell’s Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals

  https://www.dovepress.com/predicting-early-treatment-effectiveness-in-bells-palsy-using-machine–peer-reviewed-fulltext-article-IJGM

  The primary pharmacologic therapy for Bells palsy or facial nerve palsy is early short-term oral corticosteroid treatment. […] The potential benefit of adding antiviral therapy to the corticosteroid regimen for patients with new-onset Bells palsy remains uncertain. […] Our research findings demonstrate that the logistic regression model exhibited the highest predictive performance for both 3-month and 9-month recovery outcomes. […] The feature ranking analysis revealed that the patients age and Prednisolone administration were the most significant predictors of recovery. […] The identification of age and Prednisolone administration as critical predictors of recovery holds substantial implications for tailoring treatment plans. […] This underscores the importance of early intervention, especially in older patients who may face a higher likelihood of incomplete recovery. […] The study underscores the potential of machine learning in enhancing prognostic predictions for Bells palsy treatment outcomes.

• #30 Predicting Early Treatment Effectiveness in Bell’s Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals

  https://www.dovepress.com/predicting-early-treatment-effectiveness-in-bells-palsy-using-machine–peer-reviewed-fulltext-article-IJGM

  The primary pharmacologic therapy for Bells palsy or facial nerve palsy is early short-term oral corticosteroid treatment. […] The potential benefit of adding antiviral therapy to the corticosteroid regimen for patients with new-onset Bells palsy remains uncertain. […] Our research findings demonstrate that the logistic regression model exhibited the highest predictive performance for both 3-month and 9-month recovery outcomes. […] The feature ranking analysis revealed that the patients age and Prednisolone administration were the most significant predictors of recovery. […] The identification of age and Prednisolone administration as critical predictors of recovery holds substantial implications for tailoring treatment plans. […] This underscores the importance of early intervention, especially in older patients who may face a higher likelihood of incomplete recovery. […] The study underscores the potential of machine learning in enhancing prognostic predictions for Bells palsy treatment outcomes.

• #31

  https://link.springer.com/article/10.1007/s12070-021-02935-9

  Electrophysiological studies can objectively predict the functional recovery in Bells palsy but, the clinical prognostic indicators seem to be more practical where the nerve conduction studies are not available. […] 91.17% (31/34) of Bells palsy patients had complete facial nerve function recovery at the end of 8 weeks. Higher Age40 years (p=0.022) and BP patients with coronary artery disease (p=0.005) were the only two significant indicators for incomplete recovery. […] We suggest that all Bells palsy patients seek medical advice early at the onset, especially the BP patients of older age and with coronary artery disease for faster recovery.

• #32 Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis

  https://www.mdpi.com/2075-4426/11/3/171

  Reappraisal of the Prognostic Factors of Outcome and Recovery Time in Patients with Idiopathic Bell’s Palsy: A Retrospective Single-Center Analysis […] Study Objectives: This retrospective study investigated prognostic factors and recovery time in patients with Bell’s palsy after different doses and durations of oral glucocorticoid treatments. […] A favorable outcome was defined as patients who improved to grade ≤ II, and an unfavorable outcome was defined as patients who improved to grade ≥ III in 6 months according to the House–Brackmann (HB) grading system. […] The rate of favorable outcomes was 89.4% (354 of 396 patients) at the 6-month follow-up. […] A favorable outcome (HB less than grade II) was associated with a delayed BR (odds ratio, OR, 5.38; 95% CI, 1.82 to 15.90) and fENoG values (the lesion side/the healthy side) over 33% (OR, 6.67; 95% CI, 3.02 to 14.71). […] The recovery time was significantly shorter for those with a delayed BR than for those with an absent BR and shorter for those with good fENoG values (>33%) than for those with poor values (≤33%). […] However, treatment without or with different doses and durations of oral glucocorticoid did not influence the final outcome or recovery time in this study. […] The fENoG and BR tests were significant and highly valuable examinations for predicting the final outcome. Moreover, age younger than 60 years, a delayed BR, and fENoG values > 33% were associated with shorter recovery times. […] The prognosis of Bell’s palsy is generally good, with approximately 70% of patients recovering spontaneously by three to six months. […] Unfavorable fENoG values and an absent BR test are associated with a worse outcome in patients with Bell’s palsy. […] In our study, a total of 382 (96.5%) patients received steroid treatment within 72 h. However, there were no significant differences between the high dose (≤0.5 mg/kg/day) and low dose (>0.5 mg/kg/day) or between the shorter regimen (≤7 days) and longer regimen (>7 days) in terms of the final outcome and recovery time. […] Our findings showed that a favorable outcome in Bell’s palsy was associated with a delayed BR and a large fENoG value. In addition, age younger than 60 years, delayed BR and fENoG values > 33% were associated with shorter recovery times.

