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

Yıl 2024, Cilt: 46 Sayı: 3, 447 - 454, 27.05.2024
https://doi.org/10.20515/otd.1410994

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.

Kaynakça

  • 1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet [Internet]. 2014;384(9945):766–81.
  • 2. Lee EY, Yoon K-H. Epidemic obesity in children and adolescents: risk factors and prevention. Front Med [Internet]. 2018;12(6):658–66.
  • 3. Weihrauch-Blüher S, Schwarz P, Klusmann J-H. Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism [Internet]. 2019;92:147–52.
  • 4. Umano GR, Pistone C, Tondina E, Moiraghi A, Lauretta D, Miraglia Del Giudice E, et al. Pediatric obesity and the immune system. Front Pediatr [Internet]. 2019;7:487.
  • 5. Kelishadi R, Roufarshbaf M, Soheili S, Payghambarzadeh F, Masjedi M. Association of childhood obesity and the immune system: A systematic review of reviews. Child Obes [Internet]. 2017;13(4):332–46.
  • 6. Huppke B, Ellenberger D, Hummel H, Stark W, Röbl M, Gärtner J, et al. Association of obesity with multiple sclerosis risk and response to first-line disease modifying drugs in children. JAMA Neurol [Internet]. 2019;76(10):1157.
  • 7. Rasul T, Frederiksen JL. Link between overweight/obese in children and youngsters and occurrence of multiple sclerosis. J Neurol [Internet]. 2018;265(12):2755–63.
  • 8. Morales DR, Donnan PT, Daly F, Van Staa T, Sullivan FM. Impact of clinical trial findings on Bell’s palsy management in general practice in the UK 2001–2012: interrupted time series regression analysis. BMJ Open [Internet]. 2013;3(7):e003121.
  • 9. Papan C, Kremp L, Weiß C, Petzold A, Schroten H, Tenenbaum T. Infectious causes of peripheral facial nerve palsy in children-a retrospective cohort study with long-term follow-up. Eur J Clin Microbiol Infect Dis [Internet]. 2019;38(11):2177–84.
  • 10. Baringer JR. Herpes simplex virus and Bell palsy. Ann Intern Med [Internet]. 1996;124(1 Pt 1):63–5.
  • 11. Schirm J, Mulkens PSJZ. Bell’s palsy and herpes simplex virus. APMIS [Internet]. 1997;105(7–12):815–23. 12. Adour KK, Bell DN, Hilsinger RL Jr. Herpes simplex virus in idiopathic facial paralysis (Bell palsy). JAMA [Internet]. 1975;233(6):527–30.
  • 13. Linder T, Bossart W, Bodmer D. Bell’s palsy and Herpes simplex virus: fact or mystery? Otol Neurotol [Internet]. 2005;26(1):109–13.
  • 14. Kennedy PG. Herpes simplex virus type 1 and Bell’s palsy-a current assessment of the controversy. J Neurovirol [Internet]. 2010;16(1):1–5.
  • 15. Aviel A, Ostfeld E, Burstein R, Marshak G, Bentwich Z. Peripheral blood T and B lymphocyte subpopulations in Bell’s palsy. Ann Otol Rhinol Laryngol [Internet]. 1983;92(2 Pt 1):187–91.
  • 16. Charous DI, Saxe BI. The LandryeGuillaineBarr_e syndrome. N Engl J Med. 1962;267:1334-e1338.
  • 17. Abramsky O, Webb C, Teitelbaum D, Arnon R. Cellular immune response to peripheral nerve basic protein in idiopathic facial paralysis (Bell’s palsy). J Neurol Sci [Internet]. 1975;26(1):13–20.
  • 18. Hilsinger RL Jr, Adour KK, Doty HE. Idiopathic facial paralysis, pregnancy, and the menstrual cycle. Ann Otol Rhinol Laryngol [Internet]. 1975;84(4 Pt 1):433–42.
  • 19. 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 [Internet]. 2012;25(6):819–26.
  • 20. Adour K, Wingerd J, Doty HE. Prevalence of concurrent diabetes mellitus and idiopathic facial paralysis (Bell’s palsy). Diabetes [Internet]. 1975;24(5):449–51.
  • 21. Savadi-Oskouei D, Abedi A, Sadeghi-Bazargani H. Independent role of hypertension in Bell`s palsy: a case-control study. Eur Neurol. 2008;60:253-e257.
  • 22. Kim SY, Oh DJ, Park B, Choi HG. Bell’s palsy and obesity, alcohol consumption and smoking: A nested case-control study using a national health screening cohort. Sci Rep [Internet]. 2020;10(1):4248.
  • 23. Neyzi O, Binyıldız P, Alp H. Türk çocuklarında büyüme standartları. İst Tıp Fak Mecm. 1978;41:1–41
  • 24. Barlow SE, and the Expert Committee. Expert Committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics [Internet]. 2007;120(Supplement_4):S164–92.
  • 25. Yılmaz U, Cubukçu D, Yılmaz TS, Akıncı G, Ozcan M, Güzel O. Peripheral facial palsy in children. J Child Neurol [Internet]. 2014;29(11):1473–8.
  • 26. Öztoprak Ü. Assessment of Hematological Parameters and The Relationship with Paralysis Degree in Children with Idiopathic Peripheral Facial Paralysis. Van Medical Journal. 2021:28 (3): 393-9.
  • 27. Eryilmaz A, Basal Y, Tosun A, Omurlu IK,Basak S. The neutrophil to lymphocyte ratios of our pediatric patients with Bell's palsy. Int J Pediatr Otorhinolaryngol. 2015;79(12):2374-7.
  • 28. Pulgaron ER, Delamater AM. Obesity and type 2 diabetes in children: epidemiology and treatment. Curr Diab Rep [Internet]. 2014;14(8):508
  • 29. Wühl E. Hypertension in childhood obesity. Acta Paediatr. 2019;108:37e43
  • 30. Bekar E, Altunkaynak BZ, Balci K, Aslan G, Ayyildiz M. Effects of high fat diet induced obesity on peripheral nerve regeneration and levels of GAP 43 and TGF- b in rats. Biotechnic & Histochemistry. 2014, 89(6): 446–456.
  • 31. Choi SA, Shim HS, Jung JY, et al. Association between recovery from Bell's palsy and body mass index. Clin Otolaryngol. 2017;42(3):687-92.
  • 32. Noronha SSR, Lima PM, Campo GSV, Chírico MTT, Abreu AR, Figueiredo AB, et al. Association of high-fat diet with neuroinflammation, anxiety-like defensive behavioral responses, and altered thermoregulatory responses in male rats. Brain. Behav. Immun. 2019:80, 500–11.
  • 33. Duriez P, Nilsson IAK, Le Thuc O, Alexandre D, Chartrel N, Rovere C,et al. Exploring the mechanisms of recovery in anorexia nervosa through a translational approach: from original ecological measurements in human to brain tissue analyses in mice. Nutrients. 2021:13,2786.

