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Seasonal Pattern of Bell's Palsy Incidence in a Post-COVID-19 Context

Year 2025, Volume: 27 Issue: 2, 146 - 150, 30.08.2025
https://doi.org/10.18678/dtfd.1585848

Abstract

Aim: This study aimed to investigate the seasonal effects on the incidence of Bell's palsy (BP), and to determine whether the rates fluctuate with changing seasons, particularly following the coronavirus disease 2019 (COVID-19) pandemic.
Material and Methods: A retrospective analysis was conducted on 267 confirmed BP cases between January 2020 and December 2023. Data were collected on the onset dates, demographic information, and seasonal distribution of the cases. Cases were categorized based on their seasonal occurrence to identify trends and variations.
Results: The study group included 137 males and 130 females, representing 51.3% and 48.7% of the sample, respectively. The mean age was 45.71±16.11 for males, and 47.51±19.27 years for females, with no significant difference (p=0.408). The overall mean age was 46.58±17.71 years. Although there was no statistically significant difference between seasons (p=0.322), a notable increase in BP incidence was observed in spring (28.8%) and summer (26.6%). The highest number of cases was observed in June and March. No significant difference was found in seasonal variations of BP incidence in terms of age (p=0.691) and gender (p=0.905).
Conclusion: Contrary to conventional beliefs associated with BP in colder climates, findings of this study indicate a higher incidence of BP during warmer seasons, particularly in spring and summer. This trend might have been influenced by the aftermath of the COVID-19 pandemic. These results underscore the need for comprehensive studies to explore the interplay between environmental factors, viral pandemics such as COVID-19, and BP pathogenesis, potentially leading to better prevention and management strategies.

