Some immunological studies in cases of idiopathic facial palsy [Bell's palsy]

ABSTRACT

A prospective clinical and immunological study was performed on 20 consecutive Bell's palsy patients in addition to 10 normal controls of matched age and sex, to study some immunological changes that might occur in the blood and sera of the patients. They were subjected to thorough clinical neurological and medical examinations, complete blood picture, Erythrocyte sedimentation rate, glucose tolerance curve and immunological investigations that include estimation of-T-and-B lymphocytes percentage of the peripheral blood. Estimation of serum levels of immunoglobulins [IgG, IgA and IgM] and complement C[3] and C[4]. The immunological investigations were done during the acute phase of the disease [1-7 days] and after 4 weeks from the first investigations and at least 2 weeks after stopping treatment. The study revealed a significant decrease in the peripheral blood -T- lymphocyte percentage as well as an increase in -B-lymphocyte percentage [P < 0.001] in cases of Bell's palsy patients during the acute phase of the illness with a slow return to normal values which began after 4 weeks from the onset. A highly significant positive correlation was found between the increase in-B-lymphocyte percentage and the levels of immunoglobulin IgM during the acute phase of the disease. The clinical and immunological data of Bell's palsy show a similar pattern to those of several demyelinating disease such as in acute exacerbations of multiple sclerosis and the acute stage of Guillian-Barre syndrome and also similar to those found during the clinical course of many viral infections suggesting that Bell's palsy may be an autoimmune demyelinating neuropathy of the facial nerve which may be caused by a preceding viral infection