Do diabetic patients with Bell's palsy benefit from corticosteroids?

Abstract

Objective: To evaluate the beneficial effect of steroid therapy in the treatment of diabetic patients with Bell's palsy (BP).

Methods: There were three patient groups in the present retrospective study. Group I consisted of diabetic patients with BP who were hospitalized for corticosteroid treatment, whereas Group II was composed of diabetic patients with BP who refused to receive steroid therapy after being informed about the adverse effects of the regimen. Thirty age- and sex-matched non-diabetic BP patients treated with steroid therapy on an outpatient basis constituted Group III. House-Brackmann (H-B) grades at onset and 12 months after facial paralysis, mean complete recovery time and the number of patients who demonstrated satisfactory recovery were compared between the groups.

Results: There was no statistically significant difference with regard to H-B grades, mean recovery time or number of patients with satisfactory recovery at onset and 12 months after facial paralysis among the study groups.

Conclusion: In diabetic patients with BP, the recovery of facial functions may be satisfactory without steroid therapy as long as the regulation of blood sugar and blood pressure levels are ensured with regular medical follow-up.

Keywords

• Bell's palsy,diabetes mellitus,corticosteroids

Kaynakça

1. Peitersen E. Bell’s palsy: the spontaneous course of 2,500 periph- eral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl 2002;(549):4–30. 2. Hauser WA, Karnes WE, Annis J, Kurland LT. Incidence and prognosis of Bell’s palsy in the population of Rochester, Minnesota. Mayo Clin Proc 1971;46:258–64. 3. Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell palsy and herpes simplex virus: identification of viral DNA in endoneural fluid and muscle. Ann Intern Med 1996;124:27–30. 4. Devriese PP. Compression and ischaemia of the facial nerve. Acta Otolaryngol 1974;77:108–18. 5. Abramsky O, Webb C, Teitelbaum D, Ardon R. Cellular immune response to peripheral nerve basic protein in idiopathic facial paralysis (Bell’s palsy). J Neurol Sci 1975;26:13–20. 6. Madhok VB, Gagyor I, Daly F, et al. Corticosteroids for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2016;7:CD001942. 7. Gagyor I, Madhok VB, Daly F, et al. Antiviral treatment for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2015;7:CD001869. 8. McAllister K, Walker D, Donnan PT, Swan I. Surgical interven- tions for the early management of Bell's palsy. Cochrane Database Syst Rev 2013;10:CD007468. 9. Teixeira LJ, Valbuza JS, Prado GF. Physical therapy for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2011;12:CD006283. 10. Chen N, Zhou M, He L, Zhou D, Li N. Acupuncture for Bell’s palsy. Cochrane Database Syst Rev 2010;8:CD002914. 11. Giannini C, Dyck PJ. Ultrastructural morphometric abnormalities of sural nerve endoneurial microvessels in diabetes mellitus. Ann Neurol 1994;36:408–15. 12. Malik RA, Tesfays S, Thompson SD, et al. Endoneurial localisa- tion of microvascular damage in human diabetic neuropathy. Diabetologia1993;36:454–9. . Singleton JR, Smith AG, Russel JW, Feldman EL. Microvascular complications of impaired glucose tolerance. Diabetes 2003;52:2867–73. 14. Kanazawa A, Haginomori S, Takamaki A, Nonaka R, Araki M, Takenaka H. Prognosis for Bell’s palsy: a comparison of diabetic and nondiabetic patients. Acta Otolaryngol 2007;127:888–91. 15. Akkuzu G, Özgirgin N, Akkuzu B, et al. Does diabetes mellitus affect the prognosis of idiopathic peripheral facial paralysis. J Int Adv Otol 2006;2:78–82. 16. Riga M, Kefalidis G, Danielides V. The role of diabetes mellitus in the clinical presentation and prognosis of Bell palsy. J Am Board Fam Med 2012;25:819–26. 17. Saito O, Aoyagi M, Tojima H, Koike Y. Diagnosis and treatment for Bell’s palsy associated with diabetes mellitus. Acta Otolaryngol Suppl 1994;511:153–5. 18. Adour KK, Bell DN, Wingerd J. Bell palsy. Dilemma of diabetes mellitus. Arch Otolaryngol 1974;99:114–7. 19. House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93:146–7. 20. Perkins BA, Dholasania A, Buchanan RA, Bril V. Short-term metabolic change is associated with improvement in measures of diabetic neuropathy: a 1-year placebo cohort analysis. Diabet Med 2010;27:1271–9. 21. Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell’s palsy. Otolaryngol Head Neck Surg 2013;149(3 Suppl):S1–27. 22. de Almeida JR, Guyatt GH, Sud S, et al.; Bell Palsy Working Group, Canadian Society of Otolaryngology - Head and Neck Surgery and Canadian Neurological Sciences Federation. Management of Bell palsy: clinical practice guideline. CMAJ 2014; 186: 917–22. 23. Coulson SE, Croxson GR, Adams RD, O’Dwyer NJ. Reliability of the “Sydney,” “Sunnybrook,” and “House Brackmann” facial grad- ing systems to assess voluntary movement and synkinesis after facial nerve paralysis. Otolaryngol Head Neck Surg 2005;132:543– 9. 24. Croxson G, May M, Mester SJ. Grading facial nerve function: House-Brackmann versus Burres-Fisch methods. Am J Otol 1990; 11:240–6. 25. Evans RA, Harries DM, Baguley DM, Moffat DA. Reliability of the House and Brackmann grading system for facial palsy. J Laryngol Otol 1989;103:1045–6.