References

  • Glass GE, Tzafetta K. Bell's palsy: a summary of current evidence and referral algorithm. Fam Pract. 2014;31(6):631-42.
  • Kar M, Altıntaş M. Seasonal distribution of Bell's palsy. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):4065-8.
  • McCaul JA, Cascarini L, Godden D, Coombes D, Brennan PA, Kerawala CJ. Evidence based management of Bell's palsy. Br J Oral Maxillofac Surg. 2014;52(5):387-91.
  • Hsieh RL, Wang LY, Lee WC. Correlation between the incidence and severity of Bell's palsy and seasonal variations in Taiwan. Int J Neurosci. 2013;123(7):459-64.
  • Taverner D, Kemble F, Cohen SB. Prognosis and treatment of idiopathic facial (Bell's) palsy. Br Med J. 1967;4(5579):581-2.
  • Eviston TJ, Croxson GR, Kennedy PG, Hadlock T, Krishnan AV. Bell's palsy: aetiology, clinical features and multidisciplinary care. J Neurol Neurosurg Psychiatry. 2015;86(12):1356-61.
  • Varga E, Battamir U, Szegedi I, Hudák L, Kovács N, Nagy AC. Seasonal patterns in the epidemiology of Bell's palsy in Hungary. Front Neurol. 2023;14(6):1188137.
  • Jeong J, Yoon SR, Lim H, Oh J, Choi HS. Risk factors for Bell's palsy based on the Korean National Health Insurance Service National Sample Cohort data. Sci Rep. 2021;11(1):23387.
  • Erdur H, Ernst S, Ahmadi M, Albers AE, Marzinzik F, Somasundaram R, et al. Evidence for seasonal variation of Bell's palsy in Germany. Neuroepidemiology. 2018;51(3-4):128-30.
  • Ferreira EF, Portugal D, Silva N, Peixoto C, Matos C, Pereira I, et al. Rehabilitation of peripheral facial palsy associated with COVID-19 in a child: A case report. Ann Phys Rehabil Med. 2022;65(1):101600.
  • Choi GW, Yon DK, Choi YS, Lee J, Park KH, Lee YJ, et al. Comparing the clinical manifestations of Bell's palsy between pre-COVID-19 pandemic and COVID-19 pandemic periods. J Clin Med. 2023;12(4):1700.
  • Köder A, Kılıçaslan S, Belada A, Habiloğlu AD, Ataoğlu Ö, Sungur MA, et al. Evaluation of nasal mucociliary clearance in recently diagnosed COVID-19 patients before treatment. Konuralp Med J. 2023;15(3):308-12.
  • Valiuddin HM, Kalajdzic A, Rosati J, Boehm K, Hill D. Update on neurological manifestations of SARS-CoV-2. West J Emerg Med. 2020;21(6):45-51.
  • Srinivas CV, Kauser S, Sangoli B. The surge of Bell’s palsy in the COVID - pandemic era. Int J Otorhinolaryngol Head Neck Surg. 2020;6(11):2042-5.
  • Andina-Martínez D, Rodríguez-Palero S, Soto-Insuga V, Alonso-Cadenas JA, Bernardino-Cuesta B, Cartas-Carrión S, et al. Peripheral facial nerve palsy in children during the COVID-19 pandemic. Rev Neurol. 2022;74(11):361-6.
  • Kim MH, Park SY. Population-based study and a scoping review for the epidemiology and seasonality in and effect of weather on Bell's palsy. Sci Rep. 2021;11(1):16941.
  • Peitersen E. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl. 2002;(549):4-30.
  • Rowlands S, Hooper R, Hughes R, Burney P. The epidemiology and treatment of Bell's palsy in the UK. Eur J Neurol. 2002;9(1):63-7.
  • Rowhani-Rahbar A, Baxter R, Rasgon B, Ray P, Black S, Klein JO, et al. Epidemiologic and clinical features of Bell's palsy among children in Northern California. Neuroepidemiology. 2012;38(4):252-8.
  • Kokotis P, Katsavos S. Effects of Wind Chill factor, temperature and other meteorological parameters on the ıncidence of Bell's palsy: Results based on a retrospective, 7-year long, Greek population study. Neuroepidemiology. 2015;45(1):44-9.
  • Sonbay Yılmaz ND, Gur OE, Kucuktepe U, Ensari N, Yılmaz MD. Seasonal distribution of the incidence of Bell’s palsy. Med Science. 2019;8(3):750-3.
  • Gunes A, Karali E. The effect of seasonal changes on frequency and stage in Bell’s palsy. Bozok Med J. 2020;10(1):171-5. Turkish.
  • Zhao H, Zhang X, Tang YD, Zhu J, Wang XH, Li ST. Bell's palsy: Clinical analysis of 372 cases and review of related literature. Eur Neurol. 2017;77(3-4):168-72.
  • Magazi D, Longombenza B, Mda S, Van der Meyden K, Motshwane M, Nanjoh M, et al. HIV infection, seasonality and younger age predicting incident Bell's palsy among black South Africans. BMC Neurol. 2020;20(1):381.
  • Narcı H, Horasanlı B, Uğur M. Seasonal effects on Bell's palsy: Four-year study and review of the literature. Iran Red Crescent Med J. 2012;14(8):505-6.
  • Zohrevandi B, Monsef Kasmaee V, Asadi P, Tajik H. Report of 121 cases of Bell's palsy referred to the emergency department. Emerg (Tehran). 2014;2(2):66-70.
  • Franzke P, Bitsch A, Walther M, Schiffner R, Rupprecht S, Rasche M, et al. Weather, weather changes and the risk of Bell's palsy: A multicenter case-crossover study. Neuroepidemiology. 2018;51(3-4):207-15.
  • Jeon EJ, Park YS, Kim DH, Nam IC, Park SY, Noh H, et al. Effects of meteorological factors on the onset of Bell's palsy. Auris Nasus Larynx. 2013;40(4):361-5.
  • Yu M, Virani A, Akhouri S. Bell's palsy secondary to COVID-19 infection. Cureus. 2023;15(5):e39037.
  • Jeong J, Chung JH, Ryu S, Lee JD, Kim J, Lee HY, et al. Monthly variation in Bell's palsy based on population data of Korea. Audiol Neurootol. 2024;29(4):290-6.
  • Albakri K, Khaity A, Atwan H, Saleh O, Al-Hajali M, Cadri S, et al. Bell's palsy and COVID-19 vaccines: A systematic review and meta-analysis. Vaccines (Basel). 2023;11(2):236.
  • Tamaki A, Cabrera CI, Li S, Rabbani C, Thuener JE, Rezaee RP, et al. Incidence of Bell palsy in patients with COVID-19. JAMA Otolaryngol Head Neck Surg. 2021;147(8):767-8.
  • Codeluppi L, Venturelli F, Rossi J, Fasano A, Toschi G, Pacillo F, et al. Facial palsy during the COVID-19 pandemic. Brain Behav. 2021;11(1):e01939.

