Çocuklarda Periferik Fasiyal Sinir Paralizisi ve Obezite: Tesadüften Fazlası mı?

Öz

Periferik fasiyal sinir paralizisi (PFP) çocuk hastalıkları ve çocuk nöroloji polikliniklerinde sıkça karşımıza çıkmaktadır. Fizik muayene esnasında fazla kilolu oldukları gözlemlenen PFP hastalarından yola çıkılarak çocuklarda PFP ve aşırı kiloluluk ve obezite ilişkisinin araştırılması amaçlanmıştır. Çalışmaya 1 Nisan 2021 ve 31 Ekim 2022 tarihleri arasında tek merkezden Uluslararası Hastalık Sınıflandırması (ICD)-10 birincil ve ikincil G51.0 (fasiyal sinir paralizisi) tanısı alan 42 hasta dahil edildi. Hastaların yaş, cinsiyet, hastalığın ortaya çıkışından hastaneye başvuruya kadar geçen süre, başvuru sırasındaki House-Brackmann (HB) skoru ve PFP derecesi, 4. Hafta HB skoru, PFP etiyolojisi, vücut kitle indeksi (VKİ), aşırı kilo ve obezite dahil ilişkili hastalıkların varlığı retrospektif olarak kaydedildi. 18 yaşı doldurmuş hastalar, santral FP'li hastaları, verilerde eksiklikleri olan hastalar çalışma dışı bırakıldı. Verileri tam olan 30 PFP’li çocuk hasta çalışmaya dahil edildi ve bunların 22 tanesi idiyopatik olarak sınıflandırıldı. İdiyopatik grupta ve tüm kohortta PFP olan hastaların sırasıyla %73 (n=22) ve %70(n=18) 'inin VKİ'si 90. persentilin üzerindeydi. Her iki grupta kız cinsiyet daha yüksek görülse de cinsiyetler arasında anlamlı bir fark saptanmadı. Yüksek VKİ, aşırı kilolu ve obez hasta grubunda (VKİ >90. persentil; olasılık oranı [OR], 8; %95 güven aralığı [GA], 1,25 ila51,13; p < 0,05) istatistiksel olarak artmış Bell paralizisi olasılığı ile ilişkilendirildi. Aynı zamanda VKI>25kg/m2 olan idiyopatik PFP olan grupta ek hastalık oranı %53 (n=5 hipertansiyon, n=3 hipotiroidi), idiyopatik olmayan gruba göre daha yüksek saptandı, ancak istatistiksel olarak anlamlı fark saptanmadı. Bu sonuçlar aşırı kilo ve obezitenin çocuklarda artmış Bell paralizisi riski ile ilişkili olabileceğinin altını çizmektedir.

Anahtar Kelimeler

• Bell felci
• çocuk
• aşırı kilo ve obezite
• fasiyal sinir

Peripheral facial nerve paralysis and obesity in children: More Than Coincidence?

Öz

Peripheral facial nerve palsy (PFP) is frequently encountered in pediatrics and pediatric neurology outpatient clinics. The aim of this study was to investigate the relationship between PFP and overweight and obesity in children based on PFP patients who were observed to be overweight during physical examination. Forty two patients diagnosed with International Classification of Diseases (ICD)-10 primary and secondary G51.0 (facial nerve palsy) included the study retrospectively from a single centre between 1 April 2021 and 31 October 2022. Patients' age, gender, time from onset to hospital admission, House-Brackmann (HB) score and PFP grade at admission, HB score at Week 4, PFP aetiology, body mass index (BMI), presence of associated diseases including overweight and obesity were recorded. Patients over 18 years of age, patients with central PFP, and patients with missing data were excluded. Thirty paediatric patients with PFP with complete data were included in the study and 22 of them were classified as idiopathic (Bell’s palsy). In the idiopathic group and in the whole cohort, 73% (n=22) and 70% (n=18) of the patients with PFP had BMI above the 90th percentile. Although female gender was more common in both groups, no significant difference was found between genders. High BMI was associated with a statistically increased likelihood of Bell's palsy in the overweight and obese patient group (BMI >90th percentile; odds ratio [OR], 8; 95% confidence interval [CI], 1.25 to 51.13; p <0.05). At the same time, the rate of comorbidity was 53% (n=5 hypertension, n=3 hypothyroidism) higher in the idiopathic PFP group with BMI>25kg/m2 than in the non-idiopathic group, but no statistically significant difference was found. These results underline that overweight and obesity may be associated with an increased risk of Bell's palsy in children.

Anahtar Kelimeler

• Bell palsy
• Children and adolescents
• Facial nerve
• Overweight and obesity

Kaynakça

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