• #33 Bell’s palsy: clinical and neurophysiologic predictors of recovery | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-020-00171-6

  The annual incidence of Bells palsy (BP) is 15 to 20 per 100,000 with 40,000 new cases each year, and the lifetime risk is 1 in 60. […] The present study was designed to verify in BP which clinical or electrophysiological parameters could be considered as predictive of the degree of recovery of normal facial muscle function. […] We could not find statistically significant differences between BP with good and poor prognosis as regard age, sex, onset, diabetes, hypertension, dyslipidemia, or the initial HB Score. […] The initial ENoG is more predictive of recovery of Bells palsy than the initial clinical grading using the HB system. Age, sex, hypertension, diabetes, and dyslipidemia do not seem to correlate with the degree of recovery in Bells palsy. […] The prognosis of Bells palsy has been predicted based mainly on various electrophysiologic tests especially electroneurography ENoG. […] Our work showed less decrease in the amplitude of frontalis, nasalis, and orbicularis oris muscles in group 1 (good prognosis) than group 2 (poor prognosis) with statistically significant difference.

• #34 Prognostic factors for the outcome of Bells’ palsy: A cohort register-based study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/32395899/

  Objectives: There is a lack of data on patients’ and diagnostic factors for prognostication of complete recovery in patients with Bell’s palsy. […] Results: Median onset of treatment was 1.5 days. 46% of patients had a House-Brackmann scale at baseline of III. The median recovery time was 2.6 months (95% confidence interval [CI] = 2.1-3.0). 54.9% achieved a complete recovery. If prednisolone therapy started later than 96 hours after onset, the recovery rate decreased significantly. Beyond less severe palsy, no abnormal electroneurography side difference, no pathological spontaneous activity in electromyography and normal stapedius reflex testing were the most powerful tool for prognostication of recovery after Bell’s palsy. […] Conclusion: Beyond severity of the palsy, facial electrodiagnostics and stapedius reflex testing are the most powerful tool for prognostication of recovery time after Bell’s palsy. Prednisolone therapy should have started at best within a time window of 96 hours after onset to reach the highest probability of complete recovery.

• #35 NLR and Idiopathic Facial Nerve Palsy | IJGM

  https://www.dovepress.com/predictive-value-of-the-neutrophil-to-lymphocyte-ratio-and-c-reactive–peer-reviewed-fulltext-article-IJGM

  Objective: This study aims to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) in patients with idiopathic facial nerve palsy. […] Conclusion: Elevated NLR and CRP are associated with a poor prognosis of idiopathic facial nerve palsy and can serve as an indicator for clinical prognosis, and can be widely used in clinical. […] The higher the Portmann score, the higher the probability of good prognosis, while the higher the NLR and CRP levels, the higher the probability of poor prognosis, as shown in Table 2. […] Taken together, the increasing in NLR and CRP levels was related to poor 3-month prognosis of facial nerve function and had a certain predictive value. The combination of the two had a higher predictive value.

• #36 Predicting Early Treatment Effectiveness in Bell’s Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals

  https://www.dovepress.com/predicting-early-treatment-effectiveness-in-bells-palsy-using-machine–peer-reviewed-fulltext-article-IJGM

  The primary pharmacologic therapy for Bells palsy or facial nerve palsy is early short-term oral corticosteroid treatment. […] The potential benefit of adding antiviral therapy to the corticosteroid regimen for patients with new-onset Bells palsy remains uncertain. […] Our research findings demonstrate that the logistic regression model exhibited the highest predictive performance for both 3-month and 9-month recovery outcomes. […] The feature ranking analysis revealed that the patients age and Prednisolone administration were the most significant predictors of recovery. […] The identification of age and Prednisolone administration as critical predictors of recovery holds substantial implications for tailoring treatment plans. […] This underscores the importance of early intervention, especially in older patients who may face a higher likelihood of incomplete recovery. […] The study underscores the potential of machine learning in enhancing prognostic predictions for Bells palsy treatment outcomes.

• #37 Evaluation of prognostic factors in patients with Bell’s palsy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8613409/

  Age was an important determinant of outcome, with advancing age having worse outcome than younger patients. […] Hypertension at the time of onset of Bell’s palsy measured during initial presentation to hospital was significantly associated with worse outcome. […] In patients with Bell palsy, diabetes was found to be associated with a poor outcome. […] Lower HB grade was associated with favorable outcome while higher HB grade was associated with worse prognosis. […] Greater degree of amplitude reduction was associated with worse outcome. […] Age, diabetes mellitus, hypertension, initial HB grade, and extent of facial nerve degeneration as recorded by nerve conduction studies, affect clinical outcome of Bell’s palsy at 3 months after its onset.

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