COVID-19 Sonrası Bağlamında Bell Felci İnsidansının Mevsimsel Görülme Şekli

Year 2025, Volume: 27 Issue: 2, 146 - 150, 30.08.2025
https://doi.org/10.18678/dtfd.1585848

Abstract

Amaç: Bu çalışmanın amacı, Bell's palsy (BP) insidansı üzerine mevsimsel etkileri araştırmak ve oranların değişen mevsimlere göre, özellikle koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) salgını sonrasında, dalgalanıp dalgalanmadığını belirlemektir.
Gereç ve Yöntemler: Ocak 2020 ile Aralık 2023 tarihleri arasında 267 doğrulanmış BP vakası üzerinde retrospektif bir analiz yapılmıştır. Vakaların başlangıç tarihleri, demografik bilgileri ve mevsimsel dağılımları hakkında veriler toplanmıştır. Eğilimleri ve varyasyonları belirlemek için vakalar mevsimsel oluşumlarına göre kategorize edilmiştir.
Bulgular: Çalışma grubuna, sırasıyla örneklemin %51,3 ve %48,7'sini temsil eden 137 erkek ve 130 kadın dahil edildi. Yaş ortalaması erkeklerde 45,71±16,11 ve kadınlarda 47,51±19,27 yıl olup aralarında anlamlı bir farklılık yoktu (p=0,408). Genel yaş ortalaması ise 46,58±17,71 yıl idi. Mevsimler arasında istatistiksel anlamlı bir farklılık olmamakla birlikte (p=0,322), ilkbahar (%28,8) ve yaz (%26,6) aylarında BP insidansında belirgin bir artış olduğu görüldü. En yüksek vaka sayıları Haziran ve Mart aylarında gözlendi. BP insidansındaki mevsimsel varyasyonlarda, yaşa (p=0,691) ve cinsiyete (p=0,905) göre anlamlı bir farklılık bulunmadı.
Sonuç: Soğuk iklimlerde BP ile ilişkili geleneksel inanışların aksine, bu çalışmanın bulguları daha sıcak mevsimlerde, özellikle ilkbahar ve yaz aylarında BP görülme sıklığının daha yüksek olduğunu göstermektedir. Bu eğilim, COVID-19 salgını sonrasında yaşananlardan etkilenmiş olabilir. Bu sonuçlar, çevresel faktörler, COVID-19 gibi viral pandemiler ve BP patogenezi arasındaki etkileşimi araştırmak için kapsamlı çalışmalara duyulan ihtiyacın altını çizmekte ve potansiyel olarak daha iyi önleme ve yönetim stratejilerine yol açmaktadır.