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

Yıl 2024, Cilt: 46 Sayı: 3, 447 - 454, 27.05.2024
https://doi.org/10.20515/otd.1410994

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.

Etik Beyan

Yapılan çalışmada, araştırma ve yayın etiğine uyulmuştur.

Teşekkür

Akademik teşviki nedeniyle Doç. Dr. İsmail SOLMAZ’a teşekkür ederim.

Kaynakça

  • 1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet [Internet]. 2014;384(9945):766–81.
  • 2. Lee EY, Yoon K-H. Epidemic obesity in children and adolescents: risk factors and prevention. Front Med [Internet]. 2018;12(6):658–66.
  • 3. Weihrauch-Blüher S, Schwarz P, Klusmann J-H. Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism [Internet]. 2019;92:147–52.
  • 4. Umano GR, Pistone C, Tondina E, Moiraghi A, Lauretta D, Miraglia Del Giudice E, et al. Pediatric obesity and the immune system. Front Pediatr [Internet]. 2019;7:487.
  • 5. Kelishadi R, Roufarshbaf M, Soheili S, Payghambarzadeh F, Masjedi M. Association of childhood obesity and the immune system: A systematic review of reviews. Child Obes [Internet]. 2017;13(4):332–46.
  • 6. Huppke B, Ellenberger D, Hummel H, Stark W, Röbl M, Gärtner J, et al. Association of obesity with multiple sclerosis risk and response to first-line disease modifying drugs in children. JAMA Neurol [Internet]. 2019;76(10):1157.
  • 7. Rasul T, Frederiksen JL. Link between overweight/obese in children and youngsters and occurrence of multiple sclerosis. J Neurol [Internet]. 2018;265(12):2755–63.
  • 8. Morales DR, Donnan PT, Daly F, Van Staa T, Sullivan FM. Impact of clinical trial findings on Bell’s palsy management in general practice in the UK 2001–2012: interrupted time series regression analysis. BMJ Open [Internet]. 2013;3(7):e003121.
  • 9. Papan C, Kremp L, Weiß C, Petzold A, Schroten H, Tenenbaum T. Infectious causes of peripheral facial nerve palsy in children-a retrospective cohort study with long-term follow-up. Eur J Clin Microbiol Infect Dis [Internet]. 2019;38(11):2177–84.
  • 10. Baringer JR. Herpes simplex virus and Bell palsy. Ann Intern Med [Internet]. 1996;124(1 Pt 1):63–5.
  • 11. Schirm J, Mulkens PSJZ. Bell’s palsy and herpes simplex virus. APMIS [Internet]. 1997;105(7–12):815–23. 12. Adour KK, Bell DN, Hilsinger RL Jr. Herpes simplex virus in idiopathic facial paralysis (Bell palsy). JAMA [Internet]. 1975;233(6):527–30.
  • 13. Linder T, Bossart W, Bodmer D. Bell’s palsy and Herpes simplex virus: fact or mystery? Otol Neurotol [Internet]. 2005;26(1):109–13.
  • 14. Kennedy PG. Herpes simplex virus type 1 and Bell’s palsy-a current assessment of the controversy. J Neurovirol [Internet]. 2010;16(1):1–5.
  • 15. Aviel A, Ostfeld E, Burstein R, Marshak G, Bentwich Z. Peripheral blood T and B lymphocyte subpopulations in Bell’s palsy. Ann Otol Rhinol Laryngol [Internet]. 1983;92(2 Pt 1):187–91.
  • 16. Charous DI, Saxe BI. The LandryeGuillaineBarr_e syndrome. N Engl J Med. 1962;267:1334-e1338.
  • 17. Abramsky O, Webb C, Teitelbaum D, Arnon R. Cellular immune response to peripheral nerve basic protein in idiopathic facial paralysis (Bell’s palsy). J Neurol Sci [Internet]. 1975;26(1):13–20.