References

  • Glass GE, Tzafetta K. Bell's palsy: a summary of current evidence and referral algorithm. Fam Pract. 2014;31(6):631-42.
  • Kar M, Altıntaş M. Seasonal distribution of Bell's palsy. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):4065-8.
  • McCaul JA, Cascarini L, Godden D, Coombes D, Brennan PA, Kerawala CJ. Evidence based management of Bell's palsy. Br J Oral Maxillofac Surg. 2014;52(5):387-91.
  • Hsieh RL, Wang LY, Lee WC. Correlation between the incidence and severity of Bell's palsy and seasonal variations in Taiwan. Int J Neurosci. 2013;123(7):459-64.
  • Taverner D, Kemble F, Cohen SB. Prognosis and treatment of idiopathic facial (Bell's) palsy. Br Med J. 1967;4(5579):581-2.
  • Eviston TJ, Croxson GR, Kennedy PG, Hadlock T, Krishnan AV. Bell's palsy: aetiology, clinical features and multidisciplinary care. J Neurol Neurosurg Psychiatry. 2015;86(12):1356-61.
  • Varga E, Battamir U, Szegedi I, Hudák L, Kovács N, Nagy AC. Seasonal patterns in the epidemiology of Bell's palsy in Hungary. Front Neurol. 2023;14(6):1188137.
  • Jeong J, Yoon SR, Lim H, Oh J, Choi HS. Risk factors for Bell's palsy based on the Korean National Health Insurance Service National Sample Cohort data. Sci Rep. 2021;11(1):23387.
  • Erdur H, Ernst S, Ahmadi M, Albers AE, Marzinzik F, Somasundaram R, et al. Evidence for seasonal variation of Bell's palsy in Germany. Neuroepidemiology. 2018;51(3-4):128-30.
  • Ferreira EF, Portugal D, Silva N, Peixoto C, Matos C, Pereira I, et al. Rehabilitation of peripheral facial palsy associated with COVID-19 in a child: A case report. Ann Phys Rehabil Med. 2022;65(1):101600.
  • Choi GW, Yon DK, Choi YS, Lee J, Park KH, Lee YJ, et al. Comparing the clinical manifestations of Bell's palsy between pre-COVID-19 pandemic and COVID-19 pandemic periods. J Clin Med. 2023;12(4):1700.
  • Köder A, Kılıçaslan S, Belada A, Habiloğlu AD, Ataoğlu Ö, Sungur MA, et al. Evaluation of nasal mucociliary clearance in recently diagnosed COVID-19 patients before treatment. Konuralp Med J. 2023;15(3):308-12.
  • Valiuddin HM, Kalajdzic A, Rosati J, Boehm K, Hill D. Update on neurological manifestations of SARS-CoV-2. West J Emerg Med. 2020;21(6):45-51.
  • Srinivas CV, Kauser S, Sangoli B. The surge of Bell’s palsy in the COVID - pandemic era. Int J Otorhinolaryngol Head Neck Surg. 2020;6(11):2042-5.
  • Andina-Martínez D, Rodríguez-Palero S, Soto-Insuga V, Alonso-Cadenas JA, Bernardino-Cuesta B, Cartas-Carrión S, et al. Peripheral facial nerve palsy in children during the COVID-19 pandemic. Rev Neurol. 2022;74(11):361-6.
  • Kim MH, Park SY. Population-based study and a scoping review for the epidemiology and seasonality in and effect of weather on Bell's palsy. Sci Rep. 2021;11(1):16941.
  • Peitersen E. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl. 2002;(549):4-30.
  • Rowlands S, Hooper R, Hughes R, Burney P. The epidemiology and treatment of Bell's palsy in the UK. Eur J Neurol. 2002;9(1):63-7.
  • Rowhani-Rahbar A, Baxter R, Rasgon B, Ray P, Black S, Klein JO, et al. Epidemiologic and clinical features of Bell's palsy among children in Northern California. Neuroepidemiology. 2012;38(4):252-8.
  • Kokotis P, Katsavos S. Effects of Wind Chill factor, temperature and other meteorological parameters on the ıncidence of Bell's palsy: Results based on a retrospective, 7-year long, Greek population study. Neuroepidemiology. 2015;45(1):44-9.
  • Sonbay Yılmaz ND, Gur OE, Kucuktepe U, Ensari N, Yılmaz MD. Seasonal distribution of the incidence of Bell’s palsy. Med Science. 2019;8(3):750-3.
  • Gunes A, Karali E. The effect of seasonal changes on frequency and stage in Bell’s palsy. Bozok Med J. 2020;10(1):171-5. Turkish.
  • Zhao H, Zhang X, Tang YD, Zhu J, Wang XH, Li ST. Bell's palsy: Clinical analysis of 372 cases and review of related literature. Eur Neurol. 2017;77(3-4):168-72.
  • Magazi D, Longombenza B, Mda S, Van der Meyden K, Motshwane M, Nanjoh M, et al. HIV infection, seasonality and younger age predicting incident Bell's palsy among black South Africans. BMC Neurol. 2020;20(1):381.
  • Narcı H, Horasanlı B, Uğur M. Seasonal effects on Bell's palsy: Four-year study and review of the literature. Iran Red Crescent Med J. 2012;14(8):505-6.
  • Zohrevandi B, Monsef Kasmaee V, Asadi P, Tajik H. Report of 121 cases of Bell's palsy referred to the emergency department. Emerg (Tehran). 2014;2(2):66-70.
  • Franzke P, Bitsch A, Walther M, Schiffner R, Rupprecht S, Rasche M, et al. Weather, weather changes and the risk of Bell's palsy: A multicenter case-crossover study. Neuroepidemiology. 2018;51(3-4):207-15.
  • Jeon EJ, Park YS, Kim DH, Nam IC, Park SY, Noh H, et al. Effects of meteorological factors on the onset of Bell's palsy. Auris Nasus Larynx. 2013;40(4):361-5.
  • Yu M, Virani A, Akhouri S. Bell's palsy secondary to COVID-19 infection. Cureus. 2023;15(5):e39037.
  • Jeong J, Chung JH, Ryu S, Lee JD, Kim J, Lee HY, et al. Monthly variation in Bell's palsy based on population data of Korea. Audiol Neurootol. 2024;29(4):290-6.
  • Albakri K, Khaity A, Atwan H, Saleh O, Al-Hajali M, Cadri S, et al. Bell's palsy and COVID-19 vaccines: A systematic review and meta-analysis. Vaccines (Basel). 2023;11(2):236.
  • Tamaki A, Cabrera CI, Li S, Rabbani C, Thuener JE, Rezaee RP, et al. Incidence of Bell palsy in patients with COVID-19. JAMA Otolaryngol Head Neck Surg. 2021;147(8):767-8.
  • Codeluppi L, Venturelli F, Rossi J, Fasano A, Toschi G, Pacillo F, et al. Facial palsy during the COVID-19 pandemic. Brain Behav. 2021;11(1):e01939.
There are 33 citations in total.

Details

Primary Language English
Subjects Otorhinolaryngology
Journal Section Research Article
Authors

Ahmet Köder 0000-0003-4348-8109

Abdullah Belada 0000-0001-8990-8215

Saffet Kılıçaslan 0000-0001-8478-3775

Early Pub Date July 1, 2025
Publication Date August 30, 2025
Submission Date November 16, 2024
Acceptance Date May 29, 2025
Published in Issue Year 2025 Volume: 27 Issue: 2

Cite

APA Köder, A., Belada, A., & Kılıçaslan, S. (2025). Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context. Duzce Medical Journal, 27(2), 146-150. https://doi.org/10.18678/dtfd.1585848
AMA Köder A, Belada A, Kılıçaslan S. Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context. Duzce Med J. August 2025;27(2):146-150. doi:10.18678/dtfd.1585848
Chicago Köder, Ahmet, Abdullah Belada, and Saffet Kılıçaslan. “Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context”. Duzce Medical Journal 27, no. 2 (August 2025): 146-50. https://doi.org/10.18678/dtfd.1585848.
EndNote Köder A, Belada A, Kılıçaslan S (August 1, 2025) Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context. Duzce Medical Journal 27 2 146–150.
IEEE A. Köder, A. Belada, and S. Kılıçaslan, “Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context”, Duzce Med J, vol. 27, no. 2, pp. 146–150, 2025, doi: 10.18678/dtfd.1585848.
ISNAD Köder, Ahmet et al. “Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context”. Duzce Medical Journal 27/2 (August2025), 146-150. https://doi.org/10.18678/dtfd.1585848.
JAMA Köder A, Belada A, Kılıçaslan S. Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context. Duzce Med J. 2025;27:146–150.
MLA Köder, Ahmet et al. “Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context”. Duzce Medical Journal, vol. 27, no. 2, 2025, pp. 146-50, doi:10.18678/dtfd.1585848.
Vancouver Köder A, Belada A, Kılıçaslan S. Seasonal Pattern of Bell’s Palsy Incidence in a Post-COVID-19 Context. Duzce Med J. 2025;27(2):146-50.