  • 18. Hilsinger RL Jr, Adour KK, Doty HE. Idiopathic facial paralysis, pregnancy, and the menstrual cycle. Ann Otol Rhinol Laryngol [Internet]. 1975;84(4 Pt 1):433–42.
  • 19. 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 [Internet]. 2012;25(6):819–26.
  • 20. Adour K, Wingerd J, Doty HE. Prevalence of concurrent diabetes mellitus and idiopathic facial paralysis (Bell’s palsy). Diabetes [Internet]. 1975;24(5):449–51.
  • 21. Savadi-Oskouei D, Abedi A, Sadeghi-Bazargani H. Independent role of hypertension in Bell`s palsy: a case-control study. Eur Neurol. 2008;60:253-e257.
  • 22. Kim SY, Oh DJ, Park B, Choi HG. Bell’s palsy and obesity, alcohol consumption and smoking: A nested case-control study using a national health screening cohort. Sci Rep [Internet]. 2020;10(1):4248.
  • 23. Neyzi O, Binyıldız P, Alp H. Türk çocuklarında büyüme standartları. İst Tıp Fak Mecm. 1978;41:1–41
  • 24. Barlow SE, and the Expert Committee. Expert Committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics [Internet]. 2007;120(Supplement_4):S164–92.
  • 25. Yılmaz U, Cubukçu D, Yılmaz TS, Akıncı G, Ozcan M, Güzel O. Peripheral facial palsy in children. J Child Neurol [Internet]. 2014;29(11):1473–8.
  • 26. Öztoprak Ü. Assessment of Hematological Parameters and The Relationship with Paralysis Degree in Children with Idiopathic Peripheral Facial Paralysis. Van Medical Journal. 2021:28 (3): 393-9.
  • 27. Eryilmaz A, Basal Y, Tosun A, Omurlu IK,Basak S. The neutrophil to lymphocyte ratios of our pediatric patients with Bell's palsy. Int J Pediatr Otorhinolaryngol. 2015;79(12):2374-7.
  • 28. Pulgaron ER, Delamater AM. Obesity and type 2 diabetes in children: epidemiology and treatment. Curr Diab Rep [Internet]. 2014;14(8):508
  • 29. Wühl E. Hypertension in childhood obesity. Acta Paediatr. 2019;108:37e43
  • 30. Bekar E, Altunkaynak BZ, Balci K, Aslan G, Ayyildiz M. Effects of high fat diet induced obesity on peripheral nerve regeneration and levels of GAP 43 and TGF- b in rats. Biotechnic & Histochemistry. 2014, 89(6): 446–456.
  • 31. Choi SA, Shim HS, Jung JY, et al. Association between recovery from Bell's palsy and body mass index. Clin Otolaryngol. 2017;42(3):687-92.
  • 32. Noronha SSR, Lima PM, Campo GSV, Chírico MTT, Abreu AR, Figueiredo AB, et al. Association of high-fat diet with neuroinflammation, anxiety-like defensive behavioral responses, and altered thermoregulatory responses in male rats. Brain. Behav. Immun. 2019:80, 500–11.
  • 33. Duriez P, Nilsson IAK, Le Thuc O, Alexandre D, Chartrel N, Rovere C,et al. Exploring the mechanisms of recovery in anorexia nervosa through a translational approach: from original ecological measurements in human to brain tissue analyses in mice. Nutrients. 2021:13,2786.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Çocuk Nörolojisi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Pınar Ozbudak 0000-0003-3215-1738

Yayımlanma Tarihi 27 Mayıs 2024
Gönderilme Tarihi 28 Aralık 2023
Kabul Tarihi 14 Mayıs 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 46 Sayı: 3

Kaynak Göster

Vancouver Ozbudak P. Çocuklarda Periferik Fasiyal Sinir Paralizisi ve Obezite: Tesadüften Fazlası mı?. Osmangazi Tıp Dergisi. 2024;46(3):447-